糖化血红蛋白、24 h动态血压监测及心率变异性与老年2型糖尿病合并原发性高血压患者靶器官损害的关系  

Relationship between glycosylated hemoglobin,24 h ambulatory blood pressure monitoring and heart rate variability and target organ damage in elderly patients with type 2 diabetes mellitus complicated with essential hypertension

作　　者：董青 刘杨子 郭欣 费敏 崔文娟 DONG Qing;LIU Yangzi;GUO Xin;FEI Min;CUI Wenjuan(General Department,Financial Street Community Health Service Center in Xicheng District,Beijing 100032,China)

机构地区：[1]北京市西城区金融街社区卫生服务中心全科,北京100032

出　　处：《临床医学研究与实践》2024年第35期122-125,共4页Clinical Research and Practice

摘　　要：目的探讨糖化血红蛋白(HbA1c)、24 h动态血压监测(ABPM)及心率变异性(HRV)与老年2型糖尿病(T2DM)合并原发性高血压(EH)患者靶器官损害的关系。方法选择2020年5月至2023年5月收治的307例老年T2DM合并EH患者,根据是否合并靶器官损害分为T2DM合并EH组(n=129)和伴靶器官损害组(n=178)。比较两组的临床资料、24 h ABPM及HRV指标;采用Spearman相关性分析伴靶器官损害组的HbA1c、24 h ABPM、HRV参数与24 h微量白蛋白(mAlb)、左室心肌质量指数(LVMI)及颈动脉内膜中层厚度(IMT)的相关性。结果伴靶器官损害组的饮酒史、吸烟史占比、体质指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)水平、HbA1c、24 h mAlb、LVMI、IMT高于T2DM合并EH组,高密度脂蛋白胆固醇(HDL-C)水平低于T2DM合并EH组(P<0.05)。伴靶器官损害组的24 h平均收缩压(24 h SBP)、白天平均收缩压(dSBP)及夜间平均收缩压(nSBP)高于T2DM合并EH组,24 h平均舒张压(24 h DBP)、白天平均舒张压(dDBP)及夜间平均舒张压(nDBP)低于T2DM合并EH组(P<0.05)。伴靶器官损害组的HRV各项指标低于T2DM合并EH组(P<0.05)。HbA1c、24 h SBP、dSBP、nSBP与靶器官损害指标呈正相关,24 h DBP、dDBP、nDBP及HRV各项参数与靶器官损害指标呈负相关(P<0.05)。结论HbA1c、24 h ABPM及HRV与老年T2DM合并EH患者的肾脏、心脏、血管等靶器官损害有关,通过动态监测有利于早期发现高危人群,对保护靶器官有重要意义。Objective To investigate the relationship between glycosylated hemoglobin(HbA1c),24 h ambulatory blood pressure monitoring(ABPM),heart rate variability(HRV)and target organ damage in elderly patients with type 2 diabetes mellitus(T2DM)complicated with essential hypertension(EH).Methods A total of 307 elderly patients with T2DM complicated with EH admitted from May 2020 to May 2023 were selected and divided into T2DM complicated with EH group(n=129)and target organ damage group(n=178)according to whether they had target organ damage.The clinical data,24 h ABPM and HRV indexes were compared between the two groups.Spearman correlation analysis was used to analyze the correlation between HbA1c,24 h ABPM,HRV parameters and 24 h microalbumin(mAlb),left ventricular mass index(LVMI)and intima-media thickness(IMT)in the target organ damage group.Results The proportion of alcohol consumption history,smoking history,body mass index(BMI),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG)levels,HbA1c,24 h mAlb,LVMI and IMT in the target organ damage group were higher than those in the T2DM complicated with EH group,while high-density lipoprotein cholesterol(HDL-C)level was lower than that in the T2DM complicated with EH group(P<0.05).The 24 h mean systolic blood pressure(24 h SBP),daytime average systolic blood pressure(dSBP)and nighttime average systolic blood pressure(nSBP)in the target organ damage group were higher than those in the T2DM complicated with EH group,the 24 h mean diastolic blood pressure(24 h DBP),daytime average diastolic blood pressure(dDBP)and nighttime average diastolic blood pressure(nDBP)were lower than those in the T2DM complicated with EH group(P<0.05).The indexes of HRV in the target organ damage group were lower than those in the T2DM complicated with EH group(P<0.05).HbA1c,24 h SBP,dSBP and nSBP were positively correlated with target organ damage indexes,and 24 h DBP,dDBP,nDBP and HRV parameters were negatively correlated with target organ

关 键 词：糖化血红蛋白 心率变异性 24 h动态血压监测 2型糖尿病 原发性高血压 

分 类 号：R587.1[医药卫生—内分泌]