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2型糖尿病肾病患者动态血压变化与微量白蛋白尿的相关性 被引量:2

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摘要 目的探讨2型糖尿病患者动态血压变化情况,并分析其与微量白蛋白尿(MAU)的相关性。方法按Mogensen分期将2型糖尿病患者136例分为四组:正常白蛋白尿组(24h尿白蛋白〈30mg,50例)、MAU组(24h尿白蛋白30~300mg,33例)、大量白蛋白尿组(24h尿白蛋白〉300mg,23例)及肾功能不全组[24h尿白蛋白〉300mg且估计肾小球滤过率≤60ml/(min·1.73m2),30例]。观察四组患者24h动态血压、血压昼夜节律、平滑指数等指标的变化情况,并分析动态血压与尿白蛋白的相关性。结果随着24h尿白蛋白增加,24h、白昼及夜间的收缩压和舒张压均逐渐升高[收缩压分别为从(124.9±15.1)mmHg(1mmHg=O.133kPa)到(147.2±13.4)mmHg,从(127.2±13.9)mmHg到(149.1±13.6)mmHg,从(124.2±16.4)mmHg到(144.2±16.2)mmHg;舒张压分别为从(67.1±9.O)mmHg到(82.8±8.9)mmHg,从(69.1±8.9)mmHg到(84.9±8.8)mmHg,从(64.9±9.4)mmHg到(81.4±8.7)mmHg],差异有统计学意义(P〈0.05),24h收缩压标准差从(9.4±2.1)mmHg上升到(12.0±5.O)mmHg,差异有统计学意义(P〈0.05),收缩压及舒张压平滑指数逐渐降低,差异有统计学意义(P〈0.05)。Pearson相关分析显示,24h尿白蛋白与白昼、夜间的收缩压、舒张压、脉压及24h收缩压标准差均呈正相关(P〈0.05),而与平滑指数、夜间血压下降率呈负相关(P〈O.05)。结论2型糖尿病患者早期即存在血压昼夜节律异常,且血压变异性增大。
作者 涂相军
出处 《中国医师进修杂志》 2013年第16期48-51,共4页 Chinese Journal of Postgraduates of Medicine
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