中老年高血压合并2型糖尿病患者糖化血红蛋白与血压变异性的相关性研究  

The correlation of glycosylated hemoglobin and blood pressure variability in elderly patients with hypertension and type 2 diabetes mellitus

作　　者：黄江明[1] 徐琳[1] 邱健[1] 马骏[1] 

机构地区：[1]广州军区广州总医院心血管内科,广州510010

出　　处：《广东医学》2016年第24期3673-3677,共5页Guangdong Medical Journal

基　　金：广东省科技计划项目重大科技专项基金项目(编号:2013A022100036);广东省科技计划项目(编号:2014A020212257)

摘　　要：目的探讨中老年高血压合并2型糖尿病患者中糖化血红蛋白(Hb A1C)与血压变异性(BPV)的相关性。方法以144例中老年高血压合并2型糖尿病患者为研究对象,测定患者Hb A1C和BPV,分析Hb A1C与BPV的相关性;然后根据测得的Hb A1C值将患者分成正常组(Hb A1C<6.0%,n=97)、正常高值组(6.0%≤Hb A1C<7.0%,n=31)和升高组(Hb A1C>7.0%,n=16);最后在调整年龄、性别、血脂、肌酐因素的情况下分析与Hb A1C有相关性的BPV指标在3组之间的差异。结果中老年高血压合并2型糖尿病患者Hb A1C与夜间平均收缩压、白天收缩压变异系数、白天收缩压平均真实变异性、24 h收缩压连续变异性、白天收缩压连续变异性均具有明显的相关性,且升高组夜间平均收缩压、白天收缩压平均真实变异性、24 h收缩压连续变异性、白天收缩压连续变异性均显著高于正常组;白天收缩压平均真实变异性、白天收缩压连续变异性均显著高于正常高值组。结论在中老年高血压合并2型糖尿病患者中,Hb A1C与BPV之间存在显著相关性,积极控制血糖水平,将更有益于BPV的控制,从而减少靶器官的损害。Objective To investigate the correlation between glycosylated hemoglobin （HbA1C） and blood pressure variability （BPV） in elderly patients hypertension and type 2 diabetes mellitus （T2DM）. Methods A total of 144 elderly patients with hypertension and T2DM were included. HbA1C and BPV were measured and the correlation between them were analyzed. According to HbA1C level, all participants were divided into normal group （HbAlc 〈 6. 0% , n = 97）, high-normal group （6. 0% ≤HbA1C 〈7. 0%, n =31） and risen group （HbAmc 〉7. 0%, n = 16）. The BPV indexes correlated to the HbA1C were analyzed and further compared among the three groups. Results In elderly patients with hypertension and T2DM, HbA1C level was significantly correlated with BPV indexes, including night mean SBP, CV of day SBP, ARV of day SBP, 24 - hour SV of SBP and day SV of SBP. The night mean SBP, ARV of day SBP, 24 - hour SV of SBP and day SV of SBP in risen group were significantly higher than those in normal group. Meanwhile, day ARV of SBP and day SV of SBP in risen group were significantly higher than those in normal - high group. Conclusion In elderly patients with hypertension and T2DM, there is a significant correlation between HbA1C and BPV, positive control of blood glucose level would benefit the BPV control, thereby reducing the target organ damage.

关 键 词：中老年高血压 2型糖尿病 糖化血红蛋白 血压变异性 

分 类 号：R544.1[医药卫生—心血管疾病]