高血压合并抑郁症患者血浆肾素-血管紧张素Ⅱ-醛固酮及心率变异性水平变化的分析

Analysis of changes in plasma renin-angiotensinⅡ-aldosterone and heart rate variability in hypertension combined with depression patients

目的探究肾素-血管紧张素Ⅱ-醛固酮及心率变异性水平在高血压合并抑郁症患者中的变化。方法选取2018年5月~2019年6月广西壮族自治区脑科医院(以下简称"我院")51例高血压患者,依据有无合并抑郁症分为高血压合并抑郁症组(21例)及单纯高血压组(30例),另选我院同期健康人群30名作为对照组。检测分析三组人群血浆肾素、血管紧张素Ⅱ、醛固酮浓度及心率变异性指标[正常相邻RR间期标准差(SDNN)、相邻RR间期差值均方的平方根(RMSSD)、相邻RR间期>50 ms的百分比(PNN50)]。结果高血压合并抑郁症组及单纯高血压组的肾素、血管紧张素Ⅱ、醛固酮水平高于对照组,且高血压合并抑郁症组肾素、醛固酮水平高于单纯高血压组,差异有统计学意义(P<0.05)。高血压合并抑郁症组和单纯高血压组SDNN、RMSSD、PNN50均高于对照组,且高血压合并抑郁组低于单纯高血压组,差异有统计学意义(P<0.05)。结论高血压合并抑郁症及单纯高血压患者肾素、血管紧张素Ⅱ、醛固酮水平明显升高,心率变异性水平降低,且高血压合并抑郁症患者变化幅度更大。肾素-血管紧张素系统和自主神经功能紊乱的共同作用可能是高血压合并抑郁症的病理生理机制。

Objective To investigate the changes of renin-angiotensinⅡ-aldosterone and heart rate variability in hypertension combined with depression patients.Methods A total of 51 patients with hypertension in the Guangxi Zhuang Autonomous Region Brain Hospital(hereinafter referred to as"our hospital")from May 2018 to June 2019 were selected.According to the presence or absence of depression,they were divided into hypertension combined with depression group(21 cases)and simple hypertension group(30 cases),while a total of 30 healthy people in the same period in our hospital were selected as the control group.Plasma renin,angiotensinⅡ,aldosterone concentration and heart rate variability indicators[standard deviation of normal adjacent RR interval(SDNN),square root of the difference between adjacent RR intervals(RMSSD),the percentage of adjacent RR intervals>50 ms(PNN50)]in three groups were detected and analyzed.Results The levels of renin,angiotensinⅡand aldosterone in hypertension combined with depression group and simple hypertension group were higher than those in the control group,while the levels of renin,aldosterone in hypertension combined with depression group were higher than those in simple hypertension group,and the differences were statistically significant(P<0.05).The SDNN,RMSSD,and PNN50 of the hypertension combined with depression group and the simple hypertension group were higher than those in the control group,while the hypertension combined with depression group was lower than the simple hypertension group,and the differences were statistically significant(P<0.05).Conclusion The levels of renin,angiotensinⅡand aldosterone in patients of hypertension combined with depression and simple hypertension are significantly increased,while the level of heart rate variability decreased,and the changes in hypertension combined with depression patients are greater.The joint action of renin-angiotensin system and autonomic dysfunction may be the pathophysiological mechanism of hypertension combined with depression.