原发性醛固酮增多症左心室肥厚及相关影响因素分析

Increased left ventricular mass and its associated factors in patients with primary aldosteronism

目的探讨原发性醛固酮增多症（原醛）患者的并发症情况，分析原醛患者左心室肥厚的相关因素。方法对93例原发性醛固酮增多症（原醛组）患者及同期住院的84例原发性高血压（原高组）患者的临床资料进行回顾性分析。结果（1）与原高组患者相比，原醛组患者血钙水平更低（P〈0．05），但脂代谢异常程度较轻。（2）原醛组患者左心室肥厚较原高组患者严重，相关分析显示，原醛组患者的左心室质量与低血钾病程（r=0．983，P〈0．01）、立位醛固酮水平（r=0．993，P〈0．01）呈显著正相关，而与血钾（r=-0．993，P〈0．01）呈显著负相关。结论原醛组患者与原高组患者相比血钙水平更低，左心室肥厚更严重，但脂代谢异常程度较轻；原醛组患者的左心室质量与低血钾病程、立位醛固酮水平和血钾水平具有相关性。

Objectives The aim of this study was to evaluate the cormorbidities in patients with primary aldosteronism（PA） and to explore the factors associated with left ventricular hypertrophy（LVH） in patients with PA. Methods We retrieved records of 93 cases with PA and 84 controls with essential hypertension （EH）. Results （ 1 ） Compared with EH, the plasma calcium level was lower in patients with PA（P 〈0.05 ）. However, the patients with EH had severer dyslipidemia,manifesting as higher levels of TG ,LDL,Apo-A1 and Apo-B （all P 〈 0.05 ）. （2）The patients with PA had severer left ventricular hyper- trophy compared with the patients with EH with a larger left ventrieular end - diastolic dimension （LVEDd）. Correlation analysis demonstrated a correlation between the left ventrieular mass（LVM） and duration of hypokalemia, plasma potassium and plasma aldosterone（ upright position） in patients with PA. Conclusion Patients with PA had lower plasma calcium and severer left ventricular hypertrophy. The left ventricular mass of patients with PA was correlated with duration of hypokalemia, plasma potassium and plasma aldosterone （upright）.