超敏C反应蛋白与原发性醛固酮增多症相关性研究

Study on significance of serum level of high-sensitivity C-reactive protein in patients with primary aldosteronism

目的探讨炎症与原发性醛固酮增多症(PA)之间的关系。方法采用采用免疫比浊法检测超敏C反应蛋白(hsCRP),比较原发性高血压(EH)患者与PA患者之间hsCRP水平的差异,分析炎症标志与PA患者各临床指标之间的关系。结果 EH组血清hsCRP浓度为0.67(0.43～1.5)mg/L;PA组为0.44(0.16～0.98)mg/L,PA组较EH组低(P=0.002)。单双侧PA之间hsCRP差异无统计学意义(P>0.05)。EH组,hsCRP水平与年龄、体质指数(BMI)、腹围、空腹血糖(GLU)、总胆固醇(TG)及三酰甘油(TC)等临床资料有显著相关(均为P<0.05);双侧PA组,hsCRP水平与BMI、腹围、TC及TG有显著相关(均为P<0.05);单侧PA组,hsCRP水平与醛固酮呈负相关(r=-0.437,P=0.02)。结论不同类型的PA其可能的发病机制是不同的,双侧PA患者可能存在亚临床炎症状态,脂质代谢及肥胖是可能的促进炎症因素。

Objective To study the relationship between inflammation and primary aldosteronism（PA）.Methods The serum concentration of high-sensitivity C-creactive protein（hsCRP） was examined in patients with primary aldosteronism,and their hsCRP levels were compared with those of patients with essential hypertension and to find out the possible relationship with other clinical factors.Results In patients with EH group,the mean serum concentration of hsCRP was 0.67（0.43~1.5） mg/ L,and it was 0.44（0.16~0.98） mg/ L in PA patients group,and PA patients had lower level of hsCRP（P=0.002）.But there was no difference between patients with unilateral or bilateral PA（P0.05）.In EH patients group,the changes in serum levels of hsCRP were significantly related to age,body mass index（BMI）,abdominal extension,GLU,TG and TC.In bilateral PA group,the changes in serum levels of hsCRP were significantly related to BMI,abdominal extension,TG and TC;and in unilateral PA group,the serum levels of hsCRP showed a remarkable negative correlation with concentration of aldosterone（r=-0.437,P=0.02）.Conclusion The possible mechanism in pathogenesis of various types of PA may be different.A state of subclinical inflammation may be existed,and lipid metabolism and obesity can possibly be contributory factors.