摘要
目的了解原发性高血压患者的高血压五项激素水平变化特征,探讨其与原发性高血压患者的相关性。方法回顾性分析2018年4月至2019年3月黑龙江省农垦总局总医院1731例原发性高血压患者和305例健康体检者的临床资料,采用磁微粒化学发光法检测肾素、血管紧张素Ⅱ(ATⅡ)、醛固酮、促肾上腺皮质激素(ACTH)和皮质醇水平,并计算醛固酮与肾素比值(ADRR)。结果原发性高血压患者肾素、ATⅡ、醛固酮、ACTH、皮质醇和ADRR均明显高于健康对照者[(13.58±9.78)ng/L比(9.20±2.12)ng/L、(181.06±89.82)ng/L比(133.49±5.47)ng/L、(174.96±103.14)ng/L比(136.04±15.48)ng/L、(76.39±61.43)ng/L比(26.98±5.10)ng/L、(176.4±88.8)μg/L比(145.1±18.9)μg/L和27.71±18.37比15.18±1.77],差异有统计学意义(P<0.01)。男性原发性高血压患者(904例)肾素和ATⅡ明显高于女性原发性高血压患者(827例)[(16.04±10.67)ng/L比(10.34±8.59)ng/L、(194.28±96.22)ng/L比(166.37±83.42)ng/L],醛固酮明显低于女性原发性高血压患者[(166.31±101.91)ng/L比(184.68±104.37)ng/L],差异有统计学意义(P<0.01或<0.05);ACTH、皮质醇和ADRR比较差异无统计学意义(P>0.05)。51~60岁(610例)和>60岁(572例)原发性高血压患者肾素和ATⅡ明显低于≤50岁患者(549例)[(12.67±10.76)、(12.43±8.29)ng/L比(16.05±10.29)ng/L和(172.62±81.63)、(166.04±79.09)ng/L比(208.94±108.75)ng/L],差异有统计学意义(P<0.05或<0.01);三个年龄段间醛固酮、ACTH、皮质醇和ADRR比较差异无统计学意义(P>0.05)。多元线性回归分析结果显示,肾素、ATⅡ与收缩压和舒张压呈负相关(P<0.01或<0.05),醛固酮、ACTH、皮质醇与收缩压和舒张压呈正相关(P<0.05或<0.01)。结论肾素、ATⅡ与收缩压和舒张压呈负相关;醛固酮、ACTH、皮质醇与收缩压和舒张压呈正相关。高血压五项激素水平能够反映肾素-血管紧张素-醛固酮(RAAS)系统和下丘脑-垂体-肾上腺皮质轴(HPA轴)功能状态,是原发性高血压的影响因子。
Objective To investigate the characteristics of five hormone levels of hypertension in patients with essential hypertension,and explore the correlation between them and essential hypertension.Methods The clinical data of 1731 patients with essential hypertension and 305 healthy people in General Hospital of Heilongjiang Province Land Reclamation Bureau from April 2018 to March 2019 were analyzed retrospectively.The levels of renin,angiotensionⅡ(ATⅡ),aldosterone,adrenocorticotropic hormone(ACTH)and cortisol were measured by magnetic particle chemiluminescence,and the ratio of aldosterone to renin(ADRR)was calculated.Results The renin,ATⅡ,aldosterone,ACTH,cortisol and ADRR in patients with essential hypertension were significantly higher than those in healthy controls:(13.58±9.78)ng/L vs.(9.20±2.12)ng/L,(181.06±89.82)ng/L vs.(133.49±5.47)ng/L,(174.96±103.14)ng/L vs.(136.04±15.48)ng/L,(76.39±61.43)ng/L vs.(26.98±5.10)ng/L,(176.4±88.8)μg/L vs.(145.1±18.9)μg/L and 27.71±18.37 vs.15.18±1.77,and there were statistical differences(P<0.01).The renin and ATⅡin male patients with essential hypertension(904 cases)were significantly higher than those in female patients with essential hypertension(827 cases):(16.04±10.67)ng/L vs.(10.34±8.59)ng/L and(194.28±96.22)ng/L vs.(166.37±83.42)ng/L,the aldosterone was significantly lower than that in female patients with essential hypertension:(166.31±101.91)ng/L vs.(184.68±104.37)ng/L,and there were statistical differences(P<0.01 or<0.05);there were no statistical difference in ACTH,cortisol and ADRR(P>0.05).The renin and ATⅡin patients aged 51 to 60 years(610 cases)and>60 years(572 cases)were significantly lower than those in patients aged≤50 years(549 cases):(12.67±10.76),(12.43±8.29)ng/L vs.(16.05±10.29)ng/L and(172.62±81.63),(166.04±79.09)ng/L vs.(208.94±108.75)ng/L,and there were statistical differences(P<0.05 or<0.01);there were no statistical difference in aldosterone,ACTH,cortisol and ADRR(P>0.05).Multivariate linear regression analysis result showed that renin and ATⅡwere negatively correlated with systolic blood pressure and diastolic blood pressure(P<0.01 or<0.05),and aldosterone,ACTH and cortisol were positively correlated with systolic blood pressure and diastolic blood pressure(P<0.05 or<0.01).Conclusions Renin and ATⅡare negatively correlated with systolic blood pressure and diastolic blood pressure;aldosterone,and ACTH and cortisol are positively correlated with systolic blood pressure and diastolic blood pressure.The five hormone levels of hypertension can reflect the function of renin-angiotension-aldosterone(RAAS)system and hypothalamus pituitary adrenocortical axis(HPA axis),which are the influencing factors of essential hypertension.
作者
周坤
郑遵荣
周玉珍
王立庄
李艳丽
高庆峰
Zhou Kun;Zheng Zunrong;Zhou Yuzhen;Wang Lizhuang;Li Yanli;Gao Qingfeng(Department of Clinical Biochemistry Laboratory,General Hospital of Heilongjiang Province Land Reclamation Bureau,Harbin 150088,China)
出处
《中国医师进修杂志》
2020年第3期231-235,共5页
Chinese Journal of Postgraduates of Medicine
