高血压长期服用氢氯噻嗪后RAAS活性与血糖变化的内在关联

摘要

目的 探讨高血压患者在长期服用氢氯噻嗪(HCTZ)后肾素-血管紧张素-醛固酮系统(RAAS)活性变化与血糖(GLU)变化之间的动态关系.方法 选择108例高血压患者,测定基线RAAS活性和GLU水平等指标后,给予HCTZ 12.5 mg,每天1次,1年后测定RAAS活性和GLU水平,分析服用HCTZ 1年后RAAS活性变化与GLU水平之间的关系.结果 服用HCTZ 1年后,血清肾素活性(PRA)水平升高组与不升高组患者GLU水平下降幅度分别是(－0.26±0.26)mmol/L、(-1.36±0.23)mmol/L,差异有统计学意义(P＜0.05)；血清血管紧张素Ⅱ(AngⅡ)水平升高组与不升高组患者GLU水平下降幅度分别是(-0.17±0.18)mmol/L、(-1.07±0.21)mmol/L,差异有统计学意义(P＜0.05).服药后AngⅡ水平升高的患者中,GLU水平同时也升高的人数比例(40.5％)明显高于AngⅡ水平不升高患者中的相应患者比例(16.9％),差异有统计学意义(P＜0.05).结论 服用HCTZ 1年后的RAAS活性变化与GLU变化之间存在相关关系.%Objective To investigate the relationship between the change of RAAS activity and plasma glucose after one year therapy of hydrochlorothiazide. Methods A total of 108 hypertensive patients were enrolled in this study. The activity of RAAS and plasma glucose level were measured at baseline. Patients were given 12. 5 mg hydrochlorothiazide once a day for one year. Then the relationship between activity change of RAAS and the level of plasma glucose were analyzed. Results After one year treatment, the decrease of plasma glucose in PR A elevated group and PR A unelevated group were( - 0. 26 ± 0. 26) mmol/L and(- 1. 36±0. 23) mmol/L respectively, and there was statistical significance in difference(P<0. 05). The decrease of plasma glucose in AngU elevated group and Angll unelevated group were( -0. 17 ±0. 18)mmol/L and( -1. 07±0. 21)mmol/L,and there was statistical significance in difference(P<0. 05). The proportion of patients whose plasma glucose were increased in Angll elevated group(40. 5%)were significantly higher than that in Angll unelevated group, and there was statistical significance in difference(P<0. 05). Conclusion The change of RAAS activity was associated with the level of plasma glucose after one year therapy of hydrochlorothiazide.