肥胖相关性高血压患者摄盐量对醛固酮作用临床研究

摘要

目的 研究高盐对肥胖相关性高血压患者醛固酮的影响.方法 收集2016年12月至2017年6月第三军医大学大坪医院住院的高血压患者301例,按照体重指数分成正常体重组和超重肥胖组,对两组患者一般资料及24 h尿醛固酮及摄盐量等临床资料进行比较分析.结果 与正常体重的高血压患者相比较,超重肥胖的高血压患者摄盐量显著升高,同时其24 h尿醛固酮排泄量也显著增加.通过对血脂、血糖、尿酸等因素进行多变量校正后,超重肥胖的高血压患者较正常体重的高血压患者24 h尿醛固酮水平增加0.577μg、日均摄盐量增加1.754 g.对超重肥胖的高血压患者按照摄盐量(中位数8.66 g/d)分为高摄盐组和低摄盐组,结果高摄盐组的高血压患者较低摄盐组的高血压患者的24 h尿醛固酮水平显著升高,相关分析显示超重肥胖组的高血压患者24 h尿醛固酮排泄与摄盐量呈正相关(r=0.1480,P＜0.05).结论 肥胖相关性高血压患者摄盐量和24 h尿醛固酮水平显著升高,且二者显著相关,这可能是导致难治性高血压的原因之一.%Objective To study the effect of high salt intake on urinary aldostemne excretion in obesity-related hypertensive patients.Methods A total of 301 patients with hypertension were randomly divided into normal body weight group and overweight / obese group according to their body mass index (BMI).The general data and 24-hour urine aldosterone excretion were collected and analyzed.Results Compared with hypertensive patients from normal body weight group,the salt intake and 24-hour urinary aldosterone excretion were significantly increased in hypertensive patients of overweight/obesity group.After adjusting for blood fat,sugar,UA and other confounding factors,24-hour urinary aldosterone excretion of overweight/obesity group was increased by 0.577 ug and salt intake increased by 1.754 g/d,when compared to hypertensive patients of normal body weight group.According to median of salt intake (median 8.66 g/d),overweight/obesity groups was divided into high salt intake group and low salt intake group,and the analysis showed that 24-hour urinary aldosterone excretion was significantly increased in the high salt intake group,and the correlation analysis showed that 24-hour urinary aldosterone excretion was positively correlated with salt intake (r=0.1480,P＜0.05).Conclution Obesity-related hypertensive patients have higher salt intake and 24-hour urinary aldosterone excretion level.Salt intake is positively correlated with their 24-hour urinary aldosterone excretion,and it may be one of the causes of refractory hypertension.