原发性高血压患者24h尿钠与血浆肾素活性、醛固酮水平及血压节律的关系

发布时间：2018-05-23 15:17

本文选题：h尿钠 + 原发性高血压　；参考：《中华高血压杂志》2017年08期

【摘要】：目的分析原发性高血压患者24h尿钠与血浆肾素活性、醛固酮水平及血压昼夜节律之间的关系。方法回顾性分析2010年1月至2014年12月连续住院的原发性高血压患者1284例。根据24h尿钠排泄量评价患者的盐摄入量,将患者分为3组:低尿钠组(24h尿钠100 mmol)362例,中等尿钠组(24h尿钠100~200 mmol)675例,高尿钠组(24h尿钠200mmol)247例。对各组血浆肾素活性、醛固酮水平及24h动态血压情况进行分析。结果本研究人群平均24h尿钠水平为(145±69)mmol,估算平均每日摄盐量为(8.48±4.04)g。经性别、年龄、体质量指数校正后,与低尿钠组相比,中等尿钠组和高尿钠组的血浆肾素活性明显降低[(2.77±0.08)、(2.49±0.14)比(3.34±0.11)μg/(L·h),均P0.05],高尿钠组的醛固酮水平低于中等尿钠组和低尿钠组[(150.2±5.4)比(161.8±3.2)、(175.2±4.4)ng/L,均P0.05]。高尿钠组的24h、白天及夜间平均收缩压、舒张压较低尿钠组及中等尿钠组均明显升高(均P0.01)。高尿钠组非杓型血压比例高于低尿钠组(P0.05)。非杓型及夜间高血压患者的24h尿钠水平较杓型和非夜间高血压患者高(均P0.05)。结论高盐摄入患者的血浆肾素活性及醛固酮水平较低,血压水平较高,更多表现为非杓型血压及夜间高血压。
[Abstract]:Objective to analyze the relationship between 24 h urinary sodium and plasma renin activity, aldosterone level and circadian rhythm of blood pressure in patients with essential hypertension. Methods 1284 consecutive patients with essential hypertension from January 2010 to December 2014 were analyzed retrospectively. According to the salt intake of 24 hours urine sodium excretion, the patients were divided into three groups: low urine sodium group (n = 100), moderate urine sodium group (n = 200) and high urine sodium group (n = 200). Plasma renin activity, aldosterone level and 24 h ambulatory blood pressure were analyzed. Results the average 24 h urinary sodium level was 145 卤69 mmol. the average daily salt intake was estimated to be 8.48 卤4.04 g. After adjusting for sex, age and body mass index, the plasma renin activity of moderate and high urinary sodium groups was significantly lower than that of low urinary sodium group [2.77 卤0.08 卤2.49 卤0.14] compared with 3.34 卤0.11 渭 g / L hau, respectively. The aldosterone level in high urine sodium group was lower than that in moderate sodium group and hypuria sodium group [150.2 卤5.4 vs 161.8 卤3.2ngL / L, P 0.05]. The mean systolic blood pressure and diastolic blood pressure in the hyperuricemia group were significantly higher than those in the hyponatremia group and the moderate sodium group at 24 hours (all P 0.01). The percentage of non-dipper blood pressure in hyperuricemia group was higher than that in hypuria group (P 0. 05). The levels of 24 hours urinary sodium in patients with non dipper hypertension and nocturnal hypertension were higher than those with non dipper hypertension and non nocturnal hypertension (all P 0.05). Conclusion Plasma renin activity and aldosterone level were lower and blood pressure was higher in patients with high salt intake.
【作者单位】：上海市高血压研究所上海交通大学医学院附属瑞金医院高血压科;新疆喀什地区第二人民医院心血管内科;
【基金】：上海市卫生和计划生育委员会重点项目(201440023)
【分类号】：R544.11

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