高血压伴或不伴2型糖尿病患者血压晨峰与冠脉病变严重程度的相关性

发布时间：2018-03-05 13:25

本文选题：高血压　切入点：血压晨峰　出处：《第三军医大学学报》2017年01期 　论文类型：期刊论文

【摘要】：目的探讨高血压伴或不伴2型糖尿病患者血压晨峰的患病特点及其与冠脉病变严重程度的相关性。方法选择2014年1月至2015年8月我科住院的高血压患者244例,其中男性118例,女性126例,年龄(64.7±11.5)岁,根据是否合并糖尿病及其动态血压监测结果将其分为4组:糖尿病晨峰组(D-S,36例)、糖尿病非晨峰组(D-n S,56例)、非糖尿病晨峰组(n D-S,72例)、非糖尿病非晨峰组(n D-n S,80例),入选的244例患者全部进行冠状动脉造影检查,分别比较4组患者冠状动脉病变程度。结果糖尿病晨峰组、糖尿病非晨峰组和非糖尿病晨峰组24 h平均收缩压、白天平均收缩压均高于非糖尿病非晨峰组(P0.05);糖尿病晨峰组24 h平均舒张压、白天平均舒张压高于糖尿病非晨峰组、非糖尿病晨峰组和非糖尿病非晨峰组(P0.05);晨峰组三支病变率、C型病变率及晨峰组Gensini总积分显著高于非晨峰组(P0.01);Pearson相关分析显示,冠状动脉病变严重程度与年龄(r=0.786,P0.01)、BMI(r=0.284,P0.05)、空腹血糖(r=0.712,P0.05)、LDL-C(r=0.765,P0.05)、晨峰程度(r=0.852,P0.01)及24 h MSBP(r=0.804,P0.01)呈正相关;多元线性回归分析显示,年龄、空腹血糖、24 h平均收缩压及血压晨峰为冠状动脉病变严重程度独立危险因素。结论原发性高血压合并糖尿病患者血压晨峰是预测冠状动脉病变严重程度的独立危险因素,有效控制该类患者的晨峰血压及24 h长效平稳的降压可减少对靶器官的损害,降低心血管事件发生。
[Abstract]:Objective to investigate the characteristics of morning blood pressure peak in patients with or without type 2 diabetes mellitus and its correlation with the severity of coronary artery disease. Methods from January 2014 to August 2015, we selected 244 patients with hypertension, including 118 males, who were hospitalized in our department from January 2014 to August 2015. 126 female patients, aged 64.7 卤11.5 years, According to the results of diabetes mellitus and ambulatory blood pressure monitoring, they were divided into 4 groups: DM morning peak group (n = 36), diabetes non-morning peak group (n = 56), nondiabetic morning peak group (n = 72) and non-diabetic morning peak group (n = 80). All 244 patients were examined by coronary angiography. Results the mean systolic blood pressure (SBP) of 24 hours in the diabetic morning peak group, the diabetes non-morning peak group and the non-diabetic morning peak group was compared. The mean systolic blood pressure during the day was higher than that in the non-diabetic non-morning peak group, and the average diastolic blood pressure in the diabetic morning peak group was higher than that in the diabetic non-morning peak group at 24 h, and the mean diastolic blood pressure in the morning peak group was higher than that in the non-morning peak group. The incidence of type C lesions and the total Gensini score of morning peak group were significantly higher than those of non-diabetic morning peak group and non-diabetic morning peak group, and the correlation analysis showed that the three vessel lesion rate and the total Gensini score in the morning peak group were significantly higher than those in the non-morning peak group. The severity of coronary artery disease was positively correlated with the severity of coronary artery disease, the severity of coronary artery disease was positively correlated with the age of 0.786p 0.01m BMIR 0.284m P0.05, the fasting blood glucose 0.0.712m P 0.05 P 0.05, the degree of morning peak 0.852P0.01) and the 24 h MSBPrn 0.804P0.01), and the multiple linear regression analysis showed that age, age, and age, the degree of coronary artery disease were 0.852p0.01) and 0.804P0.01 (P 0.01), the results of multiple linear regression analysis showed that age, age, and severity of coronary artery disease were higher than those of control group. Mean systolic blood pressure (SBP) and morning peak were independent risk factors for severity of coronary artery disease in patients with essential hypertension and diabetes mellitus. Conclusion Morning peak of blood pressure is an independent risk factor for predicting severity of coronary artery disease in patients with essential hypertension and diabetes mellitus. Effective control of morning peak blood pressure and 24 h stable hypotension can reduce the damage to target organs and decrease the occurrence of cardiovascular events.
【作者单位】：第三军医大学大坪医院野战外科研究所心血管内科重庆市心血管病研究所;
【分类号】：R544.1;R543.3

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