原发性高血压合并2型糖尿病患者血糖控制对降压疗效的影响  

Effects of plasma glucose control on blood pressure in hypertension patients with type 2 diabetes mellitus

作　　者：薛迪中[1] 魏娜[1] 常万松[1] 

机构地区：[1]武警河南总队医院门诊部,郑州450052

出　　处：《中国实用医刊》2014年第18期37-39,共3页Chinese Journal of Practical Medicine

摘　　要：目的：通过对高血压合并2型糖尿病患者血糖水平的控制，探讨不同血糖水平对降压疗效的影响。方法连续选择住院和门诊高血压合并2型糖尿病患者68例，根据高血压和2型糖尿病治疗指南选择降压和降糖方案，记录患者治疗过程中不同血糖水平时的降压疗效，同时检测治疗开始与结束时的血浆内皮素（ ET-1）、空腹血糖（FPG）、胰岛素（FINS）及糖化血红蛋白（HbA1c）水平。结果随着治疗过程中血糖水平的逐渐改善，血压达标例数明显增加。经过4~6周的降糖治疗，血糖接近达标（6.1~6.9 mmol /L）和达标（﹤6.1 mmol/L）时，血压达标率分别为82.35%和95.59%，与血糖≥7.0 mmol/L（血压达标率51.47%）及≥7.8 mmol/L（血压达标率27.94%）水平相比差异有统计学意义；同时可以看出，治疗前后患者血浆ET-1、FPG及FINS水平均有不同程度下降。结论高血压合并2型糖尿病患者血糖水平与降压疗效关系密切，良好的血糖控制有利于血压的治疗，从而更好地防控心脑血管疾病的发生、发展。Objective To investigate the effect of different plasma glucose levels on the blood pressure in hypertension patients with type 2 diabetes mellitus. Methods Sixty-eight consecutive outpa-tients and inpatients with hypertension complicated with type 2 diabetes mellitus were selected. All pa-tients were treated according to the essential hypertension guideline and the type 2 diabetes mellitus guideline . The relationship between antihypertensive efficacy and plasma glucose levels was observed dur-ing the course of treatment. The levels of plasma endothelin（ET-1）,fasting plasma glucose（FPG）,in-sulin（FINS）,glycosylated hemoglobin（HbA1c）and insulin antibody（Anti-INS）were also detected be-fore and after treatment. Results The control rates of blood pressure increased through 4 -6 weeks’ treatment accompanied by decreased plasma glucose level. The control rates of blood pressure（95. 59%, 82. 35%,51. 47%,27. 94%）at different blood glucose levels（ ﹤6. 1 mmol/L,6. 1-6. 9 mmol /L,≥7. 0 mmol/L,≥7. 8 mmol/L）had significant difference（P﹤0. 05）. In the mean while,the levels of blood plasma,ET-1,FPG,FINS,HbA1c and Anti-INS declined in different degree after the treatment. Conclusions Plasma glucose control closely related to antihypertensive efficacy in patients with hyper-tension complicated with type 2 diabetes mellitus. Plasma glucose control can benefit blood pressure treat-ment,so as to better prevent and treat cardiovascular and cerebrovascular diseases.

关 键 词：原发性高血压 2型糖尿病 空腹血糖 

分 类 号：R544.1[医药卫生—心血管疾病]