老年糖尿病病人血压水平影响因素的研究

A survey of influencing factors on blood pressure of senile diabetes patients

[目的]探讨影响老年糖尿病病人血压控制的因素及护理措施。[方法]将184例老年糖尿病病人依据血压水平分为正常血压组、血压控制理想组、血压控制良好组、血压控制不良组及血压控制极差组。观察各组病人临床和生化指标的变化。[结果]随着年龄的增长和高血压病史的延长,血压控制的达标水平降低。糖尿病病史、年龄、体重指数、舒张压、射血分数、糖化血红蛋白、尿微量清蛋白排泄率、C反应蛋白、同型半胱氨酸与收缩压独立相关;射血分数、同型半胱氨酸、空腹胰岛素水平是影响舒张压的独立危险因素。[结论]老年糖尿病病人高血压的控制与多种因素相关,应采取综合治疗措施,控制血糖、体重;保护各脏器的功能;加强相关知识宣教;监测各项临床生化指标,及时调整落实治疗措施。

Objective: to probe into the influencing factors of blood pressure control for senile diabetes patients and its nursing strategies. Method: a total of 184 senile diabetes were divided into 5 groups based on their blood pressures that was, normal pressure group, ideally control group, well control group, not well controlled group, and uncontrolled group. Both clinical and biochemical changes of all cases were observed. Result: with their age increasing and hypertension history prolonged, standard level of pressure control lowered down gradually. The history of diabetes, age, body mass index, diastolic pressure, ejection fraction, glycosylated hemoglobin, urine small protein excretory rate, C-reactive protein, and homotype cysteine are correlated independently with systolic pressure in these patients. However, ejection fraction, homotype cysteine, and empty stomach insulin level are independent factors influencing on diastolic pressure for these patients. Conclusion: the control of blood pressure of senile diabetes patients correlated with various factors. Comprehensive therapeutic measures should be taken to control blood glucose, body weight of them, to protect the functions of all organs, to strengthen the education on relative knowledge, to monitor on clinical biochemical indexes, and to adjust all kinds of therapeutic measures.