正常高值血压对2型糖尿病动脉粥样硬化的影响  

Impact of high normal blood pressure on atherosclerosis in type 2 diabetes

作　　者：谭姣容[1] 陈宇红[1] 徐敏[1] 黄韵[1] 毕宇芳[1] 宁光[1] 李小英[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院内分泌代谢病科,上海市内分泌代谢病临床医学中心,上海市内分泌代谢病研究所 ,200025

出　　处：《中华内分泌代谢杂志》2009年第4期370-373,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：上海市科委资助项目（Shdc12007309）

摘　　要：目的明确正常高值血压对2型糖尿病患者动脉粥样硬化的影响。方法瑞金医院内分泌代谢病科门诊入选930例2型糖尿病患者，平均年龄59岁，根据血压分为3组：正常血压组（167例）、正常高值血压组（213例）、高血压组（550例）。通过测量颈动脉内中膜厚度（IMT）和臂踝脉搏波传导速度（baPWV）评估动脉粥样硬化情况，以最大IMT≥1.1mm或baPWV≥1400cm／s诊断动脉粥样硬化。结果合并高血压和正常高值血压的糖尿病患者颈动脉IMT及baPWV较正常血压的糖尿病患者均显著增加。多元logistic回归分析表明，与正常血压相比，正常高值血压是动脉粥样硬化（最大IMT≥1．1mm：OR 2．10，95％CI1．28～3．44；baPWV≥1400cm／s：OR3．09，95％CI1．78—5．36）的独立危险因素。结论在2型糖尿病中正常高值血压是动脉粥样硬化的独立危险因素。在2型糖尿病患者，保持收缩压〈120mmHg（1mmHg=0．133kPa）和舒张压〈80mmHg，可以降低糖尿病动脉粥样硬化的风险。Objective To evaluate the impact of high normal blood pressure （BP） level atherosclerosis in type 2 diabetic patients. Methods Nine hundred and thirty outpatients with type 2 diabetes were recruited in Ruijin Hospital and allocated into normotensive（n=167）, high normal BP（n= 213） and hypertensive（n= 550）groups based on blood pressure levels. Maximum intima-media thickness （ IMT ） of carotid arteries and brachial-ankle pulse-wave velocity （ baPWV ） were measured to assess atherosclerosis. Results Subjects with hypertension and high normal BP were with significantly greater maximum IMT and baPWV as compared to those with normal BP. Multiple logistic regression analysis revealed that high normal BP was a significant independent determinant factor of atherosclerosis （maximum IMT≥1.1mm：OR 2. 10,95% CI 1. 28-3. 44;baPWV≥ 1 400 cm/s：OR 3. 09,95% CI 1. 78-5. 36）. Conclusion High normal BP is a significant determinant factor of atherosclerosis independent of conventional cardiovascular risk factors in type 2 diabetic patients. Maintenance of systolic BP〈120 mm Hg（1 mm Hg= 0. 133 kPa） and diastolic BP〈80 mm Hg may reduce the risk of atherosclerosis in type 2 diabetes.

关 键 词：血压 糖尿病 2型 动脉硬化 颈动脉内中膜厚度 踝臂脉搏波传导速度 

分 类 号：R686[医药卫生—骨科学]