原发性高血压患者口服葡萄糖耐量试验血糖水平与早期肾损伤的关系  

Relationship between OGTT blood glucose levels and early kidney damage in patients with essential hypertension

作　　者：陈素芬 赵玉兰[1] 黄亚萍[1] 赵映璇 CHEN Su-fen;ZHAO Yu-lan;HUANG Ya-ping;ZHAO Ying-xuan(Department of Cardiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州大学第二附属医院心内科,郑州医学硕士研究生450000

出　　处：《医学研究生学报》2019年第1期82-86,共5页Journal of Medical Postgraduates

摘　　要：目的在糖尿病前期阶段就可出现微血管病变。文中观察口服葡萄糖耐量试验(OGTT) 1小时血糖(1hPG)及2小时血糖(2hPG)水平与尿微量白蛋白与肌酐比值(ACR)的关系。方法回顾性分析郑州大学第二附属医院心内科2016年10月至2018年4月门诊及住院符合2010中国高血压防治指南诊断标准的2级及以上原发性高血压患者408例,病程10年以内。所有入选者均行OGTT,并记录每位患者空腹血糖(FPG)、1hPG、2hPG。将所有入选患者按照血糖水平分为4组,血糖正常(NGT)组100例、单纯OGTT 1 h血糖升高(1hHPG)组102例、单纯OGTT 2 h血糖升高(2hHPG)组104例、OGTT 1 h和2 h血糖均升高(1 hH PG/2 hH PG)组102例;同时记录408例患者的身高、体重、BMI、性别、年龄、高血压病程、吸烟史、血压、血脂、肌酐等一般临床资料,并根据肌酐值、年龄值计算肾小球滤过率(eG FR)值。分析1hHPG及2hHPG水平与ACR的关系。结果 4组研究对象高血压病程、年龄、性别、体重指数、舒张压、脂代谢指标及空腹血糖等差异均无统计学意义(P>0.05);不同血糖升高水平情况患者的收缩压、血肌酐、eG FR、ACR差异有统计学意义(P<0. 05)。1hHPG组、2hHPG组、1hHPG/2hHPG组ACR均高于NGT组,差异有统计学意义(P <0. 01); 1hHPG/2hHPG组高于1hHPG组,差异有统计学意义(P<0.05); 1hHPG组高于2hHPG组,差异有统计学意义(P<0.05)。Logistic回归分析得出1hPG(OR=2.461,95%CI:1.947～3.112)、肌酐(OR=1.071,95%CI:1.027～1.117)以及2hPG(OR=2.016,95%CI:1.500～2.710)水平均为微量白蛋白尿的危险因素(P<0.01)。结论 1hHPG与2hHPG异常均与ACR相关,可作为预测早期肾损伤的重要指标。Objective More and more research shows microangiopathy may occur in the early stage of diabetes.The purpose of this study was to observe the relationship between OGTT 1-hour hyperglycemia(1hPG)and 2-hour hyperglycemia(2hPG)levels and urinary albumin creatinine ratio(UACR).Methods We retrospectively analyzed 408 patients with primary hypertension of grade 2 or above who were eligible for 2015 World Health Organization(WHO)outpatient and inpatient visits from September 2015 to April 2018 in our hospital for a course of up to 10 years.All selected participants underwent an OGTT test(1 and 2 hour post-sugar glucose)and records were made on fasting plasma glucose(FPG),OGTT1-hour blood glucose(1 hPG),OGTT 2-hour blood glucose(2 hPG).All the patients were divided into 4 groups according to blood glucose levels:NGT group(n=100),1 h PG group(n=102),2h PG group(n=104),1h PG/2h PG group(n=102).Records were made on the clinical data of 408 patients,including height,weight,BMI,gender,age,history of hypertension,smoking history,blood pressure,blood lipids,creatinine and other general clinical data,and the calculation of glomerular filtration rate(eGFR)values was based on creatinine values and age values to analyze the relationship between 1 hHPG and 2 hHPG levels with ACR.Results No significant difference was found among the four groups in the aspects of hypertension course,age,gender,body mass index(BMI),diastolic blood pressure,lipid metabolism index and fasting blood glucose(P >0.05).There were significant difference in systolic blood pressure,serumcreatinine,eGFR,and ACR among different levels of increased blood glucose(P<0.05).ACR in 1h PG group,2h PG group and 1h PG/2h PG group were significantly higher than NGT group(P<0.01),ACR in 1h HPG/2hHPG was significantly higher than 1h PG group(P<0.05)and ACR in 1h PG group was significantly higher than 2h HPG group(P<0.05).The logistic regression analysis showed that 1h PG(OR=2.461,95%CI:1.947-3.112),creatinine(OR=1.071,95%CI:1.027-1.117)and 2h PG(OR=2.016,95%CI:1.500-2.710)wer

关 键 词：口服葡萄糖耐量试验 尿微量白蛋白与肌酐比值 早期肾损害 

分 类 号：R587.1[医药卫生—内分泌]