醛固酮在高血压急症患者各种靶器官损伤中的作用:一项横断面研究。

IF 2.2 4区 医学 Q2 UROLOGY & NEPHROLOGY
Akihiro Miyake, Keita Endo, Koichi Hayashi, Taro Hirai, Yuki Hara, Keisuke Takano, Takehiro Horikawa, Kaede Yoshino, Masahiro Sakai, Koichi Kitamura, Shinsuke Ito, Naohiko Imai, Shigeki Fujitani, Toshihiko Suzuki
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引用次数: 0

摘要

背景:高血压急症是一种导致多器官损伤的危重疾病。虽然肾素-血管紧张素-醛固酮系统(RAS)在这种疾病中被大量激活,但 RAS 是否导致器官损伤的发生尚未完全阐明。本横断面研究旨在描述高血压急症患者的 RAS 与器官损伤之间的关系:我们选取了 2012 年至 2020 年期间在本医疗中心就诊的 63 名急性重症高血压和多器官损伤患者。入院时对高血压靶器官损害进行评估,包括严重肾功能损害(eGFR 小于 30 mL/min/1.73 m2,SKI)、严重视网膜病变、同心型左心室肥厚(c-LVH)、血栓性微血管病变(TMA)、射血分数降低的心力衰竭(HFrEF)和脑血管疾病。然后,分析了各器官损伤是否与血压或血浆醛固酮浓度有关:63例患者中,分别有31、37、43和8例表现为SKI、严重视网膜病变、c-LVH和缺血性中风。除脑梗塞外,所有器官损伤人群的血浆醛固酮浓度均高于其余人群,但收缩压或舒张压的差异不一。22 名患者同时患有 SKI、严重视网膜病变和 c-LVH 三种疾病,其中 5 名患者表现为 TMA。此外,受损器官的数量与血浆醛固酮水平相关(Spearman 系数 = 0.50),血浆醛固酮(≥ 250 pg/mL)与 3 种或更多并发症之间存在密切联系(几率比 = 9.16 [95%CI:2.76-30.35]):结论:在高血压急症患者中,较高的醛固酮水平不仅有助于器官损伤的发展,而且与每位患者受损器官的数量有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of aldosterone in various target organ damage in patients with hypertensive emergency: a cross-sectional study.

Background: Hypertensive emergency is a critical disease that causes multiple organ injuries. Although the renin-angiotensin-aldosterone system (RAS) is enormously activated in this disorder, whether the RAS contributes to the development of the organ damage has not been fully elucidated. This cross-sectional study was conducted to characterize the association between RAS and the organ damage in patients with hypertensive emergencies.

Methods: We enrolled 63 patients who visited our medical center with acute severe hypertension and multiple organ damage between 2012 and 2020. Hypertensive target organ damage was evaluated on admission, including severe kidney impairment (eGFR less than 30 mL/min/1.73 m2, SKI), severe retinopathy, concentric left ventricular hypertrophy (c-LVH), thrombotic microangiopathy (TMA), heart failure with reduced ejection fraction (HFrEF) and cerebrovascular disease. Then, whether each organ injury was associated with blood pressure or a plasma aldosterone concentration was analyzed.

Results: Among 63 patients, 31, 37, 43 and 8 cases manifested SKI, severe retinopathy, c-LVH and ischemic stroke, respectively. All populations with the organ injuries except cerebral infarction had higher plasma aldosterone concentrations than the remaining subset but exhibited a variable difference in systolic or diastolic blood pressure. Twenty-two patients had a triad of SKI, severe retinopathy and c-LVH, among whom 5 patients manifested TMA. Furthermore, the number of the damaged organs was correlated with plasma aldosterone levels (Spearman's coefficient = 0.50), with a strong association observed between plasma aldosterone (≥ 250 pg/mL) and 3 or more complications (odds ratio = 9.16 [95%CI: 2.76-30.35]).

Conclusion: In patients with hypertensive emergencies, a higher aldosterone level not only contributed to the development of the organ damage but also was associated with the number of damaged organs in each patient.

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来源期刊
BMC Nephrology
BMC Nephrology UROLOGY & NEPHROLOGY-
CiteScore
4.30
自引率
0.00%
发文量
375
审稿时长
3-8 weeks
期刊介绍: BMC Nephrology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of kidney and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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