Ⅱ型糖尿病合并原发性高血压患者的动态血压与微量白蛋白尿的关系  

Relationship between ambulatory blood pressure andmicroalbuminuria in patient with noninsulin dependentdiabetes mellitus and hypertension

作　　者：路影[1] 陈梅晞[1] 蓝红林[1] 

机构地区：[1]桂林医学院附属医院内科

出　　处：《临床心血管病杂志》1999年第6期246-249,共4页Journal of Clinical Cardiology

摘　　要：目的：了解Ⅱ型糖尿病（ＮＩＤＤＭ）合并原发性高血压（ＥＨ）患者的动态血压与微量白蛋白尿（ＭＡＵ）的关系。方法：对２６例伴ＭＡＵ的ＮＩＤＤＭ合并ＥＨ患者与２７例正常白蛋白尿（ＮＡＵ）的ＮＩＤＤＭ合并ＥＨ患者的２４ｈ动态血压、胰岛素、糖化血红蛋白、体重指数、血脂等的比较分析，并对所有患者的尿白蛋白排泄率（ＵＡＥＲ）与有关因素进行多因素回归分析。结果：ＭＡＵ组的夜间平均收缩压（ＮＭＳＰ）较ＮＡＵ组显著增高〔（１４１．２０±６．７７）ｍｍＨｇ对（１３０．５３±６．９２）ｍｍＨｇ，Ｐ＜０．００１〕，而且ＮＭＳＰ与ＵＡＥＲ呈独立的相关性〔标准偏回归系数（β）＝０．４５３，Ｐ＝０．０００６〕。结论：在ＮＩＤＤＭ合并ＥＨ患者中，ＮＭＳＰ升高是ＭＡＵ的独立危险因素，而且可能是ＭＡＵ使心血管病死亡率增加的主要原因之一。Objective: To investigate the relationship between ambulatory blood pressure and microalbuminuria in patient with noninsulin dependent diabetses mellitus (NIDDM) and hypertension. Methods: 26 microalbuminuric NIDDM with hypertension and 27 normoalbuminuric NIDDM with hypertension were monitored with 24hour ambulatory blood pressure,and measured fasting insulin,HbAlc,blood glucose,lipids and computed body mass index. Results: The group with microalbuminuria had significantly higher nocturnal systolic blood pressure compared to the group with normoalbuminuria (141.206.77) mmHg VS (130.536.92) mmHg,P<0.001.In multiple regressive analysis,nocturnal systolic blood pressure was independently associated with urinary albumin excretion rate (=0.453,P=0.0006). Conclusion: In NIDDM with hypertension,increased nocturnal systolic blood pressure is an independent risk factor for microalbuminuiria,and may be one of the major cause of microalbuminuria which increases mortality from cardiovascular disease.

关 键 词：糖尿病 高血压 白蛋白尿 动态血压 Ⅱ型 

分 类 号：R587.206[医药卫生—内分泌] R544.102[医药卫生—内科学]