文章摘要
马建强,李 平,李洪运,冯文焕,沈山梅,朱大龙.原发性醛固酮增多症中血清甲状旁腺素水平的变化、影响因素及与左心室结构参数之间的相关性[J].南京医科大学学报,2018,(4):482~487
原发性醛固酮增多症中血清甲状旁腺素水平的变化、影响因素及与左心室结构参数之间的相关性
Changes and factors affecting parathyroid hormone in primary aldosteronism and its correlation with parameters of left ventricular structure
投稿时间:2017-08-01  
DOI:10.7655/NYDXBNS20180411
中文关键词: 原发性醛固酮增多症  甲状旁腺激素  左心室结构
英文关键词: primary aldosteronism  serum parathyroid hormone  left ventricular structure
基金项目:国家自然科学基金(81000350);南京市医学科技发展项目杰出青年基金(JQX13010);南京市青年卫生人才(第三层次);江苏省“六大人才高峰项目”(WSN?051);江苏省代谢病重点学科(XK201105)
作者单位
马建强 南京大学医学院附属鼓楼医院内分泌科江苏 南京 210008江苏大学附属金坛医院内分泌科江苏 金坛 213200 
李 平 南京大学医学院附属鼓楼医院内分泌科江苏 南京 210008 
李洪运 南京大学医学院附属鼓楼医院内分泌科江苏 南京 210008 
冯文焕 南京大学医学院附属鼓楼医院内分泌科江苏 南京 210008 
沈山梅 南京大学医学院附属鼓楼医院内分泌科江苏 南京 210008 
朱大龙 南京大学医学院附属鼓楼医院内分泌科江苏 南京 210008 
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中文摘要:
      目的:探讨原发性醛固酮增多症(primary aldosteronism,PA)患者中血清甲状旁腺激素(parathyroid hormone,PTH)水平的变化,影响因素及与左心室结构参数之间的相关性。方法:回顾性分析本院近5年诊断的PA患者(59例)及原发性高血压患者(148例)临床资料,比较PA患者中血清PTH、血钙等生化指标以及心脏超声中相关参数的变化。采用线性回归分析探讨影响PTH水平变化的独立影响因素,并进行PTH水平与左心室结构参数间的相关性分析。结果:与原发性高血压相比,PA患者中血清PTH水平升高,血钙水平下降,且低钙及高PTH血症患者比例显著增加(P < 0.05)。进一步多元逐步回归分析显示血钙(B=-11.313,P=0.008)、血钾(B=-4.577,P =0.003)及基础PRA(B=-9.229,P=0.030)是血清PTH水平的独立影响因素;PA患者中左心室肥厚所占比例明显高于原发性高血压患者(P < 0.05),血清PTH水平与左心室舒张末期内径(LVDD)、左心室收缩末期内径(LVSD)及左心房内径(LAD)正相关,且独立于高血压及血浆醛固酮水平。结论:高血清PTH水平、低血钙是PA患者的重要生化特征。其中高PTH水平可能与PA患者心血管风险增加有关。
英文摘要:
      Objective:To investigate changes and factors affecting serum parathyroid hormone(PTH) level in patients with primary aldosteronism(PA)and its correlation with parameters of left ventricular structure. Methods:A total of 148 patients with primary hypertension(PH)and 59 patients with PA were enrolled in this study. The plasma levels of aldosterone,renin activity,PTH and calcium and related markers were measured. Parameters of Doppler echocardiography were recorded. Univariate and logistic analysis were conducted to investigate the predicators of serum PTH level. Correlation analysis was conducted between the serum PTH levels and parameters of left ventricular structure. Results:Serum PTH level was significantly elevated,along with decreased calcium levels in patients with PA compared with patients with PH(P < 0.05). Stepwise multiple regression analysis showed that plasma levels of renin activity(B=-9.229,P=0.030),serum levels of K+(B=-4.577,P=0.003)and Ca2+(B=-11.313,P=0.008) were independently associated with serum PTH level. Serum PTH level was positively correlated with left ventricular diastolic diameter(LVDD),left ventricular end systolic dimension(LVSD)and left atrial diameter(LAD),irrelevant with blood pressure and plasma levels of aldosterone. Conclusion:Elevated serum PTH level is an important character in PA patients. Plasma levels of renin activity,serum levels of K+ and Ca2+ are main factors influencing the serum PTH level in PA patients. Elevated serum PTH level might relate with increased cardiovascular risk in PA patients.
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