2型糖尿病患者体位性低血压的发生率及其影响因素

The Prevalence and Related Risk Factors of Orthostatic Hypotension in Patients With Type 2 Diabetes Mellitus

目的:本研究旨在对住院2型糖尿病人群中体位性低血压(OH)的发生率、不同类型OH的发生率及其可能的影响因素进行调查分析。方法:调查我院2010-08至2011-08住院2型糖尿病患者256例,并将患者分为单纯2型糖尿病组(非OH组,n=176),2型糖尿病合并OH组(OH组,n=80)。采用直立倾斜床测量立卧位血压、心率,并检测相关化验指标及超声心动图。结果:住院2型糖尿病人群OH的发生率为31.1%,OH伴收缩期血压下降(OH-S)、舒张期血压下降(OH-D)以及收缩压和舒张压均下降的OH(OH-C)的所占比例分别为11.2%、6.8%、13.1%,而持续性、短暂性和延迟性OH的所占比例分别为13.1%,11.8%,6.2%。OH的影响因素主要有合并糖尿病肾病、糖化血红蛋白升高、卧位收缩压升高、坐位收缩压降低及室间隔厚度增加。结论:住院2型糖尿病人群合并OH发生率较高,并可表现为不同的类型;2型糖尿病合并OH主要与糖尿病病情严重程度、合并并发症情况等因素有关。

Objective：To study the prevalence with related risk factors and pathogenesis for different types of orthostatic hypotension （OH） in patients of type 2 diabetes mellitus（T2DM）. Methods ：A total of 256 T2DM patients admitted in our hospital from August 2010 to August 2011 were investigated, and they were divided in to 2 groups. Non-OH group,n = 176,the patient without OH, and OH group, n = 80. The blood pressure and heart rate were measured by head-up tilt testing position;the relevant laboratory test and echocardiography were examined in all pa- tients. Results ： The occurrence rate of OH was 31.1%, the prevalence of OH combined with decreased systolic pressure, combined with decreased diastolic and consensus OH were 11.2% ,6. 8% and 13.1% respectively. The prevalence sustained OH,transient OH and delayed OH were 13.1%, 11.8% and 6. 2% respectively. The major related risk factors for OH were diabetic nephro pathy,elevated glycolated hemoglobin, increased systolic pressure in supine position, decreased systolic pressure in sitting posi- tion, and more thickness of ventricular septal. Conclusion ： T2DM patients have higher risk to combine with different type of OH, it is mainly related to the severity of diabe- tes and other complications.