老年H型高血压合并糖尿病患者动脉硬化研究

发布时间：2018-05-25 08:12

本文选题：高血压 + 糖尿病　；参考：《兰州大学》2017年硕士论文

【摘要】：目的:讨论老年H型高血压合并糖尿病患者与单纯老年H型高血压患者动脉硬化严重程度比较。方法:选取2014年01月至2016年07月,于兰州大学第一医院老年病一科入院的324名患者。该324名患者均为老年H型高血压,根据其是否存在糖尿病分为2组:老年H型高血压合并糖尿病组(合并组)158例、老年H型高血压组(高血压组)166例,分别对其进行无创动脉硬化检查,检测其动脉硬化指标(C-RPWV、C-FPWV、C-DPWV),比较两组间动脉硬化程度,及其影响因素并对其临床检查结果做一比较与分析。结果:1.高血压组、合并组:年龄、TC、TG、LDL、UA、BMI均差距不大。而两组间的Hcy水平、C-RPWV、C-FPWV检测指标均有所差距且具有统计学意义(P0.05)。2.血浆同型半胱氨酸:合并组的Hcy水平(20.53±7.54)较高血压组的Hcy水平(15.91±4.87)升高且P0.05,差异具有统计学意义。3.动脉硬化指标:(1)C-RPWV:合并组(11.13±2.80)较高血压组(10.06±1.16)C-RPWV水平升高(P0.05)差异具有统计学意义。(2)C-FPWV:合并组(13.68±2.68)较高血压组(11.62±2.52)的C-FPWV水平升高(P0.05)差异具有统计学意义。(3)C-DPWV:合并组(10.42±7.01)水平较高血压组的C-DPWV(10.41±1.56)水平无明显差异。4.使用Pearson线性相关分析:分析Hcy水平与动脉硬化指标相关性结果示:Hcy水平与动脉硬化指标(C-RPWV、C-FPWV)成线性正相关,相关系数分别为0.441、0.906,提示Hcy水平越高,动脉指数(C-RPWV、C-FPWV)值越高,动脉硬化程度亦越严重。5.使用多元回归分析法分析多因素:年龄、血糖、TC、TG、LDL、BMI、UA、Hcy对动脉动脉硬化指标危险因素。结果显示:年龄、血糖、TC、TG、BMI、Hcy均是动脉硬化发生发展的危险因素。结论:在我院2014年至2016年上半年期间住院的老年患者中,老年H型高血压合并糖尿病患者较老年H型高血压患者的动脉硬化程度明显升高。表现为动脉硬化指标(C-RPWV、C-FPWV)的升高,且Hcy水平与动脉硬化指标水平呈正相关。提示:Hcy水平与动脉硬化发生呈正相关。年龄、血糖、TC、TG、BMI、Hcy均是影响动脉硬化发生发展的危险因素。对老年高血压患者的诊治过程中,除监测治疗血压外,还应注意对血脂、血浆同型半胱氨酸、体重指数的监测,老年糖尿病合并高血压患者较单纯老年高血压患者动脉硬化程度严重,提示对老年高血压合并糖尿病的患者在降压的同时注意对血糖的调节,延缓高血压患者并发症及靶器官的损害,对于心血管、脑血管、肾功能损害患者还应注意监测动脉硬化指标,降低疾病的发生及死亡率。
[Abstract]:Objective: to compare the severity of arteriosclerosis between elderly patients with type H hypertension and diabetes mellitus. Methods: from January 2014 to July 2016, 324 patients were admitted to Department of Geriatrics in the first Hospital of Lanzhou University. The 324 patients were all elderly patients with type H hypertension and were divided into two groups according to whether they had diabetes mellitus: elderly patients with type H hypertension combined with diabetes mellitus (158 cases) and elderly patients with type H hypertension (166 cases of hypertension group). Non-invasive arteriosclerosis examination was performed to detect the arteriosclerosis index (C-RPWV), C-FPWVV C-DPWVV, to compare the degree of arteriosclerosis between the two groups and its influencing factors, and to make a comparison and analysis on the results of clinical examination. The result is 1: 1. In hypertension group and complicated group, there was no significant difference in BMI of age group. The Hcy level of C-RPWV and C-FPWV between the two groups were different and had statistical significance. Plasma homocysteine: the level of Hcy in the combined group (20.53 卤7.54) was higher than that in the hypertensive group (15.91 卤4.87) and the difference was statistically significant (P 0.05). Arteriosclerosis index: the level of C-RPWV in the combined group (11.13 卤2.80) was significantly higher than that in the hypertension group (10.06 卤2.80) (P < 0.05). The level of C-FPWV in the combined group was 13.68 卤2.68) higher than that in the hypertension group (11.62 卤2.52). There were significant differences in the level of C-FPWV between the combined group (10.42 卤7.01) and the hypertension group (10.42 卤7.01). There was no significant difference in C-DPWV(10.41 卤1. 56) level. 4. Using Pearson linear correlation analysis, the correlation between Hcy level and arteriosclerosis index was analyzed. The results showed that there was a positive linear correlation between Hcy level and atherosclerosis index C-RPWV C-FPWV, and the correlation coefficient was 0.441 ~ 0.906, respectively, indicating that the higher the Hcy level, the higher the C-RPWVV C-FPWV value. The more severe the arteriosclerosis. Multivariate regression analysis was used to analyze the risk factors for atherosclerosis: age, TCG-TGG, LDL- BMI-UAHcy. The results showed that age and blood glucose levels were all risk factors for the development of atherosclerosis. Conclusion: the degree of arteriosclerosis in elderly patients with type H hypertension complicated with diabetes is significantly higher than that in elderly patients with type H hypertension. There was a positive correlation between the level of Hcy and the index of arteriosclerosis. The results suggest that the level of Hcy is positively correlated with the occurrence of arteriosclerosis. Age, blood glucose, TGG and BMI Hcy were all risk factors for the development of atherosclerosis. In the diagnosis and treatment of elderly patients with hypertension, in addition to monitoring the blood pressure, we should also pay attention to the monitoring of blood lipids, plasma homocysteine, body mass index. The degree of arteriosclerosis in elderly patients with diabetes complicated with hypertension is more serious than that in patients with simple hypertension. It suggests that the elderly patients with hypertension and diabetes should pay attention to the regulation of blood glucose while lowering blood pressure. Patients with cardiovascular, cerebrovascular and renal dysfunction should pay attention to monitoring arteriosclerosis indexes and reducing the incidence and mortality of diseases.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1;R544.1

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