摘要
目的探讨原发性高血压患者中醛固酮与肾素活性比值(ARR)与夜间血压及高血压靶器官损害的相关性。方法选择2014年11月1日至2015年11月30日,大连医科大学附属第一医院高血压科住院的单纯原发性高血压患者237例,按ARR高低等分为3组,每组79例:ARR<5.8、5.8-<12.6、≥12.6(ng/dL)/[μg/(L·h)]组。分析ARR与夜间血压、高敏C反应蛋白(hsCRP)、脑钠尿肽、肱踝动脉脉搏波传导速度(baPWV)、踝臂指数、左心室质量指数(LVMI)的关系。结果随着ARR升高,hsCRP、踝臂指数、脑钠尿肽、LVMI、夜间收缩压(nSBP)及夜间舒张压(nDBP)随之升高,而nSBP和nDBP下降百分比降低(P<0.05);Pearson相关分析显示,ARR与踝臂指数、脑钠尿肽、LVMI、nSBP呈正相关(r=0.161、0.270、0.190、0.225);与nSBP及nDBP下降百分比呈负相关(r=-0.360、-0.285,均P<0.05)。多元线性回归显示,ARR是nSBP及nDBP下降百分比的独立影响因素(β=-0.360,-0.264,均P<0.05)。结论ARR是原发性高血压患者nSBP及nDBP下降百分比的独立危险因素。
Objective To explore the correlations between aldosterone-renin ratio(ARR)and nighttime blood pressure,as well as the correlations between ARR and target organ damage in essential hypertension patients.Methods Between November 2014 and November 2015,a total of 237 essential hypertensive patients hospitalized in the First Affiliated Hospital of Dalian Medical University were enrolled.Patients were classified into three groups with 79 cases in each group based on ARR:ARR<5.8,ARR 5.8-<12.6,ARR≥12.6(ng/dL)/[μg/(L·h)],and the relationships between ARR and nighttime blood pressure,hypersensitive C-reactive protein(hsCRP),brain natriuretic peptide(BNP),brachial-ankle pulse wave velocity(baPWV),ankle-brachial index(ABI)and left ventricular mass index(LVMI)were examined.Results In the group with higher ARR,hsCRP,ABI,BNP,LVMI,nighttime systolic pressure and diastolic pressure(nSBP and nDBP)were significantly higher(P<0.05),and nocturnal blood pressure decline was significantly lower(P<0.01).Bivariate correlation analysis indicated that ABI,BNP,LVMI,nSBP were positively correlated with ARR(r=0.161,0.270,0.190,0.225);nSBP and nDBP decline were negatively correlated with ARR(r=-0.360,-0.285,both P<0.05),and multivariate logistic regression analysis found that ARR was an independent risk factor for nSBP and nDBP decline in essential hypertension(β=-0.360,-0.264,both P<0.05).Conclusion ARR is an independent risk factor of nSBP and nDBP decline in essential hypertension.
作者
徐茵
程云鹏
刘佳
姜一农
XU Yin;CHENG Yun-peng;LIU Jia;JIANG Yi-nong(Cardiovascular Department,The First Affiliated Hospital of DalianMedical University,Dalian Liaoning 116012,China)
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2020年第7期624-629,共6页
Chinese Journal of Hypertension
关键词
醛固酮与肾素活性比值
原发性高血压
夜间血压
靶器官损害
aldosterone to renin ratio
essential hypertension
nighttime blood pressure
target organ damage
