原发性高血压患者RAAS三项检测的临床意义
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摘要
目的探讨不同分级和不同年龄原发性高血压患者RAAS[即肾素(PRA)、血管紧张素Ⅱ(AngⅡ)和醛固酮(ALD)]检测的临床意义。方法按照高血压分级标准和年龄,将102例原发性高血压患者均分为3组,其中1级36例、2级42例、3级24例,≤50岁34例、51～65岁38例、>65岁30例,同期选取43名健康人群作为正常对照组。采用电化学发光法测定各组血浆中PRA、AngⅡ、ALD含量,比较分析高血压组、各级高血压组、各年龄组与正常对照组以及各级高血压组之间、各年龄组之间的统计学差异,以评价RAAS三项检测对原发性高血压的临床价值。结果高血压组PRA、AngⅡ、ALD血浆含量分别为(16.68±10.10)pg/mL、(130.31±27.97)pg/mL和(152.15±38.59)pg/mL,均显著高于正常对照组的(7.16±2.32)pg/mL、(91.13±16.94)pg/mL和(116.53±18.12)pg/mL,差异有统计学意义(t=6.883、6.035、4.714,P均<0.01)。各级高血压组和各年龄组PRA、AngⅡ、ALD水平与正常对照组之间差异均有统计学意义(P均<0.01)。各级高血压组血浆样本PRA、AngⅡ、ALD水平比较差异有统计学意义(F=8.046、18.252、14.338,P均<0.01)。3级和2级高血压组血浆样本PRA、AngⅡ、ALD水平与1级高血压组比较显著升高,差异有统计学意义(P均<0.01),3级高血压组血浆PRA、AngⅡ、ALD水平与2级高血压组比较差异有统计学意义(P均<0.05)。各年龄组之间PRA、AngⅡ、ALD水平差异均无统计学意义(P均>0.05)。结论血清PRA、AngⅡ、ALD水平与原发性高血压患者的年龄无关,与高血压级别有关,可作为高血压患者诊断和治疗的重要参考指标。
Objective To investigate the clinical significance of detection of renin(PRA),angiotensin Ⅱ(AngⅡ)and aldosterone(ALD) in patients with essential hypertension of different grades and ages. Methods 102 patients with essential hypertension were divided into three groups according to the classification standard of hypertension and age respectively,including 36 cases of grade 1,42 cases of grade 2,24 cases of grade 3,34 cases under 50 years old,38 cases between 51 and 65 years old,30 cases over 65 years old. 43 health volunteers were selected as normal control group.The levels of PRA,Ang Ⅱ and ALD in plasma of each group were determined by ELC Method. The statistical differences among hypertension group,hypertension groups with different grades and ages and normal control group were comparatively analyzed and the statistical differences among groups in different degrees and at different ages were also analyzed. The clinical value of detection of renin,angiotensin Ⅱ and aldosterone in essential hypertension was evaluated. Results The plasma levels of PRA,Ang Ⅱ and ALD in hypertension group were(16.68±10.10)pg/mL,(130.31±27.97)pg/mL and(152.15±38.59)pg/mL,respectively,which were significantly higher than those in normal control group[PRA:(7.16±2.32)pg/mL,Ang Ⅱ:(91.13±16.94)pg/mL,ALD:(116.53±18.12)pg/mL]and the differences between groups were statistically significant(t=6.883,6.035,4.714,P<0.01).The levels of PRA,Ang Ⅱ and ALD in hypertension groups with different grades and ages were significantly higher than those in normal control group(P<0.01). There were significant differences in the levels of PRA,Ang Ⅱ and ALD among hypertension groups of different grades(F=8.046,18.252,14.338,P<0.01). The levels of PRA,Ang Ⅱand ALD of grade 3 and grade 2 hypertension groups were significantly higher than those in grade 1 hypertension group(P<0.01)and there were significant difference between the grade 3 and grade 2 hypertension groups(t=2.103,3.924,2.435,P<0.05). There were no significant differences in the levels of PRA,Ang Ⅱand ALD among groups at different ages(P>0.05). Conclusion The levels of PRA,Ang Ⅱ and ALD in plasma were not related to the age of patients with essential hypertension,but related to the grade of hypertension. Plasma PRA,Ang Ⅱ and ALD could be used as an important reference index for the diagnosis and treatment of hypertension.
