高血压合并原发性醛固酮增多症患者卧立位血浆醛固酮/肾素比值及血钠/血钾比值与血管紧张素Ⅱ水平检测意义分析  

Significance of plasma aldosterone/renin ratio,sodium/potassium ratio and angiotensinⅡlevel in patients with hypertension and primary aldosteronism in lying position

作　　者：申海彬 廖建芳[1] 沈志明 SHEN Haibin;LIAO Jianfang;SHEN Zhiming(Department of Clinical Laboratory,The First Affiliated Hospital of Gannan Medical College,Ganzhou,Jingci,341000,China)

机构地区：[1]赣南医学院第一附属医院检验科,江西赣州341000

出　　处：《当代医学》2023年第7期162-165,共4页Contemporary Medicine

基　　金：赣州市指导性科技计划项目(GZ2020ZSF084)。

摘　　要：目的分析高血压合并原发性醛固酮增多症患者卧立位血浆醛固酮/肾素比值(ARR)及血钠/血钾比值(Na^(+)/K^(+))与血管紧张素Ⅱ(AngⅡ)水平检测的意义。方法回顾性分析2020年3至2021年3月本院收治的56例高血压合并原发性醛固酮增多症患者和73例原发性高血压患者的临床资料,将其分别纳入PA组(n=56)和对照组(n=73),比较两组卧位、立位血浆ARR及Na^(+)/K^(+)与AngⅡ水平,采用Pearson分析卧位、立位血浆ARR及Na^(+)/K^(+)、AngⅡ与血压、醛固酮水平的相关性,采用ROC曲线,评估卧位、立位血浆ARR及Na^(+)/K^(+)、AngⅡ对原发性醛固酮增多症的诊断效能。结果PA组卧位、立位血浆ARR及Na^(+)/K^(+)均明显高于对照组(P<0.05),AngⅡ水平均低于对照组(P<0.05),两组立位血浆ARR、AngⅡ明显高于卧位(P<0.05),两组卧立位Na^(+)/K^(+)差异无统计学意义。患者卧位、立位血浆ARR及Na^(+)/K^(+)、AngⅡ水平均与患者血压、患者血浆醛固酮水平成正相关(P<0.05)。卧位、立位血浆ARR及Na^(+)/K^(+)、AngⅡ曲线AUC明显大于参考线(P<0.05),卧位血浆ARR、卧位血钠/血钾、卧位AngⅡ、立位血浆ARR、立位血钠/血钾、立位AngⅡ分别为22.620 ng/L、32.671 ng/L、53.311 ng/L,26.404 ng/L、34.184 ng/L、64.242 ng/L。结论患者卧位、立位血浆ARR及Na^(+)/K^(+)、AngⅡ均与患者血压、血浆醛固酮水平关系紧密,借助上述指标能有效诊断高血压合并原醛症,具有较高临床检测价值。Objective To analyze the significance of plasma aldosterone/renin ratio(ARR),sodium/potassium ratio(Na^(+)/K^(+))and angiotensinⅡ(AngⅡ)level in patients with hypertension and primary aldosteronism in lying position.Methods Clinical data of 56 patients with hypertension combined with primary aldosteronism and 73 patients with primary hypertension admitted to our hospital from March 2020 to March 2021 were retrospectively analyzed,and the patients were included in the PA group(n=56)and the control group(n=73),respectively.The differences in plasma ARR,Na^(+)/K^(+)and AngⅡlevels were compared between the two groups.Pearson was used to analyze the correlation of plasma ARR,Na^(+)/K^(+)and AngⅡwith blood pressure and aldosterone levels in the two groups.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of plasma ARR,Na^(+)/K^(+)and AngⅡin decubing and standing positions for primary aldosteronism.Results Plasma ARR and Na^(+)/K^(+)in recumbent and upright positions of PA group were significantly higher than those in control group(P<0.05),AngⅡlevels were lower than those in control group(P<0.05).Plasma ARR and AngⅡin standing position were significantly higher than those in recumbent position(P<0.05),there was no significant difference in Na^(+)/K^(+)between the two groups.Plasma ARR,Na^(+)/K^(+)and AngⅡlevels in recumbent and standing position were positively correlated with blood pressure and plasma aldosterone levels(P<0.05).The plasma ARR,Na^(+)/K^(+)and AngⅡin recumbent and standing position of AUC curves were significantly higher than those of the reference line(P<0.05).Recumbent position plasma ARR,recumbent position Na^(+)/K^(+),recumbent position AngⅡ,standing position plasma ARR,standing position Na^(+)/K^(+),standing position AngⅡwere 22.620 ng/L,32.671 ng/L,53.311 ng/L,26.404 ng/L,34.184 ng/L,64.242 ng/L,respectively.Conclusion Plasma ARR,Na^(+)/K^(+)and AngⅡare closely related to blood pressure and plasma aldosterone level in patients in both re

关 键 词：高血压 原发性醛固酮增多症 卧立位 醛固酮 肾素 

分 类 号：R586.24[医药卫生—内分泌] R446.1[医药卫生—内科学]