高血压合并糖尿病患者糖化血红蛋白水平与血压变异性的相关性研究  

Study on the relationship between glycosylated hemoglobin level and blood pressure variability in hypertensive patients with diabetes mellitus

作　　者：顾力 余意君[1] 徐艳玲 吴慧君 郑伟 周志云 顾晔[1] GU Li;YU Yijun;XU Yanling;WU Huijun;ZHENG Wei;ZHOU Zhiyun;GU Ye(Department of ECG Science,Wuhan Fourth Hospital/Puai Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430033,China)

机构地区：[1]武汉市第四医院/华中科技大学同济医学院附属普爱医院心电生理科,430033

出　　处：《重庆医学》2019年第7期1164-1167,共4页Chongqing medicine

摘　　要：目的高血压合并糖尿病患者糖化血红蛋白(HbA1c)水平与血压变异性(BPV)之间的关系。方法分析2015年5月至2017年10月在该院住院的高血压病合并糖尿病患者95例,根据入院时HbA1c水平分为HbA1c水平正常组(n=43)和HbA1c水平增高组(n=52),对两组HbA1c水平及其与BPV的关系进行分析。结果两组收缩压和舒张压明显差异(P>0.05),HbA1c水平增高组24h收缩压变异系数(24hSBPCV)、24h舒张压变异系数(24hDBPCV)、白天收缩压变异系数(dSBPCV)和白天舒张压变异系数(dDBPCV)均高于HbA1c水平正常组(P<0.05)。两组非杓形血压发生比例无明显差异(P>0.05)。在校正性别、年龄和β受体阻滞剂的影响后,多因素Logistic回归分析显示,24hSBPCV、24hDBPCV、dSBPCV和dDBPCV升高是高血压合并糖尿病患者HbA1c水平增高的危险因素。Pearson相关分析显示,HbA1c水平与24hSBPCV、24hDBPCV、dSBPCV和dDBPCV呈正相关(r=0.212、0.257、0.216、0.286,P<0.05)。结论 HbA1c水平增高的高血压合并糖尿病患者BPV增加,自主神经功能受损更严重。Objective To explore the relationship between glycosylated hemoglobin(HbA1c)level and blood pressure variability(BPV)in hypertensive patients with diabetes mellitus.Methods A total of 95 cases of hypertensive patients with diabetes mellitus in this hospital,from May 2015 to October 2017,were selected and divided into the normal HbA1c group(n=43)and the high HbA1c group(n=52)according to the HbA1c level at admission.The HbA1c level and its correlation to BPV were analyzed in the two groups.Results There was no significant difference in systolic and diastolic blood pressure between the two groups(P>0.05).The 24 h systolic blood pressure coefficient of variation(24 h SBPCV),24 h diastolic blood pressure coefficient of variation(24 h DBPCV),daytime systolic blood pressure coefficient of variation(dSBPCV)and daytime diastolic blood pressure coefficient of variation(dDBPCV)in the high HbA1c group were higher than those in the normal HbA1c group(P<0.05).There was no significant difference in the proportion of non-dipper blood pressure between the two groups(P>0.05).The results of multivariate logistic regression analysis showed that the increase of 24 h SBPCV,24 h DBPCV,dSBPCV and dDBPCV were risk factors for high HbA1c level after adjusting for gender,age and beta-blockers.Pearson correlation analysis showed that HbA1c level was positively correlated with 24 h SBPCV,24 h DBPCV,dSBPCV and dDBPCV in hypertensive patients with diabetes mellitus(r=0.212,0.257,0.216,0.286,P<0.05).Conclusion Hypertensive patients with diabetes mellitus with high HbA1c have increased BPV,which indicates more severe impairment of autonomic function.

关 键 词：高血压 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]