摘要
目的:探讨原发性高血压(HP)患者升主动脉内径与血浆醛固酮水平的相关性,为控制大血管病变提供新的思路。方法:研究纳入2021年1月至2021年4月,在首都医科大学附属北京安贞医院高血压中心住院患者275例,男151例,女124例,年龄23~70岁,平均(51±9.02)岁。收集一般临床资料,并进行相关生化检验(肾素、血管紧张素II、醛固酮浓度测定),动态血压监测和超声心动图检查。根据升主动脉内径将研究对象分为升主动脉内径正常(对照组,≤35mm)145例和升主动脉内径增宽(研究组,>35mm)130例,分析两组升主动脉内径相关参数的差异,用多元回归分析醛固酮水平与升主动脉内径的相关性。结果:升主动脉内径增宽组校正后血浆醛固酮水平高于正常组,差异有统计学意义(P<0.05)。Logistic回归分析显示,调整其他危险因素之后,女性(OR=0.25,95%CI:0.13~0.49,P<0.01);年龄(OR=1.07,95%CI:1.03~1.11,P<0.01);醛固酮(OR=1.90,95%CI:1.06~3.41,P<0.05);腹围(OR=1.04,95%CI:1.01~1.08,P<0.05);24h舒张压(OR=1.04,95%CI:1.04~2.00,P<0.05)。结论:升主动脉内径的增宽不仅受性别和年龄不可控制的因素影响,同时与醛固酮水平、舒张压和腹围可控制的因素相关,对升主动脉内径的变化有重要的作用。为改善大血管病变,减少风险事件的发生提供新的依据。
Objective:To investigate the correlation between the inner diameter of ascending aorta and plasma aldosterone level in patients with essential hypertension(HP),and to provide a new idea for the control of great vessel disease.Methods:a total of 275 patients,151males and 124 females,aged 23-70years,with an averageage of 51±9.02years,were enrolled in this study from January 2021 to April 2021.General clinical data were collected,related biochemical tests were performed,ambulate blood pressure,reninangiotensin-aldosterone concentration determination and echocardiography were performed.According to the inner diameter of ascending aorta,the subjects were divided into 145 patients with normal inner diameter of ascending aorta(≤35mm)and 130 patients with widened inner diameter of ascending aorta(>35mm).The difference of parameters related to the inner diameter of the ascending aorta between the two groups was analyzed.The correlation between aldosterone level and the inner diameter of the ascending aorta was analyzed by multiple regression.Results:the corrected plasma aldosterone level in the widened inner diameter of ascending aorta group was higher than that in the normal group,and the difference was significant statistical(P<0.05).Logistic regression analysis showed that after adjustment for other risk factors,women(OR=0.25;95%CI:0.13-0.49,P<0.01);Age(OR=1.07;95%CI:1.03-1.11.P<0.01);aldosterone(OR=1.90;95%CI:1.06-3.41,P<0.05);Abdominal circumference(OR=1.04;95%CI:1.01-1.08,P<0.05);24h diastolic blood pressure(OR=1.04;95%CI:1.04-2.00,P<0.05).Conclusions:The inner diameter of ascending aorta is not only affected by the uncontrollable factors of gender and age,but also related to aldosterone level,diastolic pressure and abdominal circumference,which plays an important role in the changes of the inner diameter of ascending aorta.It provides a new basis for improving macrovascular disease and reducing risk events.
作者
屈丰雪
曾荣
闫家富
刘傲亚
程文立
QU Fengxue;ZENG Rong;YAN Jiafu;LIU Aoya;CHENG Wenli(Department of Hypertension Center,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)
出处
《心肺血管病杂志》
CAS
2022年第7期762-767,共6页
Journal of Cardiovascular and Pulmonary Diseases
基金
国家自然科学基金(81370229)。
关键词
原发性高血压
升主动脉内径
肾素-血管紧张素-醛固酮
动态血压
腹围
Essential hypertension
inner diameter of ascending aorta
renin-angiotensin-aldosterone
dynamic blood pressure
abdominal circumference
