原发性高血压合并心房颤动患者血管紧张素Ⅱ、尿酸、心功能指标及血压测量值的特征分析

Study on the characteristic features of AngⅡ,uric acid,cardiac function and blood pressure in patients with primary hypertension and atrial fibrillation

目的分析原发性高血压合并心房颤动(下称房颤)患者血浆血管紧张素Ⅱ(AngⅡ)、血清尿酸、心功能指标及血压测量值的特征。方法选择2017年3月至2020年8月浙江衢化医院的原发性高血压患者180例,根据其是否伴房颤,分成观察组和对照组各90例。比较两组患者AngⅡ、血清尿酸、超声心功能和血压。分析血浆AngⅡ、血清尿酸、心功能参数与原发性高血压患者房颤发生的关系。结果观察组患者24 h平均收缩压(24 h SBP)、日间最大收缩压(dHSBP)、日间最小收缩压(dLSBP)、日间最小舒张压(dLDBP)、夜间最大收缩压(nHSBP)、夜间最小舒张压(nLDBP)测定值均高于对照组患者,差异均有统计学意义(均P<0.05)。观察组血浆AngⅡ水平高于对照组,差异有统计学意义(P<0.05)。两组患者血清尿酸水平比较,差异无统计学意义(P>0.05)。观察组LAD、LVEDd、LVMI测定值高于对照组,LVEF低于对照组,差异均有统计学意义(均P<0.05)。结论原发性高血压合并房颤患者血浆AngⅡ水平较高,心功能受损、血压的昼夜节律改变较单纯原发性高血压患者更显著。

Objective To investigate the changes of plasma angiotensinⅡ(AngⅡ),serum uric acid(UA),cardiac function and blood pressure in patients with primary hypertension and atrial fibrillation(AF).Methods A total of 180 patients with primary hypertension from March 2017 to August 2020 in Zhejiang Quhua Hospital were selected.They were assigned to the observation group(observation group,n=90)and control group(n=90)based on whether they have atrial fibrillation.Compare the plasma AngⅡ,serum UA,echocardiographic function parameters and blood pressure of the two groups.The relationship between plasma AngⅡ,serum UA and cardiac function parameters and the occurrence of atrial fibrillation in patients with primary hypertension were analyzed.Results The measured values of 24 h SBP,dHSBP,dLSBP,dLDBP,nHSBP,and nLDBP in the observation group were significantly higher than those in the control group(P<0.05).Plasma AngII level was significantly higher in the observation group compared with the control group(P<0.05).However,the serum UA level was similar in both groups(P>0.05).The left atrial diameter(LAD),LV end-diastolic diameter(LVEDd)and LV mass index(LVMI)were higher than the control group(P<0.05).However,the LV ejection fraction(LVEF)was significantly lower than that of the control group(P<0.05).Conclusion Patients with primary hypertension and atrial fibrillation have higher plasma AngⅡlevel,UA level,more impaired cardiac function,and more significantly changed circadian rhythm of blood pressure compared with those with simple primary hypertension.