2型糖尿病患者动态动脉僵硬指数和24h脉压的相关性研究

The relationship between ambulatory arterial stiffness index and 24-hour pulse pressure in patients with type 2 diabetes

目的:探讨2型糖尿病患者动态动脉僵硬指数(AASI)与24h脉压(24hPP)的相关关系。方法:入选2型糖尿病患者共100例,按照是否合并高血压分为:非合并高血压组(n=32例)和合并高血压组(68例)。记录患者临床情况,包括性别、年龄、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1C)和尿微量白蛋白与肌酐的比值(ACR),记录患者24h动态血压参数,包括24h平均收缩压(24hSBP)、24h平均舒张压(24hDBP)、24h脉压(24hPP)、夜间平均收缩压/白昼平均收缩压比值(nSBP/dSBP)、夜间平均舒张压/白昼平均舒张压比值(nDBP/dDBP)。然后按AASI=1-舒张压对收缩压的回归斜率计算每个个体的AASI值。结果:两组患者在ACR、24hSBP、24hDBP、24hPP和AASI差异有显著性(均P<0.05)。AASI与年龄、ACR、24hPP、nSBP/dSBP和nDBP/dDBP有显著性相关性(均P<0.05)。结论:糖尿病患者,无论是否合并存在高血压,AASI均与24h脉压存在密切的相关性,可以反映动脉的僵硬度。

Objective To investigate the relationship between ambulatory arterial stiffness index and 24- hour pulse pressure in patients with type 2 diabetes. Methods One hundred patients with type 2 diabetes （51 males and 49 females） were enrolled. According to whether or not coexisting with hypertension, the patients are divided into diabetes with hypertension group （n = 32）and diabetes without hypertension group （n = 68）. Clinic characteristics of the patients were recorded, including age, gender, TG, TC, LDL-C, HDL-C, HbA1C and albumin/creatinine ratio （ACR）. The parameters of ambulatory blood pressure were also recorded, including 24 h SBP, 24 h DBP, 24 h PP, nSBP/dSBP and nDBP/dDBP. Based on all the blood pressure recordings, we plotted diastolic blood pressure against systolic blood pressure from each patient and calculated the regression slope, and AASI was derived from 1 minus this regression slope above. Results There were significant differences in ACR,24 h SBP,24 h DBP,24 h PP, nSBP/dSBP and nDBP/dDBP of patients in these two groups （P 〈 0.05, respectively）.AASI correlated closely with age,ACR,24 h PP,nSBP/dSBP and nDBP/dDBP（P 〈 0.05, respectively）. Conclusion AASI correlated closely with 24 h PP in patients with type 2 diabetes with or without hypertention, AASI may be an index of arterial stiffness.