上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

血管紧张素Ⅱ和醛固酮对原发性高血压患者心房颤动的诊断价值

赵利群1，李旭光1，谢力俊1，吴海清1，王志敏2，刘少稳1   

  1. 1.上海交通大学附属第一人民医院心内科，上海 200080；2. 国家人类基因组南方研究中心遗传学部，上海 201203
  • 出版日期:2016-12-28 发布日期:2016-12-29
  • 通讯作者: 刘少稳，电子信箱：shaowen.liu@hotmail.com。
  • 作者简介:赵利群（1971—），女，副主任医师，博士；电子信箱：zhaoliq8570@hotmail.com。
  • 基金资助:

    国家自然科学基金青年科学基金（81300090）

Value of angiotensin Ⅱ and aldosterone for the diagnosis of atrial fibrillation in patients with primary hypertension

ZHAO Li-qun1, LI Xu-guang1, XIE Li-jun1, WU Hai-qing1, WANG Zhi-min2, LIU Shao-wen1   

  1. 1. Department of Cardiology, Shanghai Genersl Hospital, Shanghai Jiao Tong University, Shanghai 200080, China;2. Department of Genetics, Chinese National Human Genome Center and Shanghai Industrial Technology Institute, Shanghai 201203, China

  • Online:2016-12-28 Published:2016-12-29
  • Supported by:

    National Natural Science Foundation-Outstanding Youth Foundation, 81300090

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摘要：

目的 ·探讨原发性高血压患者血浆血管紧张素Ⅱ（Ang Ⅱ）和醛固酮（ALD）是否可作为发生心房颤动（房颤）的生物标志物，以指导房颤治疗。方法 ·高血压组患者189例，其中训练组75例，验证组114例；房颤组患者179例，其中训练组72例，验证组107例。采用放射免疫法测定血浆肾素活性（PRA）、Ang Ⅱ和ALD值，进行组间比较。采用受试者工作特征（ROC）曲线分析Ang Ⅱ和ALD对房颤的诊断效能。结果 ·房颤组Ang Ⅱ和ALD水平高于高血压组（均P=0.000）。ROC曲线分析结果显示Ang Ⅱ或ALD预测房颤的敏感度分别为0.92和0.93，特异度分别为0.80和0.96，临界点为58.00和150.00 pg/mL。2组Ang Ⅱ和ALD分布差异均有统计学意义（均P=0.000）。结论 ·血浆Ang Ⅱ和ALD可作为高血压患者预测房颤的生物标志物，并可作为房颤治疗中是否选用肾素—血管紧张素—醛固酮系统阻滞剂的重要指标。

关键词: 心房颤动；原发性高血压；肾素&mdash, 血管紧张素&mdash, 醛固酮系统

Abstract:

Objective · To explore whether plasma angiotensin Ⅱ(AngⅡ) and aldosterone (ALD) in patients with primary hypertension can be used as biomarkers for the occurrence of atrial fibrillation and to guide the treatment of atrial fibrillation. Methods · 179 atrial fibrillation patients were enrolled and assigned to the train group (n=72) and the verification group (n=107) and 189 primary hypertensive patients were enrolled and assigned to the train group (n=75) and the verification group (n=114). Plasma renin activity (PRA), Ang Ⅱ, and ALD levels were measured using radioimmunity and compared between groups. The efficacy of Ang Ⅱand ALD on the diagnosis of atrial fibrillation was analyzed using ROC curves. Results · The atrial fibrillation group had higher Ang Ⅱand ALD levels than the hypertensive group (P=0.000). ROC curve analysis showed that sensitivity, specificity, and cut-off value were 0.92, 0.80, and 58.00 pg/mL for Ang Ⅱand 0.93, 0.96, and 150.00 pg/mL for ALD. The differences in AngⅡand ALD distributions between two groups were statistically significant (P =0.000). Conclusion · The plasma Ang Ⅱand ALD can be used as biomarkers for predicting atrial fibrillation in patients with primary hypertension and as an important index for using RAAS system blockers for the treatment of atrial fibrillation.

Key words: atrial fibrillation, essential hypertension, renin-angiotensin-aldosterone system