血浆儿茶酚胺肾素醛固酮与血压的昼夜节律  

Chronobiological feature of plasma catecholamine, renin, and aldosterone and their relationship with the circadian rhythm of blood pressure

作　　者：郭艺芳[1] Phyllis K.Stein 姚丽霞[1] 宋光耀[1] Peter P.Domitrovich 

机构地区：[1]河北省人民医院老年医学研究所,石家庄050051 [2]美国华盛顿大学医学院

出　　处：《中华心血管病杂志》2004年第1期26-29,共4页Chinese Journal of Cardiology

基　　金：河北省科技厅计划课题 (992 761171);2000年度河北省卫生厅出国留学基金

摘　　要：目的　探讨昼夜血压呈非杓型、杓型、超杓型分布的高血压病患者中血浆儿茶酚胺、肾素与醛固酮水平的昼夜波动特征及其与血压时间生物学特征的关系。方法　入选新近诊断未经治疗的高血压病患者 10 4例 ,据其昼夜血压分布特征分为三组 :非杓型组 ;杓型组 ;超杓型组。分别测定各组患者的血浆肾上腺素、去甲肾上腺素、肾素、醛固酮水平 (每 4h 1次 ,连续测 6次 ) ,并应用余弦拟合法分析其时间生物学特征。结果　各组患者的上述 4种检测指标均表现为昼夜节律。非杓型组与超杓型组的肾上腺素和去甲肾上腺素昼夜平均水平及超杓型组的波动振幅均高于杓型组 ,非杓型组患者儿茶酚胺的振幅低于杓型组。超杓型组醛固酮的振幅明显高于杓型组 ,三组间肾素时间生物学特征无显著区别。结论　不同昼夜血压分布特征的高血压病患者 ,其血浆儿茶酚胺的时间生物学特征明显不同 。Objective To investigate the chronobiological features of plasma catecholamine, renin, and aldosterone and their relationship with the circadian rhythm of blood pressure. Methods One hundred and four untreated hypertensive patients were included in this study and allocated into 3 groups based on their circadian character of blood pressure: GⅠ, non dippers; GⅡ, dippers; and GⅢ, extreme dippers. Plasma epinephrine, norepinephrine, renin, and aldosterone were measured at the interval of 4 hours within 24 hours . Cosinor fitting analysis was introduced to deal with the results. Results All of the 4 biochemical assays showed as circadian rhythms. Mid values of plasma epinephrine and norepinephrine were significantly higher in GⅠ and GⅢ when compared with GⅡ, its amplitude was lower in GⅠ and higher in GⅢ than that in GⅡ, and also, amplitude of aldosterone in GⅢ was higher than that in GⅡ, although there were no significant chronobiological differences of renin among these 3 groups. Conclusion Circadian rhythms of plasma catecholamine were different among hypertensive patients with different diurnal characters of blood pressure, and many mechanisms which need to be further investigated may be involved in.

关 键 词：血浆儿茶酚胺 肾素醛固酮 血压 昼夜节律 高血压 时间生物学 

分 类 号：R544.1[医药卫生—心血管疾病]