缬沙坦对高血压合并糖尿病患者血清脂联素的影响

发布时间：2018-01-03 00:21

本文关键词：缬沙坦对高血压合并糖尿病患者血清脂联素的影响　出处：《青岛大学》2015年硕士论文　论文类型：学位论文

【摘要】：背景:目前有研究表明,糖尿病患者近些年来在全球范围内的人数正在快速的增加,已经高达2.85亿人,同时依然以一个较为惊人的增长速度在逐年的增长。我国是世界上的一个人口大国,人口数量极其庞大,根据中华医学会糖尿病分会对我国14个省市的调查发现,年龄大于20岁以上的糖尿病患者,高达9.7%,患病的人数共9300万人。此外,英国一些较为权威的机构对于糖尿病的研究结果显示,38%的糖尿病患者均同时患有高血压并发症。WHO的相关研究结果报道,高血压疾病在糖尿病患者中是一种极其常见的并发症,患病率高达30%左右,我国的糖尿病并发高血压的患者患病率高达45%左右,高过英国的10%左右。同时,根据CDS对糖尿病慢性并发症的研究调查结果表明,在三甲医院进行住院治疗的患者糖尿病并发症中脑血管疾病的患病率为13%,高血压疾病的患病率40%,下肢血管疾病的患病率4%,心血管疾病的患病率为19%,由以上的调查研究结果可以看出,高血压是糖尿病患者最为常见且发病率最高的并发症。目的:糖尿病和高血压作为临床中两种常见的疾病,多为合并存在。尤其是高血压合并糖尿病的发生,将患者大动脉的粥样硬化加速。高血糖、高血压以及动脉粥样硬化,不仅仅有着共同的遗传性,同时也存在一定的生化代谢基础,基于胰岛素的抵抗过程,同样也是病理生理的关键环节。研究表明,高血压伴糖尿病患者血清脂联素水平,处于不断降低的状态,同时患者高血清脂联素水平不仅仅对代谢紊乱有着有益作用,同时对于心血管疾病也有着一定的积极作用。本研究旨在对高血压合并糖尿病患者应用缬沙坦治疗前后血清脂联素的变化情况进行观察,并对高血压合并糖尿病应用缬沙坦治疗效果进行医学科学的论证。方法:回顾性分析我院收治的合格的高血压合并糖尿病患者的病历资料,随机的分为两组,也即是缬沙坦组和氨氯地平组。两组患者治疗前,对两组患者的血压心率以及脂联素等进行检测,缬沙坦组应用缬沙坦治疗,氨氯地平组应用氨氯地平治疗,两组患者均至少治疗两个月,治疗后对两组患者心率以及血压和脂联素水平进行复查。得到的结果均应用统计学SAS8.1进行统计学分析,对两组患者治疗前后指标变化情况确定。结果:缬沙坦患者治疗后的收缩压和舒张压,和治疗前比较,明显处于降低的状态,P0.05,有统计学意义。同时缬沙坦患者治疗后德旺血清脂联素水平和治疗前比较,明显升高,P0.05,有统计学意义。缬沙坦患者治疗后血糖和胰岛素抵抗水平和治疗前比较,明显较低,P0.05,有统计学意义。氨氯地平患者治疗前后的各指标比较,无明显变化,P0.05,无统计学意义,但有可比性;在CRP的变化方面,组内比较,治疗后两组患者的Hs-CRP水平均显著低于治疗前,P0.05;组间比较,治疗前后两组患者的Hs-CRP水平之间的差异均不显著,P0.05。结论:对比分析试验结果,研究发现,高血压合并糖尿病患者应用缬沙坦治疗,血清脂联素水平处于升高的状态,同时高血清脂联素水平不仅对代谢紊乱有着有益作用,同时对于心血管疾病也有着积极作用。研究中缬沙坦治疗高血压合并糖尿病患者对血清脂联素的影响,为以后的研究提供了理论依据。同时缬沙坦降低患者血压的同时,不仅仅将患者血清脂联素水平升高,同时对于胰岛素抵抗也有着积极改善作用,并实现降压外良好的代谢过程。
[Abstract]:Background: the current studies have shown that, in recent years the number of patients with diabetes worldwide is increasing rapidly, has reached 285 million people, while still in a more amazing growth rate increase year by year. China is a country with a large population of the world population is extremely large, according to the Chinese Medical Association to the survey of 14 provinces in China Diabetes Society, older than diabetic patients over the age of 20, up to 9.7%, in the total number of 93 million people. In addition, some of the more British authority for diabetes research results showed that 38% of patients were suffered from hypertension complications related to.WHO results reported hypertension is a common complication in patients with diabetes, the prevalence rate of up to about 30%, the patients with diabetes mellitus complicated with hypertension prevalence rate as high as 45%, higher than the UK About 10% of the country. At the same time, according to the results of a survey of chronic complications of diabetes CDS, were hospitalized patients with diabetic complications of cerebral vascular disease prevalence rate was 13% in the hospital, hypertension prevalence rate of 40%, lower extremity vascular disease prevalence rate was 4%, the prevalence of cardiovascular disease was 19%, by investigation and study the above results can be seen in patients with diabetes mellitus hypertension is the most common and the highest incidence of complications. Objective: diabetes and hypertension as two common clinical diseases, mostly associated. Especially high blood pressure diabetes, the atherosclerosis of large arteries in patients with accelerated. Hyperglycemia, hypertension and