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目的探讨立、坐、卧三体位血浆醛固酮浓度及立、卧位差值与颈动脉粥样硬化(CA)的关系。方法入选在新疆自治区人民医院高血压科住院的高血压患者252例,并进行体位实验。根据颈动脉超声检查结果将252例患者分为斑块组(80例)和无斑块组(172例)。测定入选患者立、坐、卧三体位的血浆醛固酮水平。用Spearman等级相关分别分析两组双侧颈动脉内膜中层厚度(IMT)均值与不同体位的醛固酮及立卧位醛固酮差值的相关性。采用Logistic回归分析CA与立、坐、卧三体位的醛固酮及立卧位醛固酮差值的关系。结果斑块组的立位醛固酮(rs=0.237,P=0.041)、立卧位醛固酮差值(rs=0.262,P=0.023)与双侧颈总动脉IMT均值呈正相关;Logistic回归分析显示,校正了相关混杂因素后,立位醛固酮与CA独立相关(OR=1.22,95%CI1.09～2.38,P=0.028)。结论立位醛固酮水平与高血压患者CA相关。
Objective To investigate the relationship between plasma aldosterone concentration and the difference between standing and lying position and carotid atherosclerosis (CA) in standing, sitting and lying three positions. Methods Totally 252 hypertensive patients admitted to the Hypertension Section of People’s Hospital of Xinjiang Autonomous Region were enrolled in this study. 252 patients were divided into plaque group (80 cases) and no plaque group (172 cases) according to carotid ultrasonography. Determination of selected patients standing, sitting, lying three levels of plasma aldosterone levels. Spearman rank correlation was used to analyze the association between mean carotid intima-media thickness (IMT) and aldosterone and vertical aldosterone difference at different positions in two groups. Logistic regression analysis was used to analyze the relationship between aldosteronism and aldosteronism in standing, sitting and lying position of the three bodies. Results The aldosterone (rs = 0.237, P = 0.041) and aldosterone difference (rs = 0.262, P = 0.023) were positively correlated with mean carotid artery IMT in plaque group. Logistic regression analysis showed that the corrected The relative aldosterone was independently associated with CA (OR = 1.22, 95% CI, 1.09 ~ 2.38, P = 0.028) after related confounding factors. Conclusion The level of aldosterone is correlated with CA in hypertensive patients.