帕金森病初诊患者肾素-血管紧张素系统与高血压的相关性

Correlation between renin-angiotensin system and hypertension in newly-diagnosed patients with Parkinson’s disease

目的分析帕金森病(Parkinson’s disease,PD)初诊患者血清肾素-血管紧张素系统与高血压的相关性。方法选取2014年7月—2016年6月在南京医科大学附属淮安第一医院神经内科门诊初次诊断为原发性PD的40例患者作为研究对象,同时纳入40例健康人群为对照组,测定两组研究对象血清中肾素活性、血管紧张素(angiotensin,Ang)Ⅱ、醛固酮及去甲肾上腺素(norepinephrine,NE)水平。对两组研究对象进行5年随访,评估两组间高血压发病率差异是否与RAS的相关性。结果PD初诊患者与对照组相比,血清肾素活性、AngⅡ、醛固酮及NE水平差异无统计学意义(P>0.05)。随着时间推移,PD组患者血清肾素活性、NE水平进行性下降,随访5年与初诊时相比,分别下降39.12%、27.94%,差异有统计学意义(P<0.05);随访5年后,PD组患者血清肾素活性、NE水平均较对照组明显下降,分别为对照组的63.91%、81.69%,差异有统计学意义(P<0.05),但AngⅡ和醛固酮水平分别为对照组的86.88%、95.04%,差异无统计学意义(P>0.05)。随访5年后,PD组和对照组高血压发病率分别为11.11%、32.35%,PD组显著低于对照组,差异有统计学意义(P<0.05),血清中肾素活性、NE水平与高血压发病率均呈正相关(r值分别为0.635、0.526,P<0.05)。结论随着时间推移,PD初诊患者高血压发病率呈下降趋势,并且与血清肾素活性和NE水平密切相关。

Objective To determine the relationship between the renin-angiotensin system(RAS)and hypertension in newly-diagnosed patients with Parkinson’s disease(PD).Methods We selected 40 patients from the Neurology Clinic of Huaian First Hospital Affiliated to Nanjing Medical University who were diagnosed with primary PD between July 2014 and June 2016.We enrolled 40 healthy individuals as the control group.The serum levels of renin activity,angiotensin(Ang)Ⅱ,aldosterone,and norepinephrine(NE)were determined in the two groups.The two groups were followed for 5 years to determine if the difference in incidence of hypertension between the groups was related to the RAS.Results As PD progressed,the serum renin activity and NE level in the PD group progressively decreased.Compared with the initial diagnosis of PD,the renin activity and NE level at the 5-year follow-up evaluation decreased by39.12%and 27.94%respectively,and the difference was statistically significant(P<0.05).There were no significant differences in serum renin activity,AngⅡ,aldosterone,and NE levels between newly-diagnosed patients with PD and the control group(P>0.05).After 5 years of follow-up,the serum renin activity and NE level in the PD group were significantly lower than the control group 63.91%and 81.69%of the control group,respectively(P<0.05).The levels of AngⅡand aldosterone were 86.88%and 95.04%of the control group,respectively(P>0.05).In addition,after 5 years of follow-up,the incidence of hypertension in the PD and control groups was 11.11%and 32.35%,respectively;the incidence of hypertension in the PD group was significantly lower than the control group(P<0.05).The correlation coefficients between serum renin activity,NE level,and the incidence of hypertension were 0.635 and 0.526,respectively(P<0.05).Conclusion The incidence of hypertension in newly-diagnosed patients with PD showed a decreasing trend over time and was closely related to the serum renin activity and NE level.