清晨高血压伴2型糖尿病对靶器官的影响  

Effects of morning blood pressure surge on target organ in the patients with type 2 diabetes mellitus

作　　者：胥勇斌[1] 胡蓉[1] 佘强[1] 陈运清[1] 刘东[1] 叶春姬[1] 

机构地区：[1]重庆医科大学附属第二医院心内科,重庆400010

出　　处：《临床心血管病杂志》2011年第8期586-589,共4页Journal of Clinical Cardiology

基　　金：国家自然科研基金项目(No:81070140);重庆市卫生局医学科研资助项目(No:2008-2-45)

摘　　要：目的:探讨清晨高血压(MBPS)伴2型糖尿病(T2DM)对靶器官的影响。方法:600例原发性高血压(EH)患者,其中伴T2DM者188例,不伴T2DM者412例;依据有无MBPS和T2DM分为:MBPS伴T2DM组(A组,72例)、MBPS不伴T2DM组(B组,120例)、T2DM非MBPS组(C组,116例)、非MBPS不伴T2DM组(D组,292例)。检测24 h动态血压、臂踝脉搏波传导速度(baPWV)、颈动脉内膜中层厚度(IMT)、左室质量指数(LV-MI)、超敏C反应蛋白(hsCRP)、尿微量白蛋白(UAM)。结果:伴T2DM的EH患者MBPS发生率为38.30%,明显高于不伴T2DM的EH患者(29.13%),P<0.05。A组hsCRP[(5.70±1.07)mg/L]、baPWV[(2 129±115)cm/s]、LVMI[(141.0±13.1)g/m2]、IMT[(1.11±0.07)mm]、UAM[(38.04±15.61)mg/L]均显著高于其他各组(P<0.05)。B组和C组hsCRP、baPWV、IMT、LVMI、UAM也显著高于D组(均P<0.05)。结论:EH伴T2DM患者的MBPS发生率明显增加;MBPS或T2DM都会加重EH患者的动脉粥样硬化,导致hsCRP、baPWV、IMT、LVMI、UAM明显增加,当两者并存时,对靶器官的损害更加明显。Objective：To study the effects of morning blood pressure surge（MBPS） on target organ in the patients with type 2 diabetes mellitus（T2DM）. Method：The total of 600 cases of essential hypertensive patients were according to whether the MBPS and T2DM divided into 4 groups： group morning blood pressure surge complicated with T2DM（group MBPS＋T2DM,n=72）,group morning blood pressure surge（group MBPS,n=120）,group T2DM complicated without morning blood pressure surge（group MBPS＋EH,n=116）,group essential hypertension complicated without T2DM and MBPS（group EH,n=292）.The 24 h ambulatory blood pressure monitoring was performed.The high-sensitivity C-reactive protein（hsCRP）,left ventricular mass index（LVMI）,intima-media thickness（IMT）,urine microalbuminur（UAM） and the brachial-ankle artery pulse wave velocity（baPWV） were measured too. Result：Compared with nondiabetic patients,the occurrence of MBPS were significant greater in diabetic patients（P0.05）.The value of hsCRP,baPWV,IMT,LVMI,UAM were significantly lower in the group MBPS,group EH＋T2DM,group EH than that in the group MBPS＋T2DM（[5.70±1.07]mg/L,[2129±115]cm/s,[1.11±0.07]mm,[141.0±13.1]g/m2,[38.04±15.61]mg/L）,P0.05.It showed that there were statistical differences in hsCRP,baPWV,LVMI,IMT,UAM between group MBPS and group EH.It showed that there were statistical differences in hsCRP,baPWV,LVMI,IMT,UAM between group MBPS＋EH and group EH too. Conclusion：T2DM patients with EH have a greater incidence of MBPS.For the patients with EH,whether T2DM or MBPS are contributing to atherosclerosis and the increasment of hsCRP,baPWV,LVMI,UAM,while MBPS complicated with T2DM the degree of atherosclerosis and the damage of target organs were further increased.

关 键 词：高血压 清晨高血压 2型糖尿病 靶器官 

分 类 号：R544.1[医药卫生—心血管疾病]