中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
28期
29-33
,共5页
高血压%糖尿病%昼夜节律%血压变异性%靶器官
高血壓%糖尿病%晝夜節律%血壓變異性%靶器官
고혈압%당뇨병%주야절률%혈압변이성%파기관
Hypertension%Diabetes mellitus%Circadian rhythm%Blood pressure variability%Target organ
目的 探讨老年原发性高血压合并糖尿病患者血压昼夜节律改变、血压变异性及其与靶器官损害的关系.方法 根据合并糖尿病情况,将老年原发性高血压患者132例分为单纯高血压组74例和高血压合并糖尿病组58例,选择年龄、性别相匹配的健康体检者39例作为对照组,单纯糖尿病患者61例作为单纯糖尿病组.比较4组的一般临床资料及动态血压检测结果,如24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 h DBP)、白昼平均收缩压(dSBP)、白昼平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)等,分析各组间收缩压和舒张压昼夜差值百分比(△SBP％、△DBP％)及靶器官损害的情况.结果 高血压合并糖尿病组的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及颈动脉内膜-中层厚度(IMT)明显高于单纯高血压组[(5.48±1.03) mmol/L比(4.96±1.14) mmol/L;(3.92±0.63) mmol/L比(3.17 ±0.55) mmol/L;(1.41±0.19) mm比(0.93±0.20) mm],差异有统计学意义(P＜0.05).与单纯高血压组比较,高血压合并糖尿病组的24 h SBP、nSBP明显增高,24 h DBP、dDBP明显降低[(145.3±13.1) mm Hg(1 mm Hg=0.133 kPa)比(137.1±12.8)mm Hg;(139.4±9.9) mm Hg比(131.1±11.6)mm Hg;(74.2±9.6)mm Hg比(80.9±9.2) mm Hg; (77.2±9.1) mm Hg比(82.4±9.3) mm Hg],差异有统计学意义(P＜0.05).高血压合并糖尿病组发生靶器官损害的比例要高于其他各组[55.17％ (32/58)比27.87％(17/61)、21.62％(16/74)、10.26％ (4/39)],差异有统计学意义(P＜0.05).Logistic回归分析显示,年龄(OR=1.145,95％CI:1.088～ 1.201,P＜0.05)是靶器官损害的危险因素,而△SBP％(OR=0.918,95％ CI:0.872 ～ 0.984,P＜0.05)是靶器官损害的保护因素.结论 原发性高血压合并糖尿病明显增加了血压变异性,加重血压昼夜节律异常及靶器官损害.
目的 探討老年原髮性高血壓閤併糖尿病患者血壓晝夜節律改變、血壓變異性及其與靶器官損害的關繫.方法 根據閤併糖尿病情況,將老年原髮性高血壓患者132例分為單純高血壓組74例和高血壓閤併糖尿病組58例,選擇年齡、性彆相匹配的健康體檢者39例作為對照組,單純糖尿病患者61例作為單純糖尿病組.比較4組的一般臨床資料及動態血壓檢測結果,如24 h平均收縮壓(24 h SBP)、24 h平均舒張壓(24 h DBP)、白晝平均收縮壓(dSBP)、白晝平均舒張壓(dDBP)、夜間平均收縮壓(nSBP)、夜間平均舒張壓(nDBP)等,分析各組間收縮壓和舒張壓晝夜差值百分比(△SBP％、△DBP％)及靶器官損害的情況.結果 高血壓閤併糖尿病組的總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)及頸動脈內膜-中層厚度(IMT)明顯高于單純高血壓組[(5.48±1.03) mmol/L比(4.96±1.14) mmol/L;(3.92±0.63) mmol/L比(3.17 ±0.55) mmol/L;(1.41±0.19) mm比(0.93±0.20) mm],差異有統計學意義(P＜0.05).與單純高血壓組比較,高血壓閤併糖尿病組的24 h SBP、nSBP明顯增高,24 h DBP、dDBP明顯降低[(145.3±13.1) mm Hg(1 mm Hg=0.133 kPa)比(137.1±12.8)mm Hg;(139.4±9.9) mm Hg比(131.1±11.6)mm Hg;(74.2±9.6)mm Hg比(80.9±9.2) mm Hg; (77.2±9.1) mm Hg比(82.4±9.3) mm Hg],差異有統計學意義(P＜0.05).高血壓閤併糖尿病組髮生靶器官損害的比例要高于其他各組[55.17％ (32/58)比27.87％(17/61)、21.62％(16/74)、10.26％ (4/39)],差異有統計學意義(P＜0.05).Logistic迴歸分析顯示,年齡(OR=1.145,95％CI:1.088～ 1.201,P＜0.05)是靶器官損害的危險因素,而△SBP％(OR=0.918,95％ CI:0.872 ～ 0.984,P＜0.05)是靶器官損害的保護因素.結論 原髮性高血壓閤併糖尿病明顯增加瞭血壓變異性,加重血壓晝夜節律異常及靶器官損害.
