高血压/2型糖尿病/2型糖尿病伴高血压血脂分析的评价

Hypertension/type 2 Diabetes/type 2 Diabetes Mellitus Hypertension Lipid analysisevaluation

目的:糖尿病患者大血管和微血管并发症的发生率都与血管收缩压的变化呈正相关,与血脂的升高也呈正相关,故需提高广大临床工作者对糖尿病伴高血压的认识,建立一套适合于糖尿病患者的科学化,现代化,规范化的降压,降脂方案尤为重要。方法:将住院病人60例分为3组,其中1组为2型糖尿病非高血压组,2组为高血压非糖尿病组,3组为2型糖尿病伴高血压组,另设门诊健康体检者20例为对照组。每组均进行血脂分析,血脂项目包括:甘油三脂(TG)胆固醇(CH)高密度脂蛋白(HDL-C)低密度脂蛋白(LDL-C)载脂蛋白A(ApoA-1)载脂蛋白B(Apo-B)脂蛋白(a)。研究3种疾病与血脂分析的相关性及3种疾病中血脂各项指标浓度变化的评价。结果:①单纯2型糖尿病组中,血脂升高占35%其中TG,CH,LDL-C,升高具非常显著性差异(P<0.01)HDL-C降低具非常显著性差异(P<0.01)LP(a)ApoA-1,Apo-B无显著性变化(P>0.05)。②高血压组中,血脂升高占30%其中TG,CH升高具非常显著性差异(P<0.01)HDL-C,LDL-C,ApoA-1,Apo-B,LP(a).无显著性差异(P>0.05)。③2型糖尿病伴高血压组中,血脂升高占80%其中TG,CH,LDL-C,Apo-B,LP(a)升高均具有非常显著性差异(P<0.01)HDL-C,ApoA-1降低具非常显著性差异(P<0.01)。结论:2型糖尿病伴高血压更易发生脂质代谢紊乱,两种疾病同时发生于一个患者,这种动脉硬化危险因素聚集存在相互影响且作用相互叠加,加速了心血管并发症的发生与发展,大大增强了发生冠心病,脑卒中的危险。

Objective： Diabetic patients with macrovascular and microvascular complications rate and changes in systolic blood pressure was positively correlated with elevated blood lipids are correlated,so clinicians need to improve the general understanding of diabetes and hypertension,for diabetic patients to establish a scientific and modern,standardized blood pressure,lipid-lowering program is particularly important.Methods： 60 cases of patients divided into three groups,one group of non-hypertensive type 2 diabetic group,two groups of hypertensive non-diabetic group,three groups of type 2 diabetes mellitus and hypertension,four groups of healthy patient20 patients in each group were analyzed for cholesterol,blood lipids include： triglycerides（TG） cholesterol（CH） high-density lipoprotein（HDL-C） low-density lipoprotein（LDL-C） apolipoprotein A（ApoA-1）,apolipoprotein B（Apo-B） lipoprotein（a）.Of the three diseases associated with lipid analysis and indicators of three diseases of the blood lipid concentration in the evaluation.Results： 1.Simple group of type 2 diabetes,elevated blood lipids,which accounted for 35% of TG,CH,LDL-C,increased with a very significant difference（P0.01） HDL-C reduction with a very significant difference（P0.01） LP（a） ApoA-1,Apo-B was no significant change（P0.05）.2.Hypertensive group,elevated blood lipids,30% of which TG,CH increased with a very significant difference（P0.01） HDL-C,LDL-C,ApoA-1,Apo-B,LP（a）.There was no significantdifferences（P0.05）.3.2 in diabetic with hypertension,elevated blood lipids,which accounted for 80% of TG,CH,LDL-C,Apo-B,LP（a） increased both very significant difference（P0.01） HDL-C,ApoA-1 is reduced with a significant difference（P0.01）.Conclusion： Type 2 diabetes and hypertension are more likely to lipid metabolism,both diseases simultaneously in a patient,the existence of this clustering of risk factors of atherosclerosis and the role of the interaction between overlay,accelerated cardiovascular complications and development,greatly enhanced the occurrence of coronary heart disease,stroke risk.