陈莹 胡允兆 吴艳婷 范丽娟

[摘要] 目的 研究抑郁与原发性高血压患者血管紧张素及醛固酮的关系。 方法 选取2015年9月～2017年9月在南方医科大学附属顺德医院心内科确诊的高血压患者为样本组（n=129），另选择同期门诊健康体检者为对照组（n=66），测定其血脂、尿酸（UA）等各项指标，以及血管紧张素（Ang-Ⅰ、Ang-Ⅱ）及醛固酮（ALD）的浓度水平。用抑郁自评量表（SDS）对每位入选者进行抑郁评分，根据以上结果将作为样本组的高血压患者进一步分为抑郁组（n = 58）、非抑郁组（n = 71）两个亚组。对上述所有数据进行统计学分析。 结果 样本组的血脂指标中低密度脂蛋白胆固醇（LDL-C）、血清总胆固醇（TC）、三酰甘油（TG）、UA明显高于对照组，差异有统计学意义（P < 0.05）；样本组和对照组的高密度脂蛋白胆固醇（HDL-C）水平差异无统计学意义（P > 0.05）。样本组的Ang-Ⅰ、Ang-Ⅱ水平均明显高于对照组，差异有统计学意义（P < 0.05），高血压抑郁组的Ang-Ⅰ、Ang-Ⅱ水平均明显高于非抑郁组，差异有统计学意义（P < 0.05）。Logistic回归分析结果显示血脂（OR = 1.84，95%CI：1.12～3.05，P < 0.05）、Ang-Ⅰ（OR = 1.84，95%CI：1.18～8.10，P < 0.05）、Ang-Ⅱ（OR = 1.84，95%CI：1.05～3.58，P < 0.05）是高血壓患者发生抑郁的独立危险因素。 结论 血管紧张素是高血压患者发生抑郁的独立危险因素，且随其血清水平增高，发生抑郁的程度逐渐增强。

[关键词] 抑郁；原发性高血压；血管紧张素

[中图分类号] R544.1 [文献标识码] A [文章编号] 1673-7210（2018）05（b）-0038-04

Study on relationship between depression and angiotensin/aldosterone levels in patients with essential hypertension

CHEN Ying1 HU Yunzhao2 WU Yanting3▲ FAN Lijuan3

1.Medical Examination Center， Shunde Hospital Affiliated to Southern Medical University， Guangdong Province， Shunde 528330， China； 2.Cardiology Center， Shunde Hospital Affiliated to Southern Medical University， Guangdong Province， Shunde 528330 China； 3.the Second Outpatient Department， Shunde Hospital Affiliated to Southern Medical University， Guangdong Province， Shunde 528330， China

[Abstract] Objective To explore the relationship between depression and angiotensin/aldosterone levels in patients with essential hypertension. Methods From September 2015 to September 2017， in Shunde Hospital Affiliated to Southern Medical University， the patients with hypertension definited were selected as sample group （n = 129） at the same period， heathy outpatients were selected as control group （n = 66）. Blood lipid and uric acid （UA） and other indicators， angiotensin （Ang-Ⅰ， Ang-Ⅱ） and aldosterone （ALD） concentration levels were measured. Self-rating scale （SDS） was used to score depression for each candidate， according to SDS results， patients with hypertension were further divided into two subgroups： depression group （n = 58） and non-depression group （n = 71）. All the above data were statistically analyzed. Results The blood lipid index such as LDL-C， TC， TG and UA in sample group were significantly higher than control group， the differences were statistically significant （P < 0.05）. There was no statistically significant difference in high density lipoprotein cholesterol （HDL-C） between the two groups （P > 0.05）. The levels of Ang-Ⅰ， Ang-Ⅱ in the sample group were significantly higher than those in the control group， the differences were statistically significant （P < 0.05）. The levels of Ang-Ⅰ， Ang-Ⅱ in the hypertensive depression group were significantly higher than non-depression group， the differences were statistically significant （P < 0.05）. Logistic analysis has shown that the risk factors of depressive disorder in patients with hypertension included serum lipid （OR = 1.84， 95%CI： 1.12-3.05， P < 0.05）， Ang-Ⅰ（OR = 1.84， 95%CI： 1.18-8.10， P < 0.05） and Ang-Ⅱ（OR = 1.84， 95%CI： 1.05-3.58， P < 0.05） Conclusion Angiotensin is the independent risk factor for depression disorder in patients with hypertension， and the depression degree changed along with the serum angiotensin level.

[Key words] Depression； Essential hypertension； Angiotensin

抑郁症在心血管疾病患者中有较高发生率，尤其是全国患病率高达18.8%的高血压合并抑郁症受到关注和重视[1-2]。目前，抑郁症的病因仍不明确，参与抑郁的病理过程中相关递质种类繁多过程复杂。众多递质中血管紧张素-Ⅱ与抑郁相关性的研究的报道较少。本研究中笔者通过对南方医科大学附属顺德医院（以下简称“我院”）心内科确诊住院的原发性高血压合并抑郁患者和同期健康体检者的各项血液生化指标、血管紧张素（Ang-Ⅰ、Ang-Ⅱ）、醛固酮（ALD）水平进行测定和分析研究，旨在研究抑郁与原发性高血压患者血管紧张素及醛固酮的关系，为临床治疗提供新思路，现报道如下：