摘要
目的分析醛固酮(ALDO)、血管紧张素Ⅱ(AngⅡ)、醛固酮/肾素比值(ARR)对原发性醛固酮增多症(PA)与原发性高血压(EHT)的筛查价值及与EHT分级、血压变异性的关系,为临床诊治提供相关依据。方法选取2017年5月-2020年5月中国航天科工集团七三-医院收治的EHT患者105例作为EHT组,PA患者57例作为PA组,比较两组ALDO、AngⅡ、ARR水平,评价ALDO、AngⅡ、ARR对PA与EHT的诊断价值,并比较EHT组不同分级、血压变异性患者ALDO、AngⅡ、ARR水平,分析ALDO、AngⅡ、ARR与EHT分级、血压变异性的关系。结果EHT组AngⅡ水平高于PA组,ALDO、ARR水平低于PA组,差异均有统计学意义(P均<0.05)。将ALDO、AngⅡ、ARR进行logistic二元回归拟合,返回预测概率Logit(P)作为独立检验变量,获取联合诊断PA与EHT的曲线下面积(AUC)为0.969(95%CI:0.929~0.990),敏感度为84.21%,特异度为98.10%,优于三者单独诊断(P<0.05)。EHT组3级患者ALDO、AngⅡ、ARR水平高于2级患者、1级患者,2级患者ALDO、AngⅡ、ARR水平高于1级患者,高变异性系数患者ALDO、AngⅡ、ARR水平高于低变异系数患者,差异均有统计学意义(P均<0.05)。Spearman相关性分析,ALDO、AngⅡ、ARR与EHT分级、血压变异性成正相关(P<0.05)。结论ALDO、AngⅡ、ARR联合检测可作为PA与EHT筛查的可靠手段,且三者与EHT分级、血压变异性具有正相关关系,为临床评估EHT病情提供新思路。
Objective To analyze the screening value of aldosterone(ALDO),angiotensinⅡ(AngⅡ)and aldosterone/renin ratio(ARR)for primary aldosteronism(PA)and essential hypertension(EHT)and their relationship with EHT grade and blood pressure variability,and provide relevant evidence for clinical diagnosis and treatment.Methods A total of 105EHT patients from May 2017 to May 2020 in the 731 Hospital of China Aerospace Science and Industry Corporation were selected as the EHT group,and 57 patients with PA as the PA group.The levels of ALDO,AngⅡand ARR between the two groups were compared,and the diagnostic value of ALDO,AngⅡand ARR for PA and EHT was evaluated.The ALDO,AngⅡand ARR levels of patients with different grades and blood pressure variability in the EHT group were compared,and the relationship between ALDO,AngⅡ,ARR and EHT grade and blood pressure variability was analyzed.Results The AngⅡlevel in the EHT group was higher than that in the PA group,and the ALDO and ARR levels were lower than those in the PA group(P<0.05).The logistic binary regression fitting of ALDO,AngⅡand ARR was performed,and the predicted probability of returning Logit(P)was used as an independent test variable.The area under curve(AUC)of the combined diagnosis for PA and EHT was 0.969(95%CI:0.929-0.990),the sensitivity was 84.21%,and the specificity was 98.10%,which was better than those of the three separate diagnoses(P<0.05).In the EHT group,the ALDO,AngⅡand ARR levels of grade 3 patients were higher than those of grade 2,grade 1 patients,and the ALDO,AngⅡand ARR levels of grade 2 patients were higher than those of grade 1;the ALDO,AngⅡand ARR of patients with high coefficient of variation were higher than those with low coefficient of variation(P<0.05).Spearman correlation analysis showed that ALDO,AngⅡand ARR were positively correlated with EHT grade and blood pressure variability(P<0.05).Conclusion The combined detection of ALDO,AngⅡand ARR could be used as a reliable means of screening for PA and EHT,and there was a positive correlation between the three and EHT grade and blood pressure variability,providing new ideas for clinical evaluation of EHT.
作者
程娜
黄成河
刘瑞秀
CHENG Na;HUANG Cheng⁃he;LIU Rui⁃xiu(Department of Clinical Laboratory,731 Hospital of China Aerospace Science and Industry Corporation,Beijing 100074,China)
出处
《热带医学杂志》
CAS
2022年第6期846-850,共5页
Journal of Tropical Medicine
基金
北京市医学科学技术研究基金项目(B2018104)
作者简介
通讯作者:程娜(1983-),女,本科,主管检验师,主要从事免疫血清方面的研究,E⁃mail:nanacheng9999@163.com
