原发性醛固酮增多症与原发性高血压代谢异常的比较

目的 探讨原发性醛固酮增多症的代谢异常.方法 入选已确诊的原发性醛固酮增多症(原醛)患者220例(男117例,女103例)与性别、年龄及高血压病程相匹配的同期住院原发性高血压(EH)患者200例(男104例,女96例).记录入选者一般临床资料和生化指标,在两组间行代谢综合征患病率及两组代谢异常特点比较.结果 (1)原醛组代谢综合征患病率显著高于同期住院EH组(47.3％对31.5％,P=0.009).(2)原醛患者整体血压水平显著高于EH患者24 h平均收缩压(150.67±15.45)mm Hg对(145.69±17.13)mm Hg,P=0.042;24 h平均舒张压(93.03±10.51)mm Hg对(85.83±14.44)mm Hg,P=0.037],且原醛组以2、3级高血压为主.(3)原醛患者腹型肥胖和胰岛素抵抗发生率显著高于EH患者86.8％(191/220)对78.5％(157/200),P=0.024;胰岛素抵抗指数42.42±16.11对49.58±22.43,P=0.008].结论 原醛以腹型肥胖、中重度高血压及严重的胰岛素抵抗为主要特征,直接导致其代谢综合征患病率显著高于EH患者.

Incidence of metabolic disorders in patients with essential hypertension and patients with primary aldosteronism

Objective To compare the incidence of metabolic disorders(MS)in patients with primary aldosteronism(PA)and essential hypertension(EH).Methods MS prevalence was observed in 200 EH patients(male 104)and 220 PA patients(male 117)hospitalized to our hospital from August 2005 to March 2007.Results (1)The prevalence of MS in PA group was significantly higher than that of EH group(47.3％vs.31.5％,P=0.009).(2)Blood pressure was significantly higher in PA group than that of EHSBP:(150.67±15.45)mm Hg vs.(145.69±17.13)mm Hg,P=0.042;DBP:(93.03±10.51)mm Hg vs.(85.83±14.44)mm Hg,P=0.037].(3)Incidences of abdominal obesity(86.8％vs.78.5％,P=0.024)and insulin resistance(insulin sensitivity index:42.42±16.11 vs.49.58±22.43,P=0.008)were significantly higher in PA group than in EH group.Conclusion The prevalence of MS in hospitalized PA patients was significantly higher than that of EH patients characterized by prevalent abdominal obesity,insulin resistant and severe hypertension.