高血压伴不明原因低钾血症的相关因素分析

Analysis of related factors of hypertension complicated with unexplained hypokalemia

目的 了解高血压伴不明原因低钾血症的影响因素,探讨高血压可能的继发原因。方法 回顾性分析2014年1月至2016年12月在上海交通大学医学院附属瑞金医院北院高血压科住院的78例高血压伴不明原因低钾血症患者临床资料,2014年1月至2015年12月住院的80例原发性高血压并血钾4.0~5.0 mmol/L的患者为对照组。通过logistic回归分析高血压伴不明原因低钾血症的影响因素。结果 不明原因低钾血症组患者年龄(44.56±12.28)岁小于对照组(50.62±13.47)岁,收缩压、舒张压、碳酸氢盐数值、吸烟人数、尿白蛋白/肌酐比值、24 h尿蛋白定量、尿α1微球蛋白、血激发醛固酮、尿醛固酮水平均明显高于对照组,且以上差异均有统计学意义(均P <0.05)。logistic回归分析显示醛固酮水平、碳酸氢盐值、尿α1微球蛋白是高血压患者发生低钾血症的危险因素。结论 激发醛固酮、碳酸氢盐、尿α微球蛋白为低钾血症的危险因素。

Objective To analyze the influencing factors of hypertension with unexplained hypokalemia,and explore the possible secondary causes of hypertension.Methods Retrospective analysis of the clinical data of 78 patients with hypertension and unexplained hypokalemia hospitalized in the department of Hypertension,Ruijin Hospital North from January 2014 to December 2016.80 patients with essential hypertension and blood potassium 4.0~5.0 mmol/L were randomly selected as control group from January 2014 to December 2015.The influencing factors of hypertension with unexplained hypokalemia were analyzed by logistic regression.Results Compared with the control group,the age of unexplained hypokalemia group was younger[(44.56+12.28)vs(50.62+13.47)years old(P<0.01)];blood pressure,bicarbonate,smoking,urinary albumin creatinine ratio(UACR),24-hour urinary protein,urine urinary alpha-1 microglobulin,blood stimulated aldosterone(Aldo),urine aldosterone((U-aldo)were significantly higher than those of control group(P<0.05).Logistic regression analysis showed that stimulated aldosterone,bicarbonate and urinary alpha-1 microglobulin were risk factors for hypokalemia in patients with hypertension.Conclusion Stimulated aldosterone,bicarbonate and urinary alpha1 microglobulin are risk factors for hypokalemia.