长期服用氢氯噻嗪后RAAS活性变化与血糖变化关系

Relationship of the Change of RAAS Activity with Plasma Glucose after Long Term Therapy of Hydrochlorothiazide

目的:探讨长期服用氢氯噻嗪(HCTZ)后肾素-血管紧张素-醛固酮系统(RAAS)活性变化与血糖(GLU)变化之间的关系。方法:选择119例高血压患者,测定基线RAAS活性和GLU水平等指标后,给予HCTZ12.5mg,qd,1年后测定RAAS活性和GLU水平,分析服用HCTZ1年后RAAS活性变化与GLU水平之间的关系。结果:服用HCTZ1年后,血清肾素活性(PRA)水平升高组与不升高组患者GLU水平下降幅度分别是(-0.26±0.26)mmol·L-1、(-1.36±0.23)mmol·L-1,差异有统计学意义(P<0.05);血清血管紧张素Ⅱ(AngⅡ)水平升高组与不升高组患者GLU水平下降幅度分别是(-0.17±0.18)mmol·L-1、(-1.07±0.21)mmol·L-1,差异有统计学意义(P<0.05)。服药后AngⅡ水平升高的患者中,GLU水平同时也升高的人数比例(40.5%)明显高于AngⅡ水平不升高患者中的相应患者比例(16.9%),差异有统计学意义(P<0.05)。校正年龄、性别、基线GLU水平等其他因素影响后,服用HCTZ1年后的血清AngⅡ水平变化与GLU水平变化独立相关。结论:服用HCTZ1年后的RAAS活性变化与GLU变化之间存在相关关系。

OBJECTIVE：To investigate the relationship between the change of RAAS activity and plasma glucose after one year therapy of hydrochlorothiazide. METHODS：A total of 119 hypertensive patients were enrolled in this study. The activity of RAAS and plasma glucose level were measured at baseline. Patients were given 12.5 mg hydrochlorothiazide once a day for one year. Then the relationship between activity change of RAAS and the level of plasma glucose were analyzed. RESULTS：After one year treatment,the decrease of plasma glucose in PRA elevated group and PRA unelevated group were（-0.26±0.26）mmol·L-1 and（-1.36±0.23）mmol·L-1respectively,and there was statistical significance in difference（P0.05）.The decrease of plasma glucose in AngⅡelevated group and AngⅡunelevated group were（-0.17±0.18）mmol·L-1and（-1.07±0.21）mmol·L-1,and elevated group（40.5%）were significantly higher than that in AngⅡ unelevated group,and there was statistical significance in difference（P0.05）. After correcting factors such as age,sex and baseline plasma glucose level,the change of RAAS activity was associated with the level of plasma glucose after one year therapy of hydrochlorothiazide. CONCLUSION：The change of RAAS activity was associated with the level of plasma glucose after one year therapy of hydrochlorothiazide.