肾素-血管紧张素-醛固酮系统在原发性高血压病中的表达

The Expression of Renin-angiotensin-aldosterone System in Primary Hypertension

目的:探讨血浆肾素-血管紧张素系统与原发性高血压病的关系。方法:采用放射免疫分析卧位血浆肾素活性(PRA),卧位血管紧张素Ⅱ(AngⅡ)浓度及卧立位醛固酮(ALD)浓度。使用病例-正常对照研究方案,筛选100例原发性高血压患者和我院35例血压正常者为对照组。结果:原发性高血压患者血浆卧位PRA低于正常对照组(P<0.05),而卧、立位ALD浓度及卧位AngⅡ浓度均高于正常对照组(P<0.05)。根据高血压病1级、2级、3级分组,卧位血浆PRA呈阶梯型下降(P<0.05);而卧、立位ALD浓度及卧位AngⅡ浓度则呈阶梯型上升(P<0.05)。结论:肾素-血管紧张素-醛固酮系统与原发性高血压病的病因关系密切,血浆PRA水平、AngⅡ及卧、立位ALD浓度可能成为原发性高血压病分级和疗效的有效指标之一;降低原发性高血压患者AngⅡ及ALD浓度是治疗高血压病的关键。

Objective To explore the correlation between primary hypertension and renin-angiotensin-aldosterone system （RAAS） in patients. Methods The plasma levels of renin activity in supine（PRA） ,angiotensin Ⅱ in supine and aldosterone in su- pine and standing（ALD） were measured with RIA, Using a case-normal study program, 100 patients with primary hypertension were compared to 35 normal controls. Results The plasma level of PRA in supine of the hypertensive patients was significantly lower than that of controls （P 〈 0.05）, but the plasma levels of Ang Ⅱ in supine and ALD in supine were obviously higher （P 〈 0.05）. With the severity of their blood pressure, the plasma level of PRA in supine decreased, but the plasma levels of Ang Ⅱ in supine and ALD in su- pine and standing increased and showed statistical difference between the groups （P 〈 0.05） . Conclusion There was a strong asso- ciation between etiology of primary hypertension and RAAS. Plasma PRA, Ang Ⅱand ALD likely to become one of the classification of primary hypertension and efficacy of an effective indicator. The reduction of Ang Ⅱ and ALD are critical events in the treatment of hy- pertension.