附属第三医院心血管内科,广东,广州,510603
网络首发:2020-09-11,
纸质出版:2020
移动端阅览
吴俊宸, 黄卓山, 朱洁明, 等. 阻塞性睡眠呼吸暂停与肾素-血管紧张素-醛固酮系统的相关性[J]. 中山大学学报(医学科学版), 2020,41(5).
WU Jun-chen, HUANG Zhuo-shan, ZHU Jie-ming, et al. Correlation between Obstructive Sleep Apnea Syndrome and Renin-Angiotensin-Aldosterone System[J]. Journal of Sun Yat-sen University (Medical Sciences), 2020, 41(5).
吴俊宸, 黄卓山, 朱洁明, 等. 阻塞性睡眠呼吸暂停与肾素-血管紧张素-醛固酮系统的相关性[J]. 中山大学学报(医学科学版), 2020,41(5). DOI:
WU Jun-chen, HUANG Zhuo-shan, ZHU Jie-ming, et al. Correlation between Obstructive Sleep Apnea Syndrome and Renin-Angiotensin-Aldosterone System[J]. Journal of Sun Yat-sen University (Medical Sciences), 2020, 41(5). DOI:
【目的】探讨不同程度阻塞性睡眠呼吸暂停(OSAS)的高血压患者肾素、血管紧张素Ⅱ 、醛固酮的水平是否与血压水平相关。【方法】选取 2018 年 11 月至 2019 年 12 月在中山大学附属第三医院心内科住院的初次诊断为高血压并完善了睡眠呼吸监测的患者,排除继发性高血压、NYHA Ⅱ-Ⅳ级心力衰竭、停用影响RAAS 激素水平药物未达 1 月的患者。OSAS 的严重程度采用阻塞性睡眠呼吸暂停低通气指数(AHI)表示,检测患者卧位血浆肾素浓度、血管紧张素Ⅱ和醛固酮水平,记录患者入院后使用降压药前所测量的血压。根据AHI 水平将患者分为两组,其中 A 组 AHI<15,代表无或轻度 OSAS 患者,B 组 AHI≥15,代表中重度 OSAS 患者。对比两组患者卧位的肾素、血管紧张素Ⅱ、醛固酮水平以及用药前血压的差异。通过线性相关分析与多因素分析,探究 OSAS 严重程度与 RAAS、血压的相关性。【结果】线性相关分析显示,AHI 与醛固酮(rs=0.215,P= 0.011)、肾素(rs=0.233,P=0.006)、ANGⅡ(rs=0.138,P=0.004)存在正相关性;AHI 与收缩压(rs=0.306,P<0.001)、平均动脉压(rs=0.263,P=0.002)存在正相关性;收缩压与肾素(rs=0.288,P=0.001)存在正相关性;舒张压与肾素(rs= 0.213,P=0.012)存在正相关性。进一步经多因素校正后醛固酮仍与 AHI 正相关(β =0.160,P=0.035)。【结论】 OSAS 严重程度与 RASS 激活密切相关,特别是与醛固酮水平相关。OSAS 主要影响患者的收缩压和平均动脉压。醛固酮受体拮抗剂对于此类高血压患者的血压控制可能更好。
【Objective】To explore the association between blood pressure and the plasma levels of renin,angiotensin Ⅱ and aldosterone in hypertensive patients with different degrees of obstructive sleep apnea syndrome(OSAS).【Methods】Patients with secondary hypertension,NYHA Ⅱ-Ⅳ heart failure,and stopping drugs which can affect renin- angiotensin-aldosterone system(RASS)for less than 1 month were excluded. Patients who were initially diagnosed as hypertension and completed polysomnography were conducted in the Third Affiliated Hospital of Sun Yat-sen University from November 2018 to December 2019. Apnea- Hypopnea Index(AHI)represents the severity of OSAS. Patients were measured plasma levels of renin concentration,angiotensin Ⅱ and aldosterone in supine positions. Blood pressure before therapy was also recorded. Subjects were divided into two groups based on AHI. Group A included no or mild OSAS patients with AHI < 15 and Group B included moderate or severe OSAS patients with AHI ≥ 15. The above indicators were compared between the two groups. We also tried to find the correlation of OSAS,blood pressure and RASS by linear correlation and multiple linear regressions.【Results】Positive correlations were found between AHI and aldosterone(rs= 0.215,P=0.011),AHI and plasma renin concentration(rs=0.233,P=0.006),AHI and ANG Ⅱ(rs=0.138,P=0.004), AHI and systolic blood pressure(rs=0.306 ,P<0.001),AHI and mean arterial blood pressure(rs=0.263 ,P=0.002), systolic blood pressure and plasma renin concentration(rs=0.288,P=0.001),diastolic blood pressure and plasma renin concentration(rs=0.213,P=0.012). After adjusting for other variables,aldosterone was also significantly associated with AHI(β =0.160 ,P=0.035).【Conclusions】OSAS severity is related to RASS ,especially to aldosterone. OSAS mainly affects systolic blood pressure and mean arterial blood pressure. Aldosterone receptor antagonist may be more available for hypertensive patients with OSAS.
0
浏览量
261
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621
