摘要
目的观察新诊断糖尿病合并H型高血压患者不同部分血管的受损情况。方法选取新诊断2型糖尿病(T2DM)患者379例,根据是否合并H型高血压分为单纯T2DM组159例、T2DM+H型高血压组110例及T2DM+非H型高血压110例。采用超声心动图检测左心室结构,计算左心室质量指数(LVMI);彩色多普勒超声仪检测颈动脉,测量颈动脉内-中膜厚度(carotid artery intima-media thickness,CIMT)或颈动脉粥样硬化斑块形成情况。收集晨尿,计算尿微量白蛋白/肌酐比值(UAlb/UCr),并计算内生肌酐清除率(CCr)。结果 1T2DM+H型高血压组和T2DM+非H型高血压组收缩压(SBP)、舒张压(DBP)及同型半胱氨酸(Hcy)水平均较单纯T2DM组升高,高密度脂蛋白胆固醇(HDL-C)较单纯T2DM组降低。T2DM+H型高血压组Hcy水平高于T2DM+非H型高血压组,HDLC低于T2DM+非H型高血压组(P<0.05或<0.01);2T2DM+H型高血压组和T2DM+非H型高血压组LVEF<50%、脑损害、颈动脉增厚发生率高于单纯T2DM组,T2DM+H型高血压组左心室肥厚和肾功能损害发生率高于单纯T2DM组(P<0.05或<0.01);3T2DM+H型高血压组和T2DM+非H型高血压组LVMI、UAlb/UCr及CIMT水平均较单纯T2DM组升高,LVEF水平较单纯T2DM组降低(P<0.05或<0.01),T2DM+H型高血压组LVMI、CCr、UAlb/UCr及CIMT水平较T2DM+非H型高血压组升高,LVEF水平较单纯T2DM组降低(P<0.05)。结论糖尿病患者在新诊断时,不同部位的血管即已经存在损伤,合并H型高血压的新诊断糖尿病患者血管损伤更严重。
Objective To observe different vascular injuries in diabetic patients with H-type hypertension.Methods A total of 379 patients with newly diagnosed T2 DM were divided into three group according to whether with H-type hypertension：T2DM＋H-type hypertension group（n =110）,T2DM＋non-H-type hypertension group（n =110）and T2 DM group（n =159）.The left ventricular structure,CIMT or with carotid atherosclerotic plaque formation were tested by ultrasonic cardiogram and color flow Doppler sonography.The LVMI,UAlb/UCr and CCr were counted.Results 1The levels of SBP,DBP and Hcy in T2DM＋H-type hypertension group and T2DM＋non-Htype hypertension group were higher than those in T2 DM group,HDL-C was lower than that in T2 DM group.Hcy level was higher in T2DM＋H-type hypertension group than in T2DM＋non-H-type hypertension group,and HDL-C was significantly lower（P〈0.05 or P〈0.01）;2Compared with T2 DM group,the rates of LVEF50%,brian damage and IMT in T2DM＋H-type hypertension group and T2DM＋non-H-type hypertension group were significantly increased（P〈0.05 or P〈0.01）,incidence of LVH and impaired renal function in T2DM＋H-type hypertension were significantly increased（P〈0.05 or P〈0.01）.The levels of LVMI,UAlb/UCr and CIMT in T2 DM ＋ H-type hypertension group and T2DM＋non-H-type hypertension group were significantly higher than those in T2 DM group,but the LVEF was significantly lower（P〈0.05 or P〈0.01）,the levels of LVMI,CCr,UAlb/UCr and CIMT were significantly higher in T2DM＋H-type hypertension group than those in T2DM＋non-H-type hypertension group,and LVEF level was significantly lower（P〈0.05）.Conclusion When patients are newly diagnosed with diabetes,vascular injury in different parts has formed,and H-type hypertension will aggravate the damage degree.
作者
黄国兰
杨卫红
浦柳美
Huang Guolan Yang Weihong Pu Liumei(Department of Endocrinology ,Fen gchen g Branch of Shanghai Ninth People＇s Hospital, Shanghai J iaoton g University School of Medicine, Shanghai 201411, China Department of Respiratory Medicine, Shanghai Jiaotong University Affiliated Sixth People＇s Hospital South Campus, Shanghai 201499, China)
出处
《临床荟萃》
CAS
2017年第3期228-232,共5页
Clinical Focus
关键词
糖尿病
2型
高血压
高同种半胱氨酸血症
血管系统损伤
diabetes mellitus
type 2
hypertension
hyperhomocysteinemia
vascular system injuries