목적 탐토노년원발성고혈압합병당뇨병환자혈압주야절률개변、혈압변이성급기여파기관손해적관계.방법 근거합병당뇨병정황,장노년원발성고혈압환자132례분위단순고혈압조74례화고혈압합병당뇨병조58례,선택년령、성별상필배적건강체검자39례작위대조조,단순당뇨병환자61례작위단순당뇨병조.비교4조적일반림상자료급동태혈압검측결과,여24 h평균수축압(24 h SBP)、24 h평균서장압(24 h DBP)、백주평균수축압(dSBP)、백주평균서장압(dDBP)、야간평균수축압(nSBP)、야간평균서장압(nDBP)등,분석각조간수축압화서장압주야차치백분비(△SBP％、△DBP％)급파기관손해적정황.결과 고혈압합병당뇨병조적총담고순(TC)、저밀도지단백담고순(LDL-C)급경동맥내막-중층후도(IMT)명현고우단순고혈압조[(5.48±1.03) mmol/L비(4.96±1.14) mmol/L;(3.92±0.63) mmol/L비(3.17 ±0.55) mmol/L;(1.41±0.19) mm비(0.93±0.20) mm],차이유통계학의의(P＜0.05).여단순고혈압조비교,고혈압합병당뇨병조적24 h SBP、nSBP명현증고,24 h DBP、dDBP명현강저[(145.3±13.1) mm Hg(1 mm Hg=0.133 kPa)비(137.1±12.8)mm Hg;(139.4±9.9) mm Hg비(131.1±11.6)mm Hg;(74.2±9.6)mm Hg비(80.9±9.2) mm Hg; (77.2±9.1) mm Hg비(82.4±9.3) mm Hg],차이유통계학의의(P＜0.05).고혈압합병당뇨병조발생파기관손해적비례요고우기타각조[55.17％ (32/58)비27.87％(17/61)、21.62％(16/74)、10.26％ (4/39)],차이유통계학의의(P＜0.05).Logistic회귀분석현시,년령(OR=1.145,95％CI:1.088～ 1.201,P＜0.05)시파기관손해적위험인소,이△SBP％(OR=0.918,95％ CI:0.872 ～ 0.984,P＜0.05)시파기관손해적보호인소.결론 원발성고혈압합병당뇨병명현증가료혈압변이성,가중혈압주야절률이상급파기관손해.
Objective To explore the relationship between blood pressure variability and target organ damage in elder essential hypertension combined with type 2 diabetes mellitus (T2DM) patients.Methods One hundred and thirty-two elder essential hypertension patients were divided into two groups:single hypertension group (74 patients) and hypertension combined with T2DM group (58 patients).Thirty-nine cases of healthy person were chosen as control group and 61 single T2DM patients were as single T2DM group.Clinical data and ambulatory blood pressure monitoring indexes of 24-hour mean systolic blood pressure (24 h SBP),24-hour mean diastolic blood pressure (24 h DBP),diurnal mean systolic blood pressure (dSBP),diurnal mean diastolic blood pressure(dDBP),night mean systolic blood pressure(nSBP),night mean diastolic blood pressure (nDBP) were measured in the four groups.The percentage difference between dSBP and nSBP(△ SBP％),between dDBP and nDBP(△ DBP％) and target organ damage in four groups were also analyzed.Results Compared with single hypertension group,hypertension combined with T2DM group showed increased total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C) and carotid artery intimal-medial thickness (IMT) [(5.48 ± 1.03) mmol/L vs.(4.96 ± 1.14) mmol/L,(3.92 ± 0.63) mmol/L vs.(3.17 ± 0.55) mmol/L,(1.41 ± 0.19) mm vs.(0.93 ± 0.20) mm](P＜ 0.05).24 h SBP and nSBP was significantly higher in hypertension combined with T2DM group than that in single hypertension group,while 24 h DBP and dDBP was significantly lower[(145.3 ± 13.1) mm Hg(1 mm Hg =0.133 kPa) vs.(137.1 ± 12.8) mm Hg,(139.4 ± 9.9) mm Hgvs.(131.1 ± 11.6) mm Hg,(74.2 ± 9.6) mm Hgvs.(80.9 ± 9.2) mm Hg,(77.2 ± 9.1) mm Hg vs.(82.4 ± 9.3) mm Hg] (P ＜ 0.05).The incidence of target organ damage in hypertension combined with T2DM group was significantly higher than that in other groups [55.17％ (32/58) vs.27.87％ (17/61),21.62 ％ (16/74),10.26％ (4/39)] (P ＜ 0.05).Logistic regression analysis showed that age was a risk factor (OR =1.145,95％ CI:1.088-1.201,P ＜ 0.05),while △ SBP％ was a protective factor (OR =0.918,95％ CI:0.872-0.984,P ＜0.05).Conclusion Hypertension combined with T2DM can increase the blood pressure variability,aggravate the abnormality of the circadian rhythm of blood pressure and target organ damage.
