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

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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。 Objective: To investigate the characteristics and clinical significance of abnormal plasma renin activity (PRA), angiotensin Ⅱ (Ang Ⅱ) and aldosterone (Aldo) secretion in patients with hypertension complicated with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: Ninety-six inpatients with essential hypertension were enrolled in this study. Polysomnography, plasma PRA, angiotensin II (AngⅡ) and Aldo were analyzed. According to the sleep apnea-hypopnea index (AHI), subjects were divided into mild OSAHS group (n = 46) and moderate-severe OSAHS group (n = 50). Plasma PRA, AngⅡ and Aldo were compared. PRA, Ang Ⅱ and Aldo concentrations compared. Results: There was no significant difference in plasma PRA and AngⅡ between hypertensive patients and OSAHS patients with moderate or severe OSAHS ([211 ± 85] ng / L], compared with 175 ± 58 ng / L] (P <0.05). After stratified by age, plasma PRA in different age groups was significantly lower than that in patients with simple hypertension (P <0.01), and plasma Aldo concentration was significantly increased (P <0.01). CONCLUSIONS: Plasma Aldo concentrations in patients with essential hypertension complicated with OSAHS are significantly elevated. The plasma concentrations of PRA, Ang II and Aldo are significantly different from those in patients with essential hypertension alone.
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