2型DM合并高血压患者血脂及血糖代谢情况与高血压病程的关系  

Relationship of blood lipid and glucose metabolism with hypertension course in patients with type 2 DM and hypertension

作　　者：李勇 党静[1] 卢健胜 何丽 郑海彦 Li Yong;Dang Jing;Lu Jiansheng;He Li;Zheng Haiyan(Department of Internal Medicine,Chancheng High-tech Zone Hospital,Foshan Traditional Chinese Medicine Hospital,Foshan 528000,China;Department of Ophthalmology,Chancheng High-tech Zone Hospital,Foshan Traditional Chinese Medicine Hospital,Foshan 52800,China)

机构地区：[1]佛山市中医院禅城高新区医院内科,528000 [2]佛山市中医院禅城高新区医院眼科,528000

出　　处：《国际医药卫生导报》2020年第14期2076-2080,共5页International Medicine and Health Guidance News

摘　　要：目的观察评价2型糖尿病(T2DM)合并高血压(EH)患者血脂(BL)、血糖(BS)代谢情况与高血压(EH)病程的关系,为临床T2DM合并EH患者治疗提供科学依据。方法选取2017年3月至2019年8月期间本院收治的T2DM合并EH患者103例,按照DM病程与EH病程长短分为:观察A组55例患者是DM早于EH;观察B组48例是EH早于DM;再选取同期收治的单纯T2DM患者53例作为对照组。并分析三组患者血脂(BL)、血糖(BS)代谢水平。结果观察A组、观察B组TC水平分别为(5.76±1.81)mmol/L、(5.83±1.39)mmol/L,均高于对照组(4.48±0.69)mmol/L,差异均有统计学意义(均P<0.05);观察A组TC水平与观察B组比较,差异无统计学意义(P>0.05);三组TG、HDL-C、LDL-C比较,差异均无统计学意义(均P>0.05);观察A组FI、2hBSAM均高于对照组,餐后2 hC肽低于对照组,差异均有统计学意义(均P<0.05);观察B组FI、2hBSAM、胰岛素抵抗指数(IRI),均高于对照组,餐后2 hC肽低于对照组,差异均有统计学意义(均P<0.05);观察B组FI、2hBSAM、胰岛素抵抗指数(IRI),均高于观察A组,差异均有统计学意义(均P<0.05);观察A组SC、UM、眼底视网膜异常发生率均高于对照组,差异均有统计学意义(均P<0.05);观察B组SC、UM、眼底视网膜异常发生率均高于观察A组,差异均有统计学意义(均P<0.05);观察B组血尿酸(BUA)显著高于对照组,差异有统计学意义(P<0.05);EH病程与TC、2hFBG、GhbAl、HO-MA指数呈正相关,差异均有统计学意义(均P<0.05)。结论T2DM合并EH患者血脂、糖代谢指标与EH病程呈正相关,随着DM患者EH病程的增长,其血脂(BL)与血糖(BS)代谢异常的严重程度逐渐增大,临床应重视EH病程对患者BL、BS的影响,将其列为T2DM合并EH患者病情评估及预后评估的重要因素之一。Objective To observe and evaluate the relationship of blood lipid(BL)and glucose(BS)metabolism with the course of hypertension(EH)in patients with type 2 diabetes(T2DM)and EH,and to provide scientific evidences for the treatment of patients with T2DM and EH.Methods 103 patients with T2DM and EH who were treated in our hospital from March,2017 to August,2019 were divided into observation group A(n=55),who got DM earlier than EH,and observation group B(n=48),who had EH earlier than DM,according to the courses of DM and EH.Fifty-three patients with T2DM alone were set as a control group.The blood lipid(BL)and glucose(BS)metabolism levels of the three groups were observed and evaluated.Results The TC level was(5.76±1.81)mmol/L in observation group A,was(5.83±1.39)mmol/L in observation group B,and was(4.48±0.69)mmol/L in the control group,with statistical differences between the control group on one hand and observation group A and B on the other hand(both P<0.05),but with no statistical difference observation group A and B(P>0.05).There were no statistical differences in TG,HDL-C,and LDL-C between these 3 groups.The fasting insulin(FI)and 2 h postprandial blood glucose(2hBSAM)were higher observation group A than in the control group(both P<0.05).The FI,2hBSAM,and insulin resistance index(IRI)were higher and the 2hC peptide(2hCP)was lower in observation group B than in the control group(all P<0.05).The FI,2hBSAM,and IRI were higher in observation group B than in observation group A(all P<0.05).The blood creatinine(SC),urine microalbumin(UM),and incidence of fundus retinal abnormalities were higher observation group A than in the control group(all P<0.05),and were higher in observation group B than in observation group A(all P<0.05).The blood uric acid(BUA)in observation group B was significantly higher than that in the control group(P<0.05).EH course was positively correlated with TC,2hFBG,GhbAl,and HO-MA(all P<0.05).Conclusion Indicators of blood lipid and glucose metabolism in patients with T2DM and EH are positi

关 键 词：2型糖尿病合并高血压 血脂代谢 血糖代谢 高血压病程 

分 类 号：R587.2[医药卫生—内分泌] R544.1[医药卫生—内科学]