引用本文:钱 静,黄荣杰,史吉莹.原发性醛固酮增多症主动脉内径重构及影响因素研究[J].中国临床新医学,2018,11(10):969-972.
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原发性醛固酮增多症主动脉内径重构及影响因素研究
钱 静,黄荣杰,史吉莹
530021 南宁,广西医科大学第一附属医院心血管内科
摘要:
[摘要] 目的 研究原发性醛固酮增多症(primary aldosteronism,PA)患者主动脉内径重构及影响的因素。方法 对30例PA患者分别测定各项血生化指标和检测并测量主动脉各部内径,将主动脉各部内径与30例原发性高血压(essential hypertension,EHT)患者测得的主动脉各部内径进行比较,并将其结果进行统计学分析。结果 (1)PA患者主动脉瓣环、窦部、根部和升主动脉内径均较EHT患者增宽(P均<0.05)。(2)直线相关分析发现PA患者主动脉瓣环、窦部、根部和升部内径均与立、卧位ARR,立、卧位PAC呈正相关;(3)多重逐步线性回归分析发现PA患者主动脉瓣环内径主要与立位ARR和立位PAC存在线性关系,主动脉窦内径与立位ARR和卧位PAC存在线性关系,主动脉根部内径与立位ARR和卧位PAC存在线性关系,主动脉升部内径与立位ARR、卧位ARR和立位PAC存在线性关系。结论 PA患者其主动脉内径存在扩张性重构;主动脉各部内径扩张性重构的影响因素有所不同,立位ARR为共同的影响因素,提示其控制可能是逆转PA患者主动脉扩张性重构的关键。
关键词:  原发性醛固酮增多症  主动脉内径  醛固酮与肾素活性比值  血浆醛固酮
DOI:10.3969/j.issn.1674-3806.2018.10.03
分类号:R 586.2+4
基金项目:广西卫计委科研课题(编号:Z2016310)
Primary aldosteronism aorta remodeling and its influencing factors
QIAN Jing, HUANG Rong-jie, SHI Ji-ying
Department of Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
Abstract:
[Abstract] Objective To study primary aldosteronism(PA) aorta remodeling and its influencing factors. Methods The blood biochemistry indexes were detected and the inner diameter of the aorta were measured in 30 patients with PA and in 30 patients with essential hypertension(EHT), respectively, and their results were compared. Results (1)The diameters of aortic annulus, sinuses, root and ascending aorta in the PA patients were significantly wider than those in the EHT patients(P<0.05); (2)Univariate analysis showed that the PA patients′ inner diameters[aortic annulus, sinuses, root and ascending portion and standing, supine ARR(aldosterone and renin activity ratio), stand, supine PAC(plasma aldosterone concentration)] were positively correlated; (3)Multiple stepwise linear regression analysis showed that the PA patients had: ①Aortic annulus inner diameter main linear relationship with orthostatic ARR and orthostatic PAC; ②Sinuses inner diameter main linear relationship with orthostatic ARR and supine PAC; ③Root inner diameter main linear relationship with orthostatic ARR and supine PAC; ④Ascending aorta inner diameter main linear relationship with orthostatic ARR, supineARR and orthostatic PAC. Conclusion Aortic diameter expansion remodeling exists in PA patients. The factors influencing the aorta expansive remodeling in the parts of the aorta are various, but the orthostatic ARR is the common factor, suggesting that it may be the key to reverse the PA patients with aortic distensibility remodeling.
Key words:  Primary aldosteronism(PA)  Aortic diameter  Aldosterone and renin activity ratio(ARR)  Aldosterone