高血压患者血清钠、钾浓度及两者比值与左心室肥厚的相关性  

Correlation of serum sodium,potassium concentration and their ratio with left ventricular hypertrophy in patients with hypertension

作　　者：刘晓斌 范金茂 朱雁洲 郑原印 陈康 LIU Xiaobin;FAN Jinmao;ZHU Yanzhou;ZHENG Yuanyin;CHEN Kang(Department of Geriatrics,Mindong Hosoital of Fujian Medical University,Fu'an,Fujian,355000,China)

机构地区：[1]福建医科大学附属闽东医院老年医学科,福建福安355000

出　　处：《临床心血管病杂志》2020年第7期631-636,共6页Journal of Clinical Cardiology

摘　　要：目的:探讨高血压患者血清钠、血清钾浓度及两者比值与左心室肥厚(LVH)的关系。方法:连续入选2017-12-2019-11在福建医科大学附属闽东医院老年科住院及门诊就诊的高血压患者292例,其中高血压并伴有LVH患者90例(LVH组);不伴LVH的高血压患者202例(NLVH组)。收集所有入选者的临床资料,入选者均进行心脏彩超检查记录左心室射血分数(LVEF)、左心室质量(LVM)及左心室质量指数(LVMI)。采用Pearson相关分析和多元线性回归分析。以血清钠、血清钾、血清钠钾比值为自变量,分别以LVMI、室间隔厚度(IVS)、舒张期左心室后壁厚度(LVPWT)、收缩末期左心室内径(LVs)、舒张末期左心室内径(LVd)、LVEF、左心房前后径(LAd)、右心房内径(RAd)为因变量,分析影响高血压LVH的独立危险因素。结果:LVH组患者血清钠浓度明显高于NLVH组[(140±2.76)mmol/L∶(138.75±3.05)mmol/L,t=3.33,P<0.01)],LVH组血清钾浓度明显低于NLVH组[(4.01±0.40)mmol/L∶(4.21±0.40)mmol/L,t=-3.95,P<0.01],LVH组血钠钾浓度比值明显高于NLVH组[(35.29±3.79)∶(33.26±3.39),t=4.45,P<0.01]。Pearson相关分析显示,血清钠浓度与高血压患者各心脏彩超参数不相关;血清钾浓度与高血压患者LVMI(R=-0.782,P<0.01)、IVS(R=-0.553,P<0.01)、LVPWT(R=-0.436,P<0.01)、LVs(R=-0.779,P<0.01)、LVd(R=-0.525,P<0.01)相关;血清钠钾浓度比值与高血压患者LVMl(R=0.804,P<0.01)、IVS(R=0.563,P<O.01)、LVPWT(R=0.459,P<0.01)、LVs(R=0.812,P<0.01)、LVd(R=0.519,P<0.01)相关。多元线性回归分析显示,血钾浓度与LVMI(β=-0.732,P<0.05)、LVS(β=-1.076,P<0.01)、LVd(β=-0.799,P<0.05)相关,血钠钾浓度比值与LVMI(β=1.042,P<0.01)、LVs(β=1.506,P<0.01)、LVd(β=0.974,P<0.05)相关。结论:血清钾浓度及血钠钾浓度比值与高血压LVH相关,在机体安全范围内尽量增加钾浓度及降低钠钾浓度比值有可能降低高血压患者LVH的发生率。Objective:To investigate the relationship between serum sodium,serum potassium,sodium/potassium ratio and left ventricular hypertrophy(LVH)in hypertensive patients.Method:The 292 hypertensive patients were classified into 2 groups,LVH group(n=90)and NLVH group(n=202).All patients underwent echocardiography detecting and was calculated left ventricular mass indes(LVMI),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVS),left ventricular end diastolic dimension(LVd).The relationships between serum sodium、serum potassium,ratio of sodium to potassium and LVH were analyzed.Result:The serum sodium concentration in LVH group was significantly higher than that in NLVH group[(140±2.76)mmol/L∶(138.75±3.05)mmol/L,t=3.33,P<0.01)],and the serum potassium concentration in LVH group was significantly lower than that in NLVH group[(4.01±0.40)mmol/L∶(4.21±0.40)mmol/L,t=-3.95,P<0.01].The ratio of serum sodium and potassium concentration in LVH group was significantly higher than that in NLVH group[(35.29±3.79)∶(33.26±3.39),t=4.45,P<0.01].Pearson correlation analysis showed that there was no correlation between serum sodium concentration and echocardiographic parameters in hypertensive patients.Pearson correlation analysis evidenced a negative correlation between serum potassium concentration and LVMI(R=-0.782,P<0.01),IVS(R=-0.553,P<0.01),LVPWT(R=-0.436,P<0.05),LVs(R=-0.779,P<0.01),and LVd(R=-0.525,P<0.01).The ratio of serum sodium and potassium concentration was significantly correlated with LVMl(R=0.804,P<0.01),IVS(R=0.563,P<0.01),LVPWT(R=0.459,P<0.01),LVs(R=0.812,P<0.01),and LVd(R=0.519,P<0.01).Multiple regression analysis displayed that there were negative correlations between serum potassium and LVMI(β=-0.732,P<0.05),LVs(β=-1.076,P<0.01),LVd(β=-0.799,P<0.05).There was positive correlation between ratio of sodium to potassium and LVMI(β=1.042,P<0.01),LVs(β=1.506,P<0.01),LVd(β=0.974,P<0.05).Conclusion:The serum potassium concentration and the ratio of serum sodium to potass

关 键 词：高血压 血清钠 血清钾 血清钠钾浓度比值 左心室肥厚 

分 类 号：R544.1[医药卫生—心血管疾病]