高血压合并糖尿病患者血压变异性与同型半胱氨酸的相关性  

Correlation between blood pressure variability and homocysteine in patients with hypertension and diabetes mellitus

作　　者：吴金花[1] 杨杨[1] 冯丽珍[1] WU Jin-hua YANG Yang FENG Li-zhen(Department of Cardiology, Inner Mongolia Autonomous Region Corps Hospital of PAP, Huhhot 010040, China)

机构地区：[1]武警内蒙古总队医院心内科,内蒙古呼和浩特010040

出　　处：《武警后勤学院学报（医学版）》2016年第8期633-636,共4页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】通过探讨高血压合并糖尿病患者的血压变异性(blood pressure varibility,BPV)和同型半胱氨酸(homocysteine,Hcy)的关系,提示临床医生在关注血压、血糖的同时也应关注血压变异性和同型半胱氨酸。【方法】选取高血压合并糖尿病的病例96例,男57例,女39例。依照Hcy水平将其分为高Hcy组(Hcy>15μmol/L)64例,正常Hcy组(Hcy<=15μmol/L)32例;依据糖化血红蛋白(glycosylated hemoglobin,Hb A1c)水平分为血糖升高组(Hb A1c≥7%)54例,血糖控制组(Hb A1c<7%)42例。分别测定患者的24 h动脉血压、血浆Hcy水平,Hb A1c水平,计算24 h收缩压标准差(24 h systolic blood pressure standard deviation,24 h SSD)、24 h舒张压标准差(24 h diastolic blood pressure standard deviation,24 h DSD)、白天收缩压标准差(day systolic blood pressure standard deviation,d SSD)、白天舒张压标准差(day diastolic blood pressure standard deviation,d DSD)、夜间收缩压标准差(night systolic blood pressure standard deviation,n SSD)、夜间舒张压标准差(night diastolic blood pressure standard deviation,n DSD),分别计算它们的变异系数(coefficient of variation,CV),分析BPV与Hcy的相关性。【结果】高血压合并糖尿病患者中,高Hcy组的BPV(24 h SSD、24 h SCV、d SSD、d SCV、n SSD、n SCV、n DSD)明显高于正常Hcy组(P<0.05),血糖升高组的Hcy水平、BPV(24 h SCV、d SCV、n SCV、n DCV)明显高于血糖控制组(P<0.05)。【结论】BPV与Hcy水平呈正相关;血糖升高可致Hcy水平升高,BPV增大。在高血压合并糖尿病患者当中,对血糖控制欠佳的患者更应关注Hcy水平和BPV。【Objective】To explore the relationship between blood pressure variability（BPV） and homocysteine（Hcy） in patients with hypertension and diabetes mellitus, and indicate that clinicians should focus on blood pressure, blood glucose, as well as BPV and Hcy at the same time.【Methods】A total of 96 cases with hypertension and diabetes were selected, including 57 males and 39 females.According to the level of Hcy, they were divided into two groups： 64 cases in high Hcy group（Hcy15 μmol/L） and 32 cases in normal Hcy group（Hcy ≤15 μmol/L）. According to the level of glycosylated hemoglobin（Hb A1c）, they were divided into another two groups： 54 cases in elevated blood-glucose group（Hb A1 c ≥ 7%） and 42 cases in controlled blood-glucose group（Hb A1 c 7%）. The 24 h arterial blood pressure, the level of plasma Hcy and Hb A1 c were detected respectively. The 24 h systolic blood pressure standard deviation（24h SSD）, 24 h diastolic blood pressure standard deviation（24 h DSD）, day systolic blood pressure standard deviation（d SSD）, day diastolic blood pressure standard deviation（d DSD）, night systolic blood pressure standard deviation（n SSD）, night diastolic blood pressure standard deviation（n DSD） were calculated. Then their coefficients of variation（CV） were also calculated. Finally, the correlation between BPV and Hcy was analyzed.【Results】In patients with hypertension and diabetes, BPV（24 h SSD, 24 h SCV, d SSD, d SCV,n SSD, n SCV and n DSD） in high Hcy group was significantly higher than that in normal Hcy group（P0.05）. The Hcy level and BPV（24h SCV, d SCV, n SCV and n DCV） in elevated blood-glucose group were significantly higher than those in controlled blood-glucose group（P0.05）. 【Conclusion】BPV is positively correlated withHcy. The elevated blood-glucose level can result in the elevated Hcy level and BPV. In patients with hypertension and diabetes, those with poor blood glucose control should pay more attention to the Hcy level

关 键 词：高血压 糖尿病 血压变异性 同型半胱氨酸 

分 类 号：R544[医药卫生—心血管疾病]