老年高血压伴抑郁患者血管紧张素Ⅱ和皮质醇与动态血压的变化

The changes of ambulatory blood pressure,angiotensin Ⅱ and cortisol in the elderly hypertensive patients with depression

目的:探讨老年高血压伴抑郁患者动态血压、血管紧张素Ⅱ、皮质醇的变化及其与高血压、抑郁症的关系。方法:以来自南京市市级机关医院老年科高血压住院患者180例为研究对象,分为老年高血压伴抑郁组(90例)和老年高血压组(90例),测量诊室血压和动态血压,采用放射免疫分析法测定血浆肾素活性、血管紧张素Ⅱ、皮质醇水平。结果:老年高血压组和老年高血压伴抑郁组24 h动态血压监测和诊室血压均显示以收缩压升高为主的单纯收缩期高血压。老年高血压伴抑郁组血管紧张素Ⅱ、皮质醇水平明显高于老年高血压组(P<0.01)。老年高血压伴抑郁组血管紧张素Ⅱ(r=0.351,P<0.01)、皮质醇(r=0.316,P<0.01)均与汉密尔顿抑郁量表(HAMD)总分存在正相关关系。结论:血管紧张素Ⅱ、皮质醇参与了老年高血压伴抑郁的病理生理过程。

Objective：To explore the changes of ambulatory blood pressure,angiotensin Ⅱ and cortisol levels in the elderly hypertensive patients with depression,and the relationship of angiotensin Ⅱ,cortisol and hypertension,depression.Methods：One hundred and eighty elderly patients selected from Department of Geriatrics,Nanjing Governmental Hospital were divided into two groups：hypertension complicated with depression（HD） group and hypertension（H） group,90 cases in each group,the office blood pressure and the ambulatory blood pressure were measured,and the plasma angiotensin Ⅱ,cortisol levels were detected by radioimmunoassay.Results：According to 24-hour ambulatory blood pressure and office blood pressure,pure systolic hypertension were indicated by the elevation of systolic pressure in both groups.The levels of angiotensin Ⅱ and cortisol were significantly higher in HD group than those in H group（P 〈 0.01）.The levels of angiotensin Ⅱ（r = 0.351,P 〈 0.01） and cortisol（r = 0.316,P 〈 0.01） had positive correlation with HAMD score in HD group.Conclusion：Angiotensin Ⅱ,cortisol might be involved in pathophysiology of hypertension complicated with depression in elderly population. 更多