原发性醛固酮增多症患者心肺运动试验中运动血压的特点  

Characteristics of exercise blood pressure during cardiopulmonary exercise test in primary aldosteronism patients

作　　者：张瑜 孔剑琼 王京 黄雯婷 王灵芝 彭艳霞 颜妙君 ZHANG Yu;KONG Jian-qiong;WANG Jing;HUANG Wen-ting;WANG Ling-zhi;PENG Yan-xia;YAN Miao-jun(Deparment of Cardiac Rehabilitation,Fuwai Hospital Chinese Academy of Medical Sciences Shenzhen,Shenzhen,Guangdong 518000,China)

机构地区：[1]中国医学科学院阜外医院深圳医院心脏康复科,广东深圳518000

出　　处：《中华高血压杂志》2022年第3期267-271,共5页Chinese Journal of Hypertension

基　　金：深圳市重点学科建设经费资助项目(SZXK001);深圳市医疗卫生三名工程项目(SZSM201811096)。

摘　　要：目的探讨原发性醛固酮增多症(PA)患者在心肺运动试验(CPET)中,随着运动强度增加,血压的经时变化。方法连续纳入2017年5月—2019年12月就诊于阜外深圳医院心脏康复科的PA患者50例及原发性高血压(EH)患者60例。通过CPET获取运动中血压参数,比较两组CPET中随着运动强度增加血压的变化。结果两组患者的静息血压,运动3 min、6 min、峰值血压差异无统计学意义(均P>0.05)。PA患者恢复期1 min收缩压[(185.2±25.4)比(172.4±25.8)mm Hg,t=2.516,P=0.011]、恢复期6 min收缩压[(152.3±17.7)比(142.8±23.9)mm Hg,t=2.356,P=0.020]较EH患者增高。性别分层后,男性PA患者恢复期1 min收缩压[(190.6±24.4)比(174.5±27.6)mm Hg,t=2.421,P=0.018]、恢复期6 min收缩压[(157.2±18.8)比(144.4±25.4)mm Hg,t=2.205,P=0.031]较男性EH患者增高。多元线性回归分析显示,恢复期1 min收缩压与24 h同步尿钾独立相关(B=0.708,P=0.001)。结论在CPET试验恢复期男性PA患者收缩压较EH患者降低延迟。Objective To observe the time-dependent changes of blood pressure with the increase of exercise intensity during cardiopulmonary exercise test(CPET)in primary aldosteronism(PA)patients.Methods Fifty PA and 60 essential hypertension(EH)patients hospitalized from May 2017 to December 2019 at deparment of cardiac rehabilitation,Fuwai Hospital of Chinese Academy of Medical Sciences,Shenzhen were retrospectively analyzed.Main parameters including exercise blood pressure were obtained by CPET.The time-dependent changes of blood pressure(BP)with the increase of exercise intensity were compared between two groups.Results There were no significant differences between two groups in blood pressure at rest and 3,6 minutes and peak blood pressure during exercise.Compared with EH group,the patients in PA group had higher level of systolic blood pressure(SBP)at 1 min[(185.2±25.4)vs(172.4±25.8)mm Hg,t=2.516,P=0.011]and 6 min[(152.3±17.7)vs(142.8±23.9)mm Hg,t=2.356,P=0.020]in recovery period.After gender stratification,SBP in male PA patient group at 1 min[(190.6±24.4)vs(174.5±27.6)mm Hg,t=2.421,P=0.018]and 6 min[(157.2±18.8)vs(144.4±25.4)mm Hg,t=2.205,P=0.031]in recovery period was significantly higher than those in male EH patient group(P<0.05).Multiple linear regression analysis showed that 1 min SBP in the recovery period was independently correlated with 24-hour synchronous urine potassium(B=0.708,P=0.001).Conclusions In the recovery period of CPET test,the decrease of SBP in male PA patient’s recovery period was delayed compared with that in male EH patients.

关 键 词：原发性醛固酮增多症 心肺运动试验 运动血压 

分 类 号：R586.24[医药卫生—内分泌]