李东晓 郭立新 潘琦

　　作者单位：100730北京，卫生部北京医院内分泌科

　　【摘要】目的　　探讨原发性醛固酮增多症(PA)患者血浆肾素-血管紧张素-醛固酮系统变化对糖代谢的影响及其可能的机制。方法收集55例PA患者以及年龄和BMI相匹配的原发性高血压(EH)患者50例的临床资料进行分析，PA患者根据血糖水平分为正常血糖组、空腹血糖受损和糖耐量减低组和糖尿病组。结果PA组的糖代谢异常发生率高于EH组(43.6% vs 20.0%，P<0.05)。PA患者中糖尿病组的血浆卧、立位醛固酮水平低于血糖正常组(P<0.05)，而肾素活性和血管紧张素水平组间比较均无显著差异，立位醛固酮与肾素比值也无显著差异。结论PA患者糖代谢异常发生率高于EH患者。在血浆肾素-血管紧张素-醛固酮系统中，糖代谢异常与醛固酮水平明显相关，与血管紧张素水平无关。

　　【关键词】肾素-血管紧张素-醛固酮系统;原发性醛固酮增多症;原发性高血压;糖代谢异常

　　doi:10.3969/j.issn.1006-6187.2011.02.012

　　The effects of the renin-angiotension-aldosterone systerm(RAAS) on the glycometablism in patients with primary aldosteronism

　　LI Dong-xiao,GUO Li-xin,PAN Qi. Department of Endocrinology,Beijing Hospital,Beijing 100730, China

　　【Abstract】Objective　　To assess the effects of the renin-angiotension-aldosterone systerm(RAAS) on the glycometablism in patients with primary aldosteronism(PA) by analyzing the clinical information of 55 patients with PA, and to explore the possible mechanism by which RAAS affects the glycometabolism.MethodsWe analyzed the patients with PA(n=55) and age-and BMI-matched patients with essential hypertension (EH,n=50). The 55 PA patients were divided into three groups: normal blood glucose, IFG and/or IGT and diabetes.ResultsThe prevalence of abnormal glycometabolism was higher in PA group than in EH group(43.6% vs 20.0%，P<0.05). The PA patients with DM showed a lower aldosterone levels (P<0.05) and similar renin and angiotensin levels (P>0.05) as compared with PA patients with normal glucose.Conclusions(1)The prevalence of glycometabolic disorder in PA was higher than in EH group;(2)The glycometabolic disorder was associated with the plasma aldosterone of the RAAS, not associated with angiotensin.

　　【Key words】Renin-angiotension-aldosterone systerm; Primary aldosteronism; Essential hypertension; Glycometabolism disorder