中国血液净化

›› 2008, Vol. 7 ›› Issue (2): 75-77.

• 论著 • 上一篇    下一篇

维持性血液透析患者肾素-血管紧张素-醛固酮系统与 心脏结构及功能的相关性

张进珍 李月红 周 旻

  

  1. 天津市人民医院血液净化中心
  • 收稿日期:2007-10-11 修回日期:1900-01-01 出版日期:2008-02-12 发布日期:2008-02-12

Relationship between renin-angiotensin-aldosterone system and changes of structure and function in left ventricle in maintenance hemodialysis patients

ZHANG Jin-zhen, LI Yue-hong, ZHOU Yu   

  1. Department of Nephrology, Tianjin People抯 Hospital
  • Received:2007-10-11 Revised:1900-01-01 Online:2008-02-12 Published:2008-02-12

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摘要： 目的 检测维持性血液透析患者血浆中肾素-血管紧张素-醛固酮系统(RAAS)活性，探讨其与患者左心室的结构及功能的关系，为改善患者的心功能及提高生存质量提供临床依据。方法 用放射免疫法测定天津市人民医院肾内科40例血液透析患者和20例健康对照组的RAAS活性并进行比较，同时将两组的RAAS水平与心脏超声指标进行相关分析。结果 ①血液透析组患者的RAAS活性较健康对照组明显增高，左心室肥厚发生率也远高于对照组；②血液透析组血浆血管紧张素(AngⅡ)、醛固酮(ALD)水平与左心室心肌重量指数(LVMI)存在显著正相关性，患者的血浆AngⅡ水平与收缩压有明显正相关。对照组血浆RAAS活性与LVMI无相关性；③血液透析组左心室肥厚(LVH)与收缩压呈正相关，与血红蛋白、红细胞压积呈负相关；但与患者的年龄、性别、透析龄及血肌酐水平无关；④根据LVMI值将血液透析组患者分为有LVH组和无LVH组，两组间血红蛋白、收缩压差异有显著性；而两组之间患者的年龄、透析龄、舒张压、透析前血肌酐差异无显著性。结论 透析患者LVH的发生率显著高于正常人，LVH发生与体内RAAS活性升高呈正相关，与血红蛋白水平呈负相关。

关键词: 血液透析, 肾素-血管紧张素-醛固酮系统, 超声心动图

Abstract: Objective We studied the relationship between the activity of renin-angiotensin-aldosterone system (RAAS) and the changes of structure and function in left ventricle in maintenance hemodialysis patients, for the improvement of patient抯 heart function and life quality. Methods We measured plasma angiotensin II and aldosterone by radioimmunoassay in 40 hemodialysis patients and 20 normal controls, and the results were compared with the changes of ultrasound cardiography. Result ① The incidence of RAAS hyperactivity and left ventricular hypertrophy (LVH) was much higher in hemodialysis patients than in controls. ② In hemodialysis patients, plasma angiotensinⅡ and aldosterone were positively correlated with left ventricular mass index (LVMI), and plasma angiotensin II was positively correlated with systolic pressure. In normal controls, however, there was no correlation between RAAS activity and LVMI. ③ In hemodialysis patients, LVH was positively correlated with systolic pressure and negatively correlated with hemoglobin and hematocrit values, but LVH had no correlation with patient抯 age, gender, dialysis age and serum creatinine. ④ In the hemodialysis patients with LVH and those without LVH, values of hemoglobin and systolic pressure were significantly different, but their age, dialysis age, diastolic pressure and creatinine before dialysis showed no difference. Conclusion The incidence of LVH was significantly higher in hemodialysis patients than in controls. The prevalence of LVH in hemodialysis patients was positively correlated with RAAS activity and negatively correlated with hemoglobin value.

Key words: RAAS, Echocardiography

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