高血压伴糖尿病患者动态血压的变异性与靶器官损害相关性分析

Analysis of the Correlation Between Ambulatory Blood Pressure Variability and Target Organ Damage in Hypertensive Patients with Diabetes Mellitus

[目的] 探讨高血压患者伴糖尿病（DM）动态血压变异性与靶器官损害相关性.[方法] 检测高血压伴DM（120例）、高血压不伴DM（120例）两组患者的24 h动态血压、变异性参数及高血压伴DM组踝-臂脉搏波传导速度（baPWV）、尿微量白蛋白、颈动脉中膜厚度等.并对高血压伴DM患者的动态血压变异性与baPWV、尿微量白蛋白、颈动脉中膜厚度作相关性分析,以评价高血压伴DM患者动态血压的变异性与靶器官损害的相关性.[结果] 高血压伴DM患者无论白天或晚上收缩压水平高于单纯高血压患者（P〈0.01）,动态血压收缩压,尤其是夜间收缩压与baPWV、尿微量白蛋白、颈动脉中膜厚度均呈正相关（P＜0.05）.[结论]收缩压的变异性,尤其是夜间收缩压的变异性,是高血压伴DM患者靶器官损害的危险因素,及时发现血压节律改变具有重要意义.

[Objective] To explore the correlation between ambulatory blood pressure variability and target organ damage in hypertensive patients with diabetes mellitus（DM）. [Methods] The 24h-ambulatory blood pressure and variability parameters in hypertension with DM group（ n = 120） and hypertension without DM group（ n=120） were measured. Brachial-ankle pulse wave velocity（baPWV） , mieroalbuminuria and carotid intima thickness in hypertension with DM group were also detected. Ambulatory blood pressure variability was compared between two groups. The correlation of ambulatory blood pressure variability with baPWV, mi-croalbuminuria and carotid intima thickness in hypertensive patients with DM was analyzed. The relationship between ambulatory blood pressure variability and target organ damage in hypertensive patients with DM was assessed. [Results] Systolic blood pressure regardless of day or night in hypertensive patients with DM was higher than that in simple hypertensive patients（ P〈0.01）. Systolic blood pressure, especially at night was positively related to baPWV, mieroalbuminuria and carotid intima thickness（ P 〈0.05）. [Conclusion] The variability of systolic blood pressure, especially at night is the risk factor of target organ damage of hyperten-sive patients with DM. Promptly monitoring the changes of blood pressure rhythm is of important significance.