糖尿病对老年高血压患者动态血压及血压变异性的影响  

Effects of diabetes mellitus on ambulatory blood pressure and blood pressure variability in elderly patients with hypertension

作　　者：林华容[1] 吴平彬[1] 周琳妮[1] 

机构地区：[1]潮州市中心医院,广东潮州521000

出　　处：《岭南心血管病杂志》2013年第3期329-331,335,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨老年2型糖尿病患者中糖尿病对原发性高血压(高血压)患者的动态血压(ambulatory bloodpressure,ABP)及血压变异性(blood pressure variability,BPV)的影响。方法选取40例单纯高血压及42例65岁以上合并2型糖尿病的高血压患者,行24 h ABP监测,对2组患者的ABP及BPV进行对比分析。结果合并2型糖尿病的高血压患者日间平均收缩压(dmSBP)及夜间平均收缩压(nmSBP)高于单纯高血压患者,差异有统计学意义(P<0.05或0.01);合并2型糖尿病的高血压患者日间脉压(dmPP)、夜间脉压(nmPP)及24 h平均脉压差(24 h-mPP)均大于单纯高血压患者,差异有统计学意义(P<0.05或0.01);BPV方面,合并2型糖尿病的高血压患者日间收缩压标准差(dSBPSD)及日间收缩压标准差变异系数(dSBPCV)、夜间收缩压标准差(nSBPSD)及夜间收缩压标准差变异系数(nSBPCV)、24 h收缩压标准差(24 h-SBPSD)均显著高于单纯高血压患者,差异有统计学意义(P<0.05或0.01)。结论年龄、高血压是老年2型糖尿病患者大血管病变的独立危险因素,2型糖尿病合并高血压时,ABP及BPV增大,心血管系统的结构与功能异常。改善糖代谢状况将有助于形成良好的代谢记忆,从而改善血流动力学,减少心血管并发症。Objectives To investigate the effects of type 2 diabetes mellitus （T2DM） on ambulatory blood pressure （ABP） and blood pressure variability （BPV） in elderly patients with essential hypertension （EH）. Methods Fourty patients with simple EH （Group A） and 42 patients with T2DM combined with EH aged over 65 （Group B） were included. 24-hour ABP monitoring was administered in both groups. ABP and BPV of the two groups were compared. Results Daytime average systolic blood pressure （dmSBP）, nocturnal average systolic blood pressure （nmSBP）, daytime pulse pressure （dmPP）, nocturnal pulse pressure （nmPP） and 24-hour average pulse pressure （24 h-mPP） in Group B were significantly higher than those in Group A （P〈0.05 or P〈0.01 ）. In BPV aspects, daytime systolic blood pressure standard deviation （dSBPSD）, daytime systolic blood pressure standard deviation coefficient of variation （dSBPCV）, nocturnal systolic blood pressure standard deviation （nSBPSD）, nocturnal systolic blood pressure standard deviation coefficient of variation （nSBPCV） and 24-hour systolic blood pressure standard deviation （24h-SBPSD） in Group B were significantly higher than those in Group A （P〈0.05 or P〈0.01 ）. Conclusions Age and hypertension are independent risk factors for macrovaseular disease in elderly patients with T2DM. In patients with T2DM combined with EH, ABP and BPV increase, and the structure and function of the cardiovascular system are anomalous.The improvement of glucose metabolism can contribute to the improvement of hemodynamies and the reduction of cardiovascular complications.

关 键 词：高血压 糖尿病 血压 老年人 

分 类 号：R544.1[医药卫生—心血管疾病]