醛固酮与肾素比值与原发性高血压患者肾损害的相关性研究

Correlation between Aldosterone to Renin Ratio and the Renal Damage in Essential Hypertension Patients

目的探讨醛固酮与肾素比值(aldosterone to renin ratio,ARR)与原发性高血压患者肾损害之间的关系。方法从2021年4月云南省昆明市安宁市参加“中国居民心血管病及其危险因素监测项目(2020)”的18岁以上居民中筛选出符合要求的原发性高血压患者201例,按ARR[(ng/dl)/(μIU/ml)]高低等分为3组,每组各67例,即A组ARR<0.44,B组0.44≤ARR≤0.92,C组ARR>0.92。采用多元线性逐步回归分析原发性高血压患者肾损害的影响因素。结果Pearson相关分析结果表明,ARR与估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)存在相关性(r=-0.225,P=0.001)。进一步多元线性逐步回归分析结果表明,ARR(β=-1.61,P=0.013)、血尿酸(β=-0.219,P=0.001)、血钾(β=-0.221,P=0.001)、收缩压(β=-0.297,P<0.001)与eGFR呈独立负相关,而舒张压(β=0.277,P<0.001)、BMI(β=0.133,P=0.037)与eGFR呈独立正相关。结论ARR与原发性高血压患者肾损害独立相关,ARR越高的原发性高血压患者肾损害越严重。

Objective To investigate the correlation between aldosterone to renin ratio(ARR)and renal damage in essential hypertension patients.Methods 201 essential hypertension patients were selected among the residents over the age of 18 in Anning,Kunming,Yunnan Province who participated in the Chinese Residents′Cardiovascular Disease and Risk Factors Monitoring Project(2020)in April 2021.We divided them into three groups according to the level of ARR[(ng/dl)/(μIU/ml)],67 cases in each group:group A ARR<0.44,group B ARR:0.44-0.92,group C ARR>0.92.Diversified linear stepwise regression analysis was used to investigate the influencing factors of renal damage in essential hypertension patients.Results The results of Pearson correlation analysis show that ARR was correlated with eGFR(r=-0.225,P=0.001).The results of diversified linear stepwise regression analysis showed that ARR(β=-1.61,P=0.013),blood uric acid(β=-0.219,P=0.001),blood potassium(β=-0.221,P=0.001),systolic blood pressure(β=-0.297,P<0.001)were independently negatively correlated with eGFR,while diastolic blood pressure(β=0.277,P<0.001),BMI(β=0.133,P=0.037)were independently positively correlated with eGFR.Conclusion ARR is independently associated with renal damage in essential hypertension patients.Essential hypertension patients with high ARR have more severe renal damage.