atherosclerosis. Not only have a genetic in common, there are also some basic biochemical metabolism, insulin resistance is also based on key pathophysiology Link. The study shows that the serum adiponectin levels in diabetic patients with hypertension, in the reduced state, while the high level of serum adiponectin in patients with metabolic disorders not only to have a beneficial effect on cardiovascular disease at the same time, also has a positive role. This study aims at observation on hypertension with valsartan in diabetic patients before and after treatment, serum adiponectin the changes of hypertension and diabetes treatment effect of Valsartan for medical scientific demonstration. Methods: a retrospective analysis of our hospital qualified hypertension and diabetes patients, were randomly divided into two groups, namely the Valsartan group and amlodipine group. Two groups of patients before treatment were detected the two groups of patients with blood pressure and heart rate of adiponectin, valsartan group, valsartan, amlodipine group application of amlodipine treatment, Two groups of patients were treated for at least two months after treatment, review the two groups of patients with blood pressure and heart rate and adiponectin levels. The results were analyzed with SAS8.1 statistics, to determine the changes of the index of two groups before and after treatment. Results: after treatment with valsartan systolic and diastolic blood pressure, and treatment first, obviously in the reduced state, P0.05, have statistical significance. At the same time, patients treated with valsartan treatment and serum adiponectin levels increased significantly compared to that before Wang, P0.05, was statistically significant. Blood glucose and insulin resistance level before treatment and treatment of patients with valsartan, significantly lower P0.05, compare the index was statistically significant. Before and after amlodipine treatment of patients with no obvious change, P0.05, no statistical significance, but comparable; changes in the CRP, the comparison group, Hs-CRP of the two groups of patients after treatment The level was significantly lower than that before treatment, P0.05; comparison between groups, the difference between the Hs-CRP level of two groups of patients before and after treatment were not significant, P0.05. conclusion: comparative analysis of the test results, the study found that hypertensive patients with diabetes with valsartan treatment, serum adiponectin levels increased in the state, while the high levels of serum adiponectin not only on metabolism the disorder of beneficial effects on cardiovascular disease, but also has a positive effect. Valsartan treatment effect on serum adiponectin in patients with hypertension and diabetes research, research provided the theory basis for the later. At the same time valsartan reduce blood pressure of patients at the same time, not only will increase the level of serum adiponectin in insulin resistance patients, at the same time also has a positive to improve the role of metabolic process and to achieve good blood pressure.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R544.1;R587.1

【相似文献】