COPD性高血压患者肾素-血管紧张素-醛固酮水平的临床研究

Clinical study on the renin⁃angiotensin⁃aldosterone system in patients with COPD induced hypertension

目的探讨慢性阻塞性肺病(COPD)性高血压患者肾素-血管紧张素-醛固酮(RAAS)水平及其与高血压的关系。方法选取2018年3月至2019年9月期间于本院收治的COPD性高血压患者80例作为研究组,另收集同期收治于本院的COPD未伴发高血压患者80例,以及在本院进行健康体检的人群35例作为对照,分别划分为COPD组和健康组,比较三组一般资料情况,并测定和比较三组血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)水平,分析PRA、AngⅡ和ALD水平与高血压之间的关系。结果研究组的收缩压、舒张压、脑卒中发生率、合并冠心病和高脂血症的占比均明显高于COPD组和健康组,差异均有统计学意义(P均<0.05);研究组PRA、AngⅡ和ALD水平>COPD组>健康组,差异均有统计学意义(P<0.05);不同病情COPD患者血压、RAAS系统水平存在明显差异,差异有统计学意义(P<0.05);相关性分析结果显示,血浆PRA、AngⅡ和ALD水平分别与收缩压、舒张压呈明显正相关性,差异均有统计学意义(P<0.05);且三指标水平之间互为正相关关系(P<0.05)。结论 COPD性高血压患者体内存在RAAS过度激活,并与患者血压存在明显正相关性。

Objective To investigate the renin⁃angiotensin⁃aldosterone system(RAAS)in patients with chronic obstructive pulmonary disease(COPD)and hypertension and its relationship with COPD induced hypertension.Methods A total of 80 patients with COPD induced hypertension admitted to the hospital from March 2018 to September 2019 were selected and included in the study group.Another 80 patients with COPD and without hypertension admitted to the hospital during the same period were selected and included in the COPD group.35 healthy people were selected and included in the healthy group.The general data of the three groups were compared.The plasma renin activity(PRA),angiotensinⅡ(AngII)and aldosterone(ALD)lev⁃els in the 3 groups were determined and compared.The relationship between PRA,AngII and ALD levels and hypertension was analyzed.Results The systolic blood pressure,diastolic blood pressure,incidence rate of stroke,proportions of patients with coronary heart disease and hyperlipidemia in the study group were signifi⁃cantly higher than those in COPD group and the healthy group(P<0.05).The levels of PRA,AngⅡand ALD were the highest in study group,followed by the COPD group and the healthy group(P<0.05).There were sig⁃nificant differences in blood pressure and RAAS system among COPD patients with different conditions(P<0.05).Correlation analysis showed that the plasma PRA,AngⅡAnd ALD levels were significantly positively correlated with systolic blood pressure and diastolic blood pressure(P<0.05).In addition,the three indexes were positively correlated with each other(P<0.05).Conclusion There is over⁃activation of RAAS in pa⁃tients with COPD induced hypertension,which is significantly positively correlated with blood pressure.