单纯高血压病及高血压病合并冠心病患者血清醛固酮及血管紧张素Ⅰ、Ⅱ水平的研究

Investigation of plasma level of aldosterone,angiotensin Ⅰ and angiotensin Ⅱ in patients with hypertension and hypertension combined with coronary heart disease

目的探讨单纯高血压病及高血压病合并冠心病患者血清醛固酮(ALD)、血管紧张素Ⅰ(AngⅠ)及血管紧张素Ⅱ(AngⅡ)水平,了解其与高血压病分级及冠状动脉受累程度的关系。方法纳入108例患者,其中单纯高血压病组81例,分为高血压病2级亚组(n=28)及高血压病3级亚组(n=53);高血压病合并冠心病组27例,分为1支病变亚组(n=9)、2支病变亚组(n=10)及3支病变亚组(n=8),用放射免疫法测定各组血清ALD、AngⅠ及AngⅡ含量。结果高血压病合并冠心病组血清ALD高于单纯高血压病组,差异有统计学意义(P<0.05),而AngⅠ及AngⅡ水平差异无统计学意义(P>0.05)。单纯高血压病组中,高血压病3级亚组血清ALD、AngⅠ及AngⅡ水平均明显高于高血压病2级亚组,差异有统计学意义(P<0.05,P<0.01)。高血压病合并冠心病组中,3支病变亚组血清ALD、AngⅡ水平明显高于1支病变亚组及2支病变亚组,差异有统计学意义(P<0.05)。2组中应用ACEI/ARB与未应用ACEI/ARB患者比较,上述3项指标差异均无统计学意义(P>0.05)。结论同时测量ALD、AngⅠ及AngⅡ水平有助于评估高血压病的分级及冠状动脉受累的严重程度。

Objective To observe the level of plasma aldosterone（ALD）,angiotensinⅠ（AngⅠ） and angiotensinⅡ（AngⅡ） detected in patients with hypertension and hypertension combined with coronary heart disease（CHD）,also investigate the relationship between them.Methods 108 patients with essential hypertension were enrolled in the study.The plasma level of ALD,AngⅠand AngⅡwere detected in 81 patients with single hypertension and in 27 patients combined with coronary heart disease by RIA.Depending on the level of blood pressure,81 single hypertension patients were divided into 2 sub-groups： gradeⅡ（n =28） and gradeⅢ（n =53）.27 patients who underwent coronary angiography and diagnosed of CHD were divided into 3 sub-groups：single vessel group（n =9）,2 vessels group（n =10） and 3 vessels and /or left main artery lesions group（n =8）.Results The plasma level of ALD in patients combined with coronary heart disease were significant higher than those of single hypertension patients（P0.05 ）,while there were no statistical differences between the level of AngⅠand AngⅡ.The plasma level of ALD,AngⅠand AngⅡin patients with gradeⅢhypertension were significantly higher than those of gradeⅡhypertension in essential hypertension group（P0.05,P0.01 ）.In the hypertension combined CHD group,the plasma level of ALD and AngⅡin patients with 3 vessels and/or left main artery lesions were significantly higher than those with single vessel and 2 vessels disease（P0.05）.There were no statistical differences of the 3 index in both groups whether the patients take the ACEI/ARB or not（P0.05）.Conclusion Dynamic observation the level of ALD,AngⅠand AngⅡmay be very useful in assessment of severity and prognosis of patients with hypertension and coronary heart disease.