儿童先天性肾上腺皮质增生症:血浆肾素活性与高血压之间的关系。

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Iranian Journal of Medical Sciences Pub Date : 2024-06-01 DOI:10.30476/ijms.2023.98508.3058
Siska Mayasari Lubis, Frida Soesanti, Eka Laksmi Hidayati, Bambang Tridjaja Aap
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引用次数: 0

摘要

背景:先天性肾上腺皮质增生症(CAH)患儿患高血压的几率较高。服用氟氢可的松药物并出现过度抑制的 CAH 儿童患高血压的几率更高。血浆肾素活性(PRA)是氟氢可的松剂量不足时的一个敏感指标。本研究旨在评估血浆肾素活性与 21- 羟化酶缺乏(21-OHD)CAH 儿童高血压之间的关系:这项横断面观察分析研究于 2019 年在印度尼西亚雅加达 Cipto Mangunkusumo 医生医院(RSCM)的儿科内分泌门诊进行。研究对象为21名年龄大于6个月至18岁的OHD CAH儿童,他们已服用氢化可的松或氟氢可的松至少6个月,分为高血压组和非高血压组。受试者通过连续抽样法选出。数据采用 SPSS 软件(23.0 版)进行分析,并进行非配对 t 检验分析和多元 Logistic 回归检验。如果结果有统计学意义,则为差异显著:纳入了 40 名 21-OHD CAH 患者,其中 20 人(50%)患有高血压。盐耗竭型 CAH 的高血压发病率高于单纯男性化型(59.3% 对 30.8%)。在盐耗竭型患者中,高血压组和非高血压组的 PRA 水平均值差异明显(P=0.016)。最后一次服用氢化可的松的剂量与盐耗竭患者中高血压患者的数量之间存在明显差异(P=0.032),PRA水平低的患者患高血压的风险比PRA水平高1.09倍:结论:PRA水平低的盐耗竭型CAH患儿患高血压的风险较高。
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Congenital Adrenal Hyperplasia in Children: The Relationship between Plasma Renin Activity and Hypertension.

Background: Children with Congenital Adrenal Hyperplasia (CAH) have a higher chance of hypertension. The likelihood of hypertension is higher in CAH children who get fludrocortisone medication and have an over-suppression. Plasma renin activity (PRA) is a sensitive indicator when the fludrocortisone dose is insufficient. The objective of this study is to assess the relationship between plasma renin activity with hypertension in 21-hydroxylase-deficient (21-OHD) CAH children.

Methods: This cross-sectional observational analytical study was conducted in 2019 at the Pediatric Endocrinology Outpatient Clinic in Dr. Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia. The subjects were 21-OHD CAH children, aged >6 months to 18 years who had already taken hydrocortisone with or without fludrocortisone for at least 6 months, and were divided into hypertension and non-hypertension groups. The subjects were selected by a consecutive sampling method. Data was analyzed using SPSS software (version 23.0) with unpaired t test analysis and multiple logistic regression test. Statistical significance was achieved if P<0.05.

Results: Forty 21-OHD CAH patients were included, and 20 subjects (50%) had hypertension. A higher incidence of hypertension was found in salt-wasting CAH than in simple virilizing types (59.3% vs 30.8%). There was a significant mean difference in PRA levels between hypertension and non-hypertension groups in salt-wasting patients (P=0.016). A significant difference between the last dose of hydrocortisone with the number of hypertension patients in salt-wasting patients (P=0.032) was found, and low PRA levels showed a 1.09 times higher risk of hypertension.

Conclusion: Children with salt-wasting CAH with low PRA levels had a higher risk of getting hypertension.

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来源期刊
Iranian Journal of Medical Sciences
Iranian Journal of Medical Sciences MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
0.00%
发文量
84
审稿时长
12 weeks
期刊介绍: The Iranian Journal of Medical Sciences (IJMS) is an international quarterly biomedical publication, which is sponsored by Shiraz University of Medical Sciences. The IJMS intends to provide a scientific medium of com­muni­cation for researchers throughout the globe. The journal welcomes original clinical articles as well as clinically oriented basic science re­search experiences on prevalent diseases in the region and analysis of various regional problems.
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