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高血压病并发阻塞性睡眠呼吸暂停低通气综合征患者血浆肾素-血管紧张素Ⅱ-醛固酮的变化

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2009年第6期
页码:
834-837
栏目:
临床研究
出版日期:
2009-11-05

文章信息/Info

Title:
Determination of plasma level of renin-angiotensin II-aldosterone in hypertensive patients with obstructive sleep apnea-hypopnea syndrome
作者:
高燕1; 涂向东2; 魏卫平1; 张立波1; 宋晓华1; 向红利1
深圳市蛇口人民医院:1.心内科，2.耳鼻喉科，广东 深圳 518067
Author(s):
GAO Yan1;  TU Xiang-dong2;  WEI Wei-ping1;  ZHANG Li-bo1;  SONG Xiao-hua1;  XIANG Hong-li1
1.Department of Cardiovascular Medicine, 2.Department of Otolaryngology, Shenzhen Shekou People’s Hospital, Shenzhen 518067, Guangdong, China
关键词:
高血压病; 阻塞性睡眠呼吸暂停低通气综合征; 血浆肾素活性; 血管紧张素Ⅱ; 醛固酮
Keywords:
hypertension;  obstructive sleep apnea-hypopnea syndrome;  plasma renin activity;  angiotensin II;  aldosterone
分类号:
R544.1
DOI:
-
文献标识码:
A
摘要:
目的: 探讨高血压病并发阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血浆肾素活性（PRA）、血管紧张素Ⅱ（AngⅡ）、醛固酮（Aldo）分泌异常的特点及其临床意义。方法: 高血压病并发OSAHS住院患者96 例,进行多导睡眠监测及其血浆PRA、AngⅡ及Aldo结果分析。根据睡眠呼吸暂停低通气指数(AHI)将研究对象分为轻度OSAHS组46例和中重度OSAHS组50例, 进行血浆PRA，AngⅡ及Aldo比较；并按年龄分层与单纯高血压病患者的PRA，AngⅡ及Aldo浓度比较。结果: 高血压病并发不同程度的OSAHS患者的血浆PRA，AngⅡ浓度比较无显著差异，中重度OSAHS组的Aldo浓度［(211±85)ng/L］较轻度组［(175±58)ng/L］明显升高(P<0.05);按年龄分层后与同血压水平的单纯高血压病比较，其不同年龄段的血浆PRA均明显降低(P<0.01),血浆Aldo浓度明显升高 (P<0.01)。结论: 高血压病并发OSAHS患者的血浆Aldo浓度明显升高，其血浆PRA，AngⅡ及Aldo浓度较单纯高血压病患者具有明显差异性。
Abstract:
AIM: To investigate the characteristics and level of renin-angiotensin II-aldosterone system in hypertensive patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: Ninety-six hypertensive inpatients with OSAHS were included for polysomnography and quantitative analysis of plasma level of renin, angiotensin II and aldosterone. All subjects were divided into two groups based on the apnea-hypopnea index (AHI), one mild group with 46 cases and the other moderate-to severe group with 50 cases. Comparison of serum level of renin, angiotensin II and aldosterone was made between groups. All the above three parameters were compared among all included subjects based on age stratification. RESULTS: No significant difference in serum level of renin and angiotensin II was found between groups, whereas a significant difference was observed in aldosterone level ［(211±85) ng/L vs. (175±58) ng/L, P<0.05］. Significantly higher serum level of aldosterone and lower level of renin were found in hypertensive patients with OSAHS compared with those with simple hypertension based on age stratification (P<0.01). CONCLUSION: Serum level of aldosterone is significantly elevated in hypertensive patients with OASHS and serum levels of renin and aldosterone are also significantly higher than those of patients with simple hypertension.

参考文献/References

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［6］ Follenius M, Krieger J, Krauth MO, et al. Obstructive sleep apnea treatment: peripheral and central effects on plasma renin activity and aldosterone［J］. Sleep, 1991, 14(3):211-217.

［7］ 张健,叶珏,裴卫东,等. 不同程度阻塞性睡眠呼吸暂停合并高血压与血管紧张素转换酶基因I/D多态性的比较研究［J］. 高血压杂志, 2000, 8(2):129-131.

［8］ Saini J, Krieger J, Brandenberger G, et al. Continuous positive airway pressure treatment. Effects on growth hormone, insulin and glucose profiles in obstructive sleep apnea patients［J］. Horm Metab Res, 1993, 25(7):375-381.

备注/Memo

备注/Memo:
收稿日期：2008-8-17.作者简介：高燕，副主任医师Email：gaoyan_0222@163.com
更新日期/Last Update: 2009-09-30