高血压合并阻塞性睡眠呼吸暂停患者肾素-血管紧张素-醛固酮系统与高尿酸血症的相关性分析  

Correlation Analysis Between Renin-angiotensin-aldosterone System and Hyperuricemia in Patientswith Hypertension Complicated with Obstructive Sleep Apnea

作　　者：姚灵 木拉力别克·黑扎提 杨文博 李南方[1] YAO Ling;HEIZHATI·Mulalibieke;YANG Wen-bo;LI Nan-fang(Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region/Xinjiang Hypertension Institute/NHC Key Laboratory of Hypertension Clinical Research/Key Laboratory of Xinjiang Uygur Autonomous Region“Hypertension Research Laboratory”/Xinjiang Clinical Medical Research Center for Hypertension(Cardio-Cerebrovascular)Diseases,Urumqi 830000,Xinjiang,China)

机构地区：[1]新疆维吾尔自治区人民医院高血压中心/新疆高血压研究所/国家卫生健康委高血压诊疗研究重点实验室/新疆维吾尔自治区重点实验室“新疆高血压病研究实验室”/新疆高血压(心脑血管)疾病临床医学研究中心,新疆乌鲁木齐830000

出　　处：《医学信息》2024年第14期85-89,共5页Journal of Medical Information

基　　金：新疆维吾尔自治区人民医院院内项目(编号:20200407);自治区卫生健康青年医学科技人才专项科研项目(编号:WJWY-202201)。

摘　　要：目的探讨高血压合并阻塞性睡眠呼吸暂停(OSA)患者的肾素-血管紧张素-醛固酮系统(RAAS)与高尿酸血症(HUA)的相关性。方法选取于2011年1月-2013年12月就诊于新疆维吾尔自治区人民医院高血压中心明确诊断为OSA的高血压患者649例。测量血浆醛固酮浓度(PAC)、血浆肾素活性(PRA)和血尿酸(SUA)水平等。采用Spearman相关分析高血压患者PAC、PRA与SUA的相关性。采用多元Logistic回归分析PAC、PRA对HUA的影响。结果Spearman相关性分析显示,SUA与PAC、PRA、舒张压、呼吸暂停低通气指数均相关(P<0.05)。Logistic回归分析显示PAC、PRA是HUA的影响因素(OR=1.03,95%CI:1.01~1.04,P=0.002;OR=1.14,95%CI:1.08~1.20,P<0.001),校正混杂因素后,PAC、PRA仍与HUA独立相关(OR=1.02,95%CI:1.00~1.05,P=0.041;OR=1.09,95%CI:1.01~1.18,P=0.024)。交互作用和亚组分析显示PAC、PRA与性别、年龄、血压水平、OSA严重程度均无交互作用(P>0.05),PAC、PRA与HUA风险独立相关(P<0.05)。结论PAC、PRA是高血压合并OSA患者HUA的独立影响因素,这可为高血压合并OSA患者HUA的防治提供新的方向。Objective To investigate the correlation between renin-angiotensin-aldosterone system(RAAS)and hyperuricemia(HUA)in patients with hypertension complicated with obstructive sleep apnea(OSA).Methods A total of 649 patients with hypertension diagnosed as OSA in Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region from January 2011 to December 2013 were selected.Plasma aldosterone concentration(PAC),plasma renin activity(PRA)and serum uric acid(SUA)were measured.Spearman correlation analysis was used to analyze the correlation between PAC,PRA and SUA in patients with hypertension.Multivariate Logistic regression analysis was used to analyze the effects of PAC and PRA on HUA.Results Spearman correlation analysis showed that SUA was correlated with PAC,PRA,diastolic blood pressure and apnea hypopnea index(P<0.05).Logistic regression analysis showed that PAC and PRA were the influencing factors of HUA(OR=1.03,95%CI:1.01-1.04,P=0.002;OR=1.14,95%CI:1.08-1.20,P<0.001);after adjusting for confounding factors,PAC and PRA were still independently associated with HUA(OR=1.02,95%CI:1.00-1.05,P=0.041;OR=1.09,95%CI:1.01-1.18,P=0.024).Interaction and subgroup analysis showed that PAC and PRA had no interaction with gender,age,blood pressure level and OSA severity(P>0.05).PAC and PRA were independently associated with HUA risk(P<0.05).Conclusion PAC and PRA are independent influencing factors of HUA in patients with hypertension complicated with OSA,which can provide a new direction for the prevention and treatment of HUA in patients with hypertension complicated with OSA.

关 键 词：血浆醛固酮浓度 血浆肾素活性 高尿酸血症 高血压 阻塞性睡眠呼吸暂停 

分 类 号：R544.1[医药卫生—心血管疾病]