Objective To investigate the clinical significance of detection of renin(PRA),angiotensin Ⅱ(AngⅡ)and aldosterone(ALD) in patients with essential hypertension of different grades and ages. Methods 102 patients with essential hypertension were divided into three groups according to the classification standard of hypertension and age respectively,including 36 cases of grade 1,42 cases of grade 2,24 cases of grade 3,34 cases under 50 years old,38 cases between 51 and 65 years old,30 cases over 65 years old. 43 health volunteers were selected as normal control group.The levels of PRA,Ang Ⅱ and ALD in plasma of each group were determined by ELC Method. The statistical differences among hypertension group,hypertension groups with different grades and ages and normal control group were comparatively analyzed and the statistical differences among groups in different degrees and at different ages were also analyzed. The clinical value of detection of renin,angiotensin Ⅱ and aldosterone in essential hypertension was evaluated. Results The plasma levels of PRA,Ang Ⅱ and ALD in hypertension group were(16.68±10.10)pg/mL,(130.31±27.97)pg/mL and(152.15±38.59)pg/mL,respectively,which were significantly higher than those in normal control group[PRA:(7.16±2.32)pg/mL,Ang Ⅱ:(91.13±16.94)pg/mL,ALD:(116.53±18.12)pg/mL]and the differences between groups were statistically significant(t=6.883,6.035,4.714,P<0.01).The levels of PRA,Ang Ⅱ and ALD in hypertension groups with different grades and ages were significantly higher than those in normal control group(P<0.01). There were significant differences in the levels of PRA,Ang Ⅱ and ALD among hypertension groups of different grades(F=8.046,18.252,14.338,P<0.01). The levels of PRA,Ang Ⅱand ALD of grade 3 and grade 2 hypertension groups were significantly higher than those in grade 1 hypertension group(P<0.01)and there were significant difference between the grade 3 and grade 2 hypertension groups(t=2.103,3.924,2.435,P<0.05). There were no significant differences in the levels of PRA,Ang Ⅱand ALD among groups at different ages(P>0.05). Conclusion The levels of PRA,Ang Ⅱ and ALD in plasma were not related to the age of patients with essential hypertension,but related to the grade of hypertension. Plasma PRA,Ang Ⅱ and ALD could be used as an important reference index for the diagnosis and treatment of hypertension.
引文
[1]刘玮,赵文娜,李伟.血浆肾素-血管紧张素系统与原发性高血压的关系分析[J].临床医学研究与实践,2017,(24):15-16.
[2]李建平,卢新政,霍勇,等.H型高血压诊断与治疗专家共识[J].中华高血压杂志,2016,24(2):123-127.
[3]岳薇薇,胡大春.肾素-血管紧张素-醛固酮系统在高血压遗传病理机制中的研究进展[J].医学综述,2018,24(22):4440-4444.
[4]哈丽达,徐新娟,珠勒皮亚·司马义.原发性高血压患者年龄与血浆肾素-血管紧张素-醛固酮系统的关系[J].心血管康复医学杂志,2010,19(2):148-151.
[5]梁莉红,谭振华,莫燕芳.肾素-血管紧张素-醛固酮系统指标联合检测诊断原发性高血压的临床意义[J].实验与检验医学,2018,36(4):591-593.
[6]《中国高血压基层管理指南》修订委员会.中国高血压基层管理指南(2014年修订版)[J].中华健康管理学杂志,2015,9(1):10-30.
[7]吴红珍,王钱虎,夏钟意.原发性高血压患者血浆肾素血管紧张素Ⅱ醛固酮含量及诊断价值分析[J].中国药物与临床,2017,17(8):1228-1229.
[8]张志玲,张火兵,纪明,等.100例不同年龄组的儿童继发性高血压患者血浆肾素活性、血管紧张素Ⅱ、醛固酮水平分析[J].标记免疫分析与临床,2018,25(6):772-773,782.
