原发性高血压病患者肾素-血管紧张素-醛固酮系统活性的影响因素

Influential factors of renin-angiotensin-aldosterone system in patients with essential hypertension

目的：探讨原发性高血压病患者血浆肾素-血管紧张素Ⅱ-醛固酮水平的影响因素。方法：原发性高血压病男性患者100例分别按高血压级别、年龄及体质量指数（body mass index,BMI）进行分组,采用放射免疫方法测定立位、卧位血浆肾素活性（plasma renin activity,PRA）,血管紧张素Ⅱ（angiotensinⅡ,AngⅡ）及醛固酮（aldosteronism,ALD）浓度。采用多元线性回归模型分析年龄、身高、体质量、收缩压、舒张压与原发性高血压病患者血浆PRA,AngⅡ及ALD水平的关系。结果：在高血压病1,2,3级3个亚组间,血浆PRA水平均依次降低（P〈0.05）;而AngⅡ及血浆ALD依次升高（P〈0.05）。在年龄≤50岁、〉50~60岁和年龄〉60岁3组间血浆PRA,AngⅡ及ALD水平均依次降低（P〈0.05）。在BMI≤24 kg/m2,〉24~28 kg/m2和〉28 kg/m23组间血浆PRA,AngⅡ及ALD水平差异均无统计学意义（P〉0.05）。多元线性回归分析显示收缩压、舒张压为AngⅡ及ALD的正性独立预测因子,而年龄是AngⅡ及ALD的负性独立预测因子;年龄、收缩压、舒张压均是血浆PRA的负性独立预测因子。身高、体质量、BMI与高血压患者血浆PRA,AngⅡ及ALD水平无相关性。结论：高血压病患者存在肾素-血管紧张素-醛固酮系统的过度激活,激活程度主要与年龄、血压有相关性。

Objective To study the influential factors of renin-angiotensin-aldosterone system in essential hypertension.Methods One hundred patients with essential hypertension were divided into groups according to blood pressure grades,ages and body mass indexes.The levels of plasma renin activity,angiotensin Ⅱ and aldosterone were measured with radioimmunoassay at erect and decubitus position.Multiple linear regression analysis was performed to evaluate the relationships of age,height,body mass,systolic blood pressure and diastolic blood pressure with plasma renin activity,angiotensin Ⅱ and aldosterone.Results With the severity of the blood pressure,the levels of plasma renin activity decreased,but angiotensin Ⅱ and aldosterone increased,which showed significant differences in three hypertension groups（P0.05）.The levels of plasma renin activity,angiotensin Ⅱ and aldosterone decreased with the aging in three different ages groups（P0.01）,and showed no significant differences in three different body mass index groups（P0.05）.Multiple linear regression analysis showed systolic blood pressure and diastolic blood pressure were the positive independent predictors,and the age was the negative independent predictor for angiotensin Ⅱ and aldosterone.The age,systolic blood pressure and diastolic blood pressure were the negative independent predictors for plasma renin activity.The height,body mass and body mass index were not correlated with plasma renin activity,angiotensin Ⅱ and aldosterone.Conclusion The over-reactivity of renin-angiotensin-aldosterone system could be observed in patients with essential hypertension,which is closely correlated with the age and blood pressure.