Chan J C, Cheung C K, Cockram C S, Critchley J A, Swaminathan R, Law L K, Nicholls M G
Department of Clinical Pharmacology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin.
J Hum Hypertens. 1994 Jun;8(6):451-6.
A total of 78 Chinese patients with clinically uncomplicated non-insulin-dependent diabetes (NIDDM) who had plasma creatinine concentrations of < 150 mumol/l were studied. Antihypertensive treatment was discontinued for at least six weeks prior to measurements of routine biochemistry, proteinuria, plasma atrial natriuretic peptide (ANP) concentrations and components of the renin-angiotensin-aldosterone system (RAAS). BP was measured on three occasions during the six weeks period prior to these measurements. At the end of the six week period, a total of 33 patients had definite hypertension (supine BP > or = 160/95 mmHg). The hypertensive patients had significantly higher plasma sodium (mean +/- SD): 140.3 +/- 1.9 vs. 138.5 +/- 2.0 mmol/l, P < 0.001) and lower plasma potassium (3.8 +/- 0.5 vs. 4.2 +/- 0.5 mmol/l, P < 0.01) concentrations. These were associated with reduced plasma aldosterone (median (range): 297 (98-1145) vs. 448.5 (93-1330) pmol/l, P < 0.01) and renin concentrations (16.8 (7.4-71.8) vs. 23.5 (7.4-83.7) ng/l, P = 0.06). The hypertensive patients also had significantly higher plasma ANP concentrations (36.5 (20.5-125.1) vs. 23.2 (11.7-63.0) pg/ml, P < 0.001), serum angiotensin converting enzyme (ACE) activity (65 (26-140.9) vs. 47 (22-106) units/l, P < 0.001) and urinary albumin excretion (UAE) (35.4 (1.6-4800) vs. 7.8 (1.8-310.4) mg/day, P < 0.001). Glycaemic control and renal function were similar between the two groups. Mean arterial pressure (MAP) correlated positively with plasma ANP concentration (r = 0.53, P < 0.001) and serum ACE activity (r = 0.37, P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
共研究了78例临床无并发症的非胰岛素依赖型糖尿病（NIDDM）中国患者，其血浆肌酐浓度<150μmol/l。在测量常规生化指标、蛋白尿、血浆心钠素（ANP）浓度以及肾素-血管紧张素-醛固酮系统（RAAS）各组分之前，停用降压治疗至少六周。在这些测量前的六周期间，三次测量血压。六周结束时，共有33例患者确诊为高血压（仰卧位血压≥160/95mmHg）。高血压患者的血浆钠浓度显著更高（均值±标准差：140.3±1.9 vs. 138.5±2.0mmol/l，P<0.001），而血浆钾浓度更低（3.8±0.5 vs. 4.2±0.5mmol/l，P<0.01）。这与血浆醛固酮（中位数（范围）：297（98 - 1145）vs. 448.5（93 - 1330）pmol/l，P<0.01）和肾素浓度降低（16.8（7.4 - 71.8）vs. 23.5（7.4 - 83.7）ng/l，P = 0.06）相关。高血压患者的血浆ANP浓度也显著更高（36.5（20.5 - 125.1）vs. 23.2（11.7 - 63.0）pg/ml，P<0.001），血清血管紧张素转换酶（ACE）活性（65（26 - 140.9）vs. 47（22 - 106）单位/l，P<0.001）以及尿白蛋白排泄量（UAE）（35.4（1.6 - 4800）vs. 7.8（1.8 - 310.4）mg/天，P<0.001）。两组间血糖控制和肾功能相似。平均动脉压（MAP）与血浆ANP浓度呈正相关（r = 0.53，P<0.001），与血清ACE活性呈正相关（r = 0.37，P<0.001）。（摘要截断于250字）
