糖脂代谢及肾素血管紧张素醛固酮系统指标检测在高血压诊断中的应用效果

Application effect of glucose and lipid metabolism and renin angiotensin aldosterone system indicators in the diagnosis of hypertension

目的探讨糖脂代谢及肾素血管紧张素醛固酮系统(RAAS)指标检测在高血压诊断中的应用效果。方法选取2019年6月至2021年6月淮安市中医院收治的95例原发性高血压患者作为研究对象,按照血压水平不同分为轻度高血压组(n=32)、中度高血压组(n=37)与重度高血压组(n=26),另选取同期于本院体检的80名健康者作为对照组。比较4组卧位、立位血浆肾素浓度(PRC)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)及空腹血糖(FPG)、稳态模型评估-胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、总胆固醇(TC)、空腹胰岛素(FIns)水平。结果4组卧位、立位PRC、AngⅡ、ALD水平比较差异有统计学意义(P<0.05)。4组立位PRC、AngⅡ、ALD水平均高于卧位,差异有统计学意义(P<0.05)。重度高血压组、中度高血压组、轻度高血压组卧位、立位PRC、AngⅡ、ALD水平均高于对照组,且重度高血压组、中度高血压组均高于轻度高血压组,重度高血压组高于中度高血压组,差异有统计学意义(P<0.05)。4组FPG、HOMA-IR、TG、TC、FIns水平比较差异有统计学意义(P<0.05)。重度高血压组、中度高血压组、轻度高血压组FPG、HOMA-IR、TG、TC及FIns水平均高于对照组,重度高血压组、中度高血压组均高于轻度高血压组,重度高血压组高于中度高血压组,差异有统计学意义(P<0.05)。结论高血压患者PRC、AngⅡ、ALD及FPG、HOMA-IR、TG、TC、FIns水平较高,且随着病情进展各指标水平不断升高,临床可通过检测糖脂代谢及RAAS指标诊断和评估高血压。

Objective To investigate the effect of glucose and lipid metabolism and renin angiotensin aldosterone system(RAAS)in the diagno-sis of hypertension.Methods A total of 95 patients with essential hypertension who were treated in Huai'an Hospital of Traditional Chinese Medi-cine from June 2019 to June 2021 were selected as the study subjects,and they were divided into the mild hypertension group(n=32),moderate hy-pertension group(n=37)and severe hypertension group(n=26)according to different blood pressure levels;another of 80 healthy subjects who had physical examination in our Hospital were selected as the control group.The plasma renin concentration(PRC),angiotensinⅡ(AngⅡ),aldosterone(ALD),fasting plasma glucose(FPG),homeostasis model assessment-insulin resistance index(HOMA-IR),triglyceride(TG),total cholesterol(TC)and fasting insulin(FIns)levels were compared among the four groups.Results There were significant differences in the levels of preposition,stand-ing PRC,AngⅡand ALD among the four groups(P<0.05).The levels of PRC,AngⅡand ALD in standing position were higher than those in lying position among the four groups,and the differences were statistically significant(P<0.05).The levels of decubitus,orthostatic PRC,AngⅡand ALD in the severe hypertension group,moderate hypertension group and mild hypertension group were higher than those in the control group,and the severe hypertension group and moderate hypertension group were higher than the mild hypertension group,and the severe hypertension group was higher than the moderate hypertension group,and the differences were statistically significant(P<0.05).There were significant differences in FPG,HOMA-IR,TG,TC and FIns among the four groups(P<0.05).The levels of FPG,HOMA-IR,TG,TC and Fins in the severe hypertension group,moderate hypertension group and mild hypertension group were higher than those in the control group,the severe hypertension group and moderate hypertension group were higher than the mild hypertension group,and the severe hypertension group was higher than the moderate hyper-tension group,the differences were statistically significant(P<0.05).Conclusion The levels of PRC,AngⅡ,ALD,FPG,HOMA-IR,TG,TC and FIns in patients with hypertension are high,and with the progression of the disease,the level of each index increased continuously,hypertension can be diagnosed and assessed by detecting glucose and lipid metabolism and RAAS indicators.