[9]樊彩妮,赵海鹰,王浩.白大衣高血压患者血浆肾素活性和血管紧张素Ⅱ及醛固酮水平变化及意义[J].中华实用诊断与治疗杂志,2017,31(11):1090-1092.
[10]朱玮玮.肾素-血管紧张素-醛固酮系统基因与高血压患者发生心血管事件相关性研究进展[J].心血管病学进展,2015,36(4):394-396.
[11]樊晓丹.肾素-血管紧张素系统中的肾素对高血压诊断分型的意义[J].标记免疫分析与临床,2017,24(8):956-960.
[12]吴建军,步睿,贾静,等.肾素-血管紧张素-醛固酮系统研究进展[J].医学研究杂志,2015,44(1):4-6.
[13]刘师节,杨莉,何燕,等.血管紧张素转化酶2与原发性高血压的研究进展[J].中华老年心脑血管病杂志,2016,18(2):202-204.
[14]王朝晖,吴国,李滢,等.肾素-血管紧张素-醛固酮系统在原发性高血压病中的表达[J].放射免疫学杂志,2013,26(2):144-146.
[15]吴泽刚,熊格,李艳.武汉地区原发性高血压患者高血压四项检测结果分析[J].微循环学杂志,2016,26(1):18-20,29.2018-11-28
[2]李建平,卢新政,霍勇,等.H型高血压诊断与治疗专家共识[J].中华高血压杂志,2016,24(2):123-127.
[3]岳薇薇,胡大春.肾素-血管紧张素-醛固酮系统在高血压遗传病理机制中的研究进展[J].医学综述,2018,24(22):4440-4444.
[4]哈丽达,徐新娟,珠勒皮亚·司马义.原发性高血压患者年龄与血浆肾素-血管紧张素-醛固酮系统的关系[J].心血管康复医学杂志,2010,19(2):148-151.
[5]梁莉红,谭振华,莫燕芳.肾素-血管紧张素-醛固酮系统指标联合检测诊断原发性高血压的临床意义[J].实验与检验医学,2018,36(4):591-593.
[6]《中国高血压基层管理指南》修订委员会.中国高血压基层管理指南(2014年修订版)[J].中华健康管理学杂志,2015,9(1):10-30.
[7]吴红珍,王钱虎,夏钟意.原发性高血压患者血浆肾素血管紧张素Ⅱ醛固酮含量及诊断价值分析[J].中国药物与临床,2017,17(8):1228-1229.
[8]张志玲,张火兵,纪明,等.100例不同年龄组的儿童继发性高血压患者血浆肾素活性、血管紧张素Ⅱ、醛固酮水平分析[J].标记免疫分析与临床,2018,25(6):772-773,782.
[9]樊彩妮,赵海鹰,王浩.白大衣高血压患者血浆肾素活性和血管紧张素Ⅱ及醛固酮水平变化及意义[J].中华实用诊断与治疗杂志,2017,31(11):1090-1092.
[10]朱玮玮.肾素-血管紧张素-醛固酮系统基因与高血压患者发生心血管事件相关性研究进展[J].心血管病学进展,2015,36(4):394-396.
[11]樊晓丹.肾素-血管紧张素系统中的肾素对高血压诊断分型的意义[J].标记免疫分析与临床,2017,24(8):956-960.
[12]吴建军,步睿,贾静,等.肾素-血管紧张素-醛固酮系统研究进展[J].医学研究杂志,2015,44(1):4-6.
[13]刘师节,杨莉,何燕,等.血管紧张素转化酶2与原发性高血压的研究进展[J].中华老年心脑血管病杂志,2016,18(2):202-204.
[14]王朝晖,吴国,李滢,等.肾素-血管紧张素-醛固酮系统在原发性高血压病中的表达[J].放射免疫学杂志,2013,26(2):144-146.
[15]吴泽刚,熊格,李艳.武汉地区原发性高血压患者高血压四项检测结果分析[J].微循环学杂志,2016,26(1):18-20,29.2018-11-28