肾素活性、血管紧张素和醛固酮在两种继发性高血压患者中的作用  

Role of plasma renin activity,angiotensin and aldosterone in two kinds of secondary hypertension

作　　者：宋涛[1] 张平安[1] 

机构地区：[1]武汉大学人民医院检验科,湖北武汉430060

出　　处：《职业与健康》2017年第14期1925-1928,1934,共5页Occupation and Health

摘　　要：目的研究肾素活性(Plasma renin activity,PRA)、血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)和醛固酮(ALDosterone,ALD)在不同类型高血压患者血清水平。方法选择2015年1月—2016年1月在武汉大学人民医院内分泌科住院的2型糖尿病合并高血压患者50例为A组,肾病内科住院的肾性高血压患者28例为B组,心血管内科住院的原发性高血压患者63例作为对照定为C组。研究比较3组患者血清肾素血管紧张素醛固酮水平,采用多因素和单因素回归分析研究其与微量白蛋白尿之间的关系。结果 3组间比较发现,肾性高血压患者发病年龄为(45.55±18.52)岁,较原发性高血压和糖尿病合并高血压更小,年龄差异有统计学意义(F=2.36,P<0.05)。3组间比较发现,血清ALD水平差异无统计学意义(F=2.41,P>0.05),血清糖化血红蛋白(Hb A1C)、随机血糖(Glu)、AngⅡ和PRA水平差异有统计学意义(F=145.23、71.19、3.37、8.18,均P<0.05)。各组间两两比较发现,C组血清AngⅡ、ALD、PRA水平与B组间比较差异有统计学差异(P<0.05),C组血清Hb A1C、随机Glu水平与A组间比较有统计学差异(P<0.05)。肾素血管紧张醛固酮在肾性高血压组微量白蛋白尿危险相关因子的单因素和多因素分析发现血清AngⅡ、ALD、PRA与微量白蛋白尿显著相关(P<0.05);肾素血管紧张醛固酮在糖尿病合并高血压组单因素分析发现年龄、病程、血清AngⅡ、ALD、PRA、随机Glu与微量白蛋白尿显著相关(P<0.05),多因素分析发现病程、随机Glu、血清ALD水平与微量白蛋白尿显著相关(P<0.05)。结论肾性高血压发病年龄较原发性高血压及糖尿病导致高血压早;肾性高血压血清AngⅡ、ALD、PRA水平较原发性高血压及糖尿病导致高血压更高;血清AngⅡ、ALD、PRA是肾性高血压微量白蛋白尿危险相关因子;病程、随机Glu、ALD是糖尿病导致高血压微量白蛋白尿危险相关因子。[Objective]To explore the serum levels of plasma renin activity（PRA）,angiotensinⅡ（AngⅡ） and aldosterone（ALD）in patients with different types of hypertension.[Methods]Patients were collected from Renmin Hospital of Wuhan University from February 2015 to February 2016. 50 patients with type 2 diabetes mellitus with hypertension in the Endocrine Department were designated as group A,28 patients with renal hypertension in the Nephrology Department as group B,and 63 patients with essential hypertension in Internal Medicine-Cardiovascular Department as group C. The levels of PRA,AngⅡ and ALD in three groups were compared. Furthermore,univariate and multivarial regression analysis were performed to determine the risk factors for microalbuminuria.[Results]Compared with the each other,the onset age of patients with renal hypertension was（45.55±18.52）years old,which was younger than that of patients with essential hypertension or diabetes mellitus with hypertension,and the differences were statistically significant（F=2.36,P〈0.05）. There was no statistically significant difference in serum ALD level among the three groups（F=2.41,P〉0.05）,while the differences in levels of serum glycosylated hemoglobin（Hb A1C）,random blood glucose（Glu）,AngⅡ and PRA were statistically significant among three groups（F=145.23,71.19,3.37,8.18,all P〈0.05）. There were statistically significant differences in the serum levels of Ang Ⅱ,ALD and PRA between group B and group C（PM〈0.05）,and the differences in the levels of serum Hb A1 C and Glu were statistically significant between group A and group C（P〈0.05）. In renal hypertension group,univariate and multivarial regression analysis revealed that the levels of serum Ang Ⅱ,ALD and PRA were significantly correlated with microalbuminuria（P〈 0.05）. In diabetes mellitus with hypertension group,the univariate analysis showed that age,course of disease,and levels of serum Ang Ⅱ,ALD,PRA and Glu were significantly correlated with microa

关 键 词：肾素活性 血管紧张素Ⅱ 醛固酮 高血压 继发性 肾脏病变 

分 类 号：R181.3[医药卫生—流行病学]