摘要
目的通过临床调查病例,建立高血压及合并糖尿病患者的血管内皮功能标准,并分析其与中医证型相关性。方法测定89例高血压患者、48例高血压合并糖尿病患者及20例对照组的年龄、性别、心率、体重指数(BMI)、血压、血流依赖性血管内皮舒张功能(FMD)、抽取空腹血糖或行OGTT试验、生化全项、Hb Alc、SOD及中医分型等数据,以SPSS20.0软件进行统计分析。结果与对照组相比,高血压组及高血压合并糖尿病组FMD值均显著降低(P<0.01);与高血压组相比,高血压合并糖尿病组FMD值亦显著降低(P<0.01);FMD在高血压2级、3级水平患者FMD明显低于对照组(P<0.01);高血压合并脉压差增大组与对照组比较FMD值显著降低(P<0.01);FMD在有心血管临床并发症组与对照组相比明显降低(P<0.01);FMD与超氧化物歧化酶(SOD)、高密度脂蛋白(HDL-C)呈正相关,与年龄、BMI、尿酸、糖化血红蛋白均呈负相关;高血压组中医证型分布依次是阴虚阳亢证<阴阳两虚证<肝火旺盛证<血瘀证<痰湿壅盛证。高血压合并糖尿病患者血管内皮功能损伤的程度最严重,高血压组其次;高血压2级、3级水平血管内皮损伤程度较轻度高血压严重;合并脉压差增大时血管内皮功能进一步损伤。结论 FMD能很好地预测出高血压病人发生心血管系统靶器官损害的倾向,并在中医证型比较中与血瘀型关系最为密切。
Objective To establish the vascular endothelial function criteria in the patients of hypertension and diabetes through clinical case investigation and analyze the correlation with TCM patterns / syndromes. Methods In 89 cases of hypertension( hypertension group),48 complicated cases of hypertension and diabetes( complication group) and 20 cases in the control group,age,gender,heart rate,BMI,hypertension,blood dependent vascular endothelial diastolic function( FMD),fasting glucose or OGTT,biochemical items,Hb Alc,SOD and TCM patterns were detected. SPSS20. 0 software was analyzed on the data statistically.Results Compared with the control group,FMD value was reduced significantly in the hypertension group and the complication group( P < 0. 01). FMD value was lower obviously among the cases of hypertension level2 and level 3 as compared with the normal control group( P < 0. 01). Compared with the control group,FMD value was reduced significantly in the cases complicated with big pulse pressure difference( P < 0. 01). Compared with control group,FMD value was reduced apparently in the group with cardiovascular complication( P< 0. 01). FMD value was positively correlative with SOD and HDL-C and negatively with age,BMI,urine acid and Hb Alc. In the hypertension group,the TCM pattern / syndrome distribution was yin deficiency and yang hyperactivity < yin and yang deficiency < hyperactivity of liver fire < blood stagnation < excessive accumulation of phlegm damp. The damage of vascular endothelial function is the worst in the patients of hypertension complicated with diabetes and that is worse in the patients of hypertension. The damage in the patients of hypertension level 2 and 3 is serious as compared with the mild case. The vascular endothelial function is further damaged in the cases with big pressure difference. Conclusion FMD value is beneficial in the prediction of the target damage tendency of cardiovascular system in the patients of hypertension. In consideration of TCM patterns / syndromes,blood stagnation is
出处
《世界中西医结合杂志》
2016年第3期395-399,共5页
World Journal of Integrated Traditional and Western Medicine
