原发性高血压患者糖代谢异常与动态血压变化151例分析

The status of abnormality of glycometabolism and its influence on change of ambulatory blood pressure in 151 patients with hypertension

目的:探讨原发性高血压患者糖代谢异常状况及其对动态血压变化规律的影响。方法:测量151例原发性高血压(EH)患者空腹血糖(FBG)、餐后2h血糖(2hPBG)和24h动态血压,根据FBG和2hPBG水平将151例原发性高血压患者分为糖耐量正常(NGT)、糖耐量受损(IGR)和2型糖尿病(T2DM)3组,对3组间的动态血压参数和糖代谢异常情况进行分析。结果:72%的EH患者存在糖代谢异常,以2hPBG增高为主。联合检测FBG及2hPBG后,糖代谢异常检出率明显增加。NGT组、IGR组和T2DM组间非杓型血压、24h收缩压及舒张压均值、白天收缩压及舒张压负荷值、夜间收缩压及舒张压负荷值、24h平均脉压(24hMPP)均无明显差别。相关分析示24hMPP与FBG呈正相关(r=0.175,P=0.032)。结论:EH患者易合并2hPBG升高糖代谢异常,联合检测FBG及2hPBG可提高异常检出率;同时控制好FBG有利于减小脉压。

Objective： To analyse the status of abnormality of glycometabolism in hypertensive patients, and it＇s effects on their ambulatory blood pressure. Methods： The fasting blood glucose test （FBG）, second hour postprandial blood glucose （2 h PBG） and 24 h ambulatory blood pressure monitoring were checked in 151 hypertensive patients . Then according to their blood glucoses, they were categorized into three groups： the normal glucose tolerance （NGT） group, the impaired glucose tolerance （IGT） group and the diagnostic type 2 diabetes （T2DM） group. Finally, we analysed the relationship between abnormal glycometabolism and hypertension. Results： 72% of hypertensive patients had abnormal glycometabolism, and more patients with abnormal glycometabolism were checked out by combine checking of FBG and 2 h PBG. The difference of non-dipper blood pressure, 24 h mean syistolic blood pressure, 24 h mean diastolic blood pressure, the syistolic blood pressure load at daytime the diastolic blood pressure load at daytime, the syis tolic blood pressure load at night, the diastolic blood pressure load at night, the 24 h mean pulse pressure （24 h MPP） in the 3 groups were not significant. The results of corelated analysis showed that the 24 h MPP assumed positive correlation with FBG not 2 h PBG. Conclusion： The essential hypertensive patients were easy to combine the abnormal glycometabolism, charactered by increasing of 2 h PBG. And it was helped to control the pulse pressure by reducing the FBG.