胰岛素依赖性糖尿病患者低血糖对血压的影响

Increased Blood Pressure during Hypoglycemia in Patients with IDDM

监测17例正常血压胰岛素依赖性糖尿病（IDDM）患者及17例合并高血压IDDM患者的24h血糖、24hMR，并测定24h尿儿茶酚胺，发现两级各有4例（23．5％）出现低血糖而诱发血压升高，正常血压组低血糖时血浆血糖浓度为2.4±0．72mmol／L，诱发的血压升高值为2．53±1．43／1．60±1．65kPa；合并高血压组低血糖时血浆血糖浓度为3．3±0．62mmol／L，诱发的血压升高值为4．66±2．60／1．73士1．55kPa。两组差另11显著（P＜0．05），说明高血压组更易引起血压升高。本研究结果提示，IDDM患者血糖的稳定对维持其血压稳定具有重要意义。

34 patients with IDDM (17 normotensive and 17 hypertensive) were studied over a 24hour period by monitoring blood glucose level at 1 h frequences during waking hours, ambulatory blood pressure using the accutracker and urinary free catecholamine by HPLC. Hypoglycemia appeared to lead to elevated blood pressure in 4 patients (23. 5% ) both normotensive and hypertensive. The average blood glucose levels were 2. 4±0. 72mmol/L and 3. 3±0. 62mmol/L, and the average blood pressure increase was 2. 53±1. 43/1. 60± 1. 65 kPa and4. 66±2. 60/1. 73± 1. 55 kPa for normotensive and hypertensive groups, respectively. Sig-nificant difference appeared (P<0. 05) between the two groups (normotensive and hypertensive). This shows that hypertensive patients with IDDM are more liable to have high bloodpressure. This study suggested that stable blood glucose level is necessary for stable bloodpressure for patients with IDDM.