醛固酮/肾素比值与高血压患者心脏损害的相关性研究  

Study on the association between aldosterone to renin ratio and cardiac damage in hypertensive patients

作　　者：梁晓莹 童嫘 雒虹郦 杨阳[2] LIANG Xiaoying;TONG Lei;LUO Hongli;YANG Yang(Chengde Medical University,Chengde 067000,Hebei,China;Chengde Central Hospital of Hebei Province,Chengde 067000,Hebei,China)

机构地区：[1]承德医学院,河北承德067000 [2]河北省承德市中心医院,河北承德067000

出　　处：《右江民族医学院学报》2025年第1期71-75,共5页Journal of Youjiang Medical University for Nationalities

基　　金：承德市科技支撑计划项目(202002A009)。

摘　　要：目的研究醛固酮/肾素(aldosterone to renin ratio,ARR)与高血压患者心脏损害的相关性,并分析ARR是否为高血压患者心脏损害的独立危险因素。方法回顾分析2019年1月至2024年6月在承德市中心医院就诊的高血压患者178例,收集患者的临床资料,完善高血压五项或高血压三项检查,计算ARR值,按照ARR中位数值大小分为高ARR组(ARR≥3.47)和低ARR组(ARR<3.47),每组各89例;完善生化常规、心脏彩超检查。ARR与高血压心脏损害各指标相关性采用Spearman相关分析;采用多元线性逐步回归分析ARR与左心室后壁厚度(LVPWT)、左心室质量指数(LVMI)关系;用二元Logistic回归分析ARR与左心室肥厚(LVH)的关系。结果两组年龄、性别、身高、体重、体重指数(BMI)、体表面积(BSA)、高血压病程、血糖、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)、左心房内径(LAD)、室间隔厚度(IVST)、左心室舒张末期内径(LVEDd)、左心室质量(LVM)方面差异均无统计学意义(P>0.05);在醛固酮(ALD)、肾素活性(PRA)、左心室后壁厚度(LVPWT)、左心室质量指数(LVMI)、左心室肥厚(LVH)方面差异有统计学意义(P<0.05)。Spearman相关分析显示,ARR与LVPWT(r_(s)=0.366,P<0.001)、LVMI(r_(s)=0.228,P=0.002)、LVH(r_(s)=0.296,P<0.001)呈正相关。行多元逐步回归分析结果表明,ARR(β=0.298,P<0.001)、体重(β=0.171,P=0.017)与LVPWT呈独立正相关;ARR(β=0.231,P=0.001)、高血压病程(β=0.218,P=0.002)与LVMI呈独立正相关,BSA(β=-0.198,P=0.005)与LVMI呈独立负相关。行二元Logistic回归分析显示,ARR(OR=1.160,95%CI:1.056~1.274,P=0.002)、高血压病程(OR=1.090,95%CI:1.021~1.164,P=0.010)与LVH呈独立正相关。结论ARR升高可以作为LVPWT增大、LVMI增加、LVH的危险因素。Objective To investigate the correlation between aldosterone to renin ratio(ARR)and cardiac damage in hypertensive patients and analyze whether ARR is an independent risk factor for cardiac damage in these patients.Methods A retrospective analysis was performed on 178 hypertensive patients who were treated in Chengde Central Hospital from January 2019 to June 2024.The clinical data were collected,and the five-item or three-item hypertension tests were completed to calculate the ARR value.Patients were divided into a high ARR group(ARR≥3.47)and a low ARR group(ARR<3.47)according to the median value of ARR,with 89 patients in each group.Routine biochemical tests and echocardiography were completed.Spearman correlation analysis was used to analyze the correlation between ARR and various indicators of hypertensive cardiac damage.Multiple linear stepwise regression analysis was used to analyze the relationship between ARR and left ventricular posterior wall thickness(LVPWT)and left ventricular mass index(LVMI).Binary Logistic regression analysis was used to analyze the relationship between ARR and left ventricular hypertrophy(LVH).Results There were no significant differences between the two groups in age,gender,height,weight,body mass index(BMI),body surface area(BSA),course of hypertension,blood glucose,triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-c),left atrial diameter(LAD),interventricular septal thickness(IVST),left ventricular end-diastolic diameter(LVEDd),and left ventricular mass(LVM)(P>0.05).However,there were significant differences in aldosterone(ALD),plasma renin activity(PRA),LVPWT,LVMI,and LVH between the two groups(P<0.05).Spearman correlation analysis showed that ARR was positively correlated with LVPWT(r_(s)=0.366,P<0.001),LVMI(r_(s)=0.228,P=0.002),and LVH(r_(s)=0.296,P<0.001).Multiple stepwise regression analysis showed that ARR(β=0.298,P<0.001)and weight(β=0.171,P=0.017)were independently and positively correlated with LVPWT;ARR(β=0.231,P=0.001)and the course

关 键 词：醛固酮/肾素 醛固酮 肾素活性 高血压 心脏损害 

分 类 号：R544.1[医药卫生—心血管疾病]