冠心病和糖尿病患者餐后血压及心率变化的研究

A Study on Postprandial Blood Pressure and Heart Rate in Patients with Coronary Atherosclerotic Heart Disease and Diabetes Mellitus

目的研究冠心病(coronaryatherosclerolicheartdisease,CD)和2型糖尿病(diabetesmellitus,DM)患者餐后血压和心率的变化特点。方法按疾病种类将187例患者分为3组,即冠心病组(CD,71例),2型糖尿病组(DM,49例),冠心病伴2型糖尿病组(CD+DM,67例)。观察各组24h动态血压和心率,以及进标准定量饮食前后收缩压(systolicbloodpressure,SBP)、舒张压(diastolicbloodpressure,DBP)和心率的变化。结果CD组和CD+DM组24h平均收缩压和24h平均舒张压较DM组明显增高(P<0.01),而DM组和CD+DM组24h平均心率较CD组快(P<0.01);CD组在餐后30～60min的SBP、DBP和心率较餐前对应时间点升高(P<0.01),餐后90min的SBP、DBP和心率恢复至餐前水平。DM组和CD+DM组在餐后30～90min的SBP、DBP和心率下降(P<0.01),餐后120min的SBP、DBP和心率恢复至餐前水平。结论冠心病和2型糖尿病患者餐后血压和心率的变化有不同的特点,表现为冠心病患者餐后血压升高和心率增快,而2型糖尿病或伴冠心病的2型糖尿病患者餐后血压和心率下降,且其血压和心率恢复至餐前水平较单纯糖尿病患者慢。

Objective To study changes in postprandial blood pressure and heart rate in patients with coronary atherosclerotic heart disease and type-2 diabetes mellitus.Methods Subjects were assigned to 3 groups:essential coronary atherosclerolic heart disease group (CD group,n=71),type-2 diabetes mellitus group (DM group,n=49), and coronary atherosclerolic heart disease with diabetes mellitus group(CD+DM group,n=67).Changes in BP and HR were evaluated by monitoring 24-h dynamic BP in 187 hospitalized patients who ate standard diets.Results 30 min to 60 min after the test meal, postprandial BP and HR increased in CD group(P<0.01) and recovered after 90 min.Postprandial BP and HR decreased significantly in DM group and CD+DM group between 30 and 90 min after the meal(P<0.01),and recovered after 120 min.HR of DM and CD+DM group was higher than that of CD group before the meal(P<0.01).Conclusion Changes of postprandial BP and HR between essential coronary atherosclerotic heart disease patients and DM patients are different.Postprandial BP and HR increased in CD patients,and decreased in DM and CD+DM group.And the recovery of BP and HR in DM group and CD+DM group is slower than that in CD group.