贵州医科大学学报

2015, v.40;No.183(12) 1366-1369

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2型糖尿病合并原发性高血压病患者血压晨峰影响因素分析
Influence Factors of Morning Blood Pressure Surge in Type 2 Diabetes Mellitus Patients with Essential Hypertension

申婷婷;时立新;张松;张巧;彭年春;李红;王睿;
SHEN Tingting;SHI Lixin;ZHANG Song;ZHANG Qiao;PENG Nianchun;LI Hong;WANG Rui;Department of Internal Medicine,Guizhou Medical University;Department of Endocrinology and Metabolism,the Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:探讨2型糖尿病(T2DM)合并原发性高血压病(EH)患者血压晨峰(MBPS)的影响因素。方法:检测60例T2DM合并EH患者的MBPS、血脂、血糖、空腹C肽及糖化血红蛋白(Hb A1c),采取三分位法根据MBPS值将其分为晨峰1组(MBPS≤15 mm Hg)、晨峰2组(15 mm Hg20 mm Hg),根据降压方案将其分为降压方案1组(未用药)、降压方案2组[使用钙离子通道阻滞剂(CCB)]和降压方案3组[使用肾素-血管紧张素Ⅱ受体阻滞剂/肾素-血管紧张素酶转换酶抑制剂(ARB/ACEI)];根据患者是否吸烟分为不吸烟组和吸烟组,使用方差分析和t检验分析各组间MBPS的差异,再使用Pearson相关及多元回归分析各指标与MBPS的相关性。结果:MBPS晨峰1、2、3组间空腹C肽比较,差异具有统计学意义(P=0.035);血脂、血糖及Hb A1c的差异无统计学意义(P>0.05);降压方案和吸烟各分组间MBPS分别比较,差异均有统计学意义(P<0.05),多元线性回归显示,未用降压药组、CCB组及ARB/ACEI组间MBPS呈下降趋势(P<0.05),吸烟组MBPS高于不吸烟组(P<0.05)。结论:T2DM合并EH患者的MBPS与降压药物种类及是否吸烟存在一定的相关性。
Objective: To investigate the influence factors of morning blood pressure surge( MBPS)in type 2 diabetes mellitus( T2DM) patients with essential hypertension( EH). Methods: Levels of MBPS,blood lipids,blood glucose,fasting plasma C-peptide and Hb A1 c were recorded in 60 patients with T2 DM and EH. According to the levels of MBPS,patients were divided into group 1( MBPS ≤15 mm Hg),group 2( 15 mm Hg < MBPS≤20 mm Hg) and group 3( MBPS > 20 mm Hg). According to the antihypertensive scheme,patients were divided into group 1( no medication),group 2( using CCB),group 3( using ARB / ACEI). According to smoking status,patients were divided into group 1( no smoking) and group 2( smoking). The relationship between the MBPS and above parameters was analyzed. Results: Among the MBPS groups,there were significant differences in fasting plasma Cpeptide( P = 0. 035),while there was no significant difference in blood glucose,blood lipids and Hb A1c( P > 0. 05). Among the antihypertensive medication groups,there were significant differences in MBPS( P < 0. 05),as well as in smoking status groups. Multiple regression analysis showed that MBPS in no medication group,CCB group and ARB / ACEI group had the declining trend. MBPS was higher in smoking group than no smoking group. Conclusions: In patients with T2 DM and EH,MBPS was correlated with antihypertensive drugs and smoking status.

关键词(KeyWords): 血压晨峰;降压药物;血糖;血脂;空腹C肽
morning blood pressure surge;antihypertensive drugs;blood glucose;blood lipids;fasting plasma C-peptide

Abstract:

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基金项目(Foundation): 贵州省科技计划课题任务(TN2014-36)

作者(Author): 申婷婷;时立新;张松;张巧;彭年春;李红;王睿;
SHEN Tingting;SHI Lixin;ZHANG Song;ZHANG Qiao;PENG Nianchun;LI Hong;WANG Rui;Department of Internal Medicine,Guizhou Medical University;Department of Endocrinology and Metabolism,the Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2015.12.021

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