Ⅱ型糖尿病合并高血压患者血压昼夜节律的临床分析

CLINICAL ANALYSIS OF BLOOD PRESSURE CIRCADIAN RHYTHM IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND HYPERTENSION

目的 :探讨Ⅱ型糖型糖尿病合并高血压 (HDM )患者动态血压水平、昼夜节律改变及与尿白蛋白排泄率(UAER)的关系。方法 :行 2 4h动态血压监测 (ABPM) ,测UAER。结果 :HDM组夜间血压明显高于原发性高血压组 (对照组 ) (P <0 .0 5 ) ,昼夜血压变化差值百分率明显小于对照组 (P <0 .0 1) ,昼夜节律异常 ;HDM组夜间血压与UAER成正相关 (P <0 .0 5 ) ,昼夜血压变化差值百分率与UAER成负相关 (P <0 .0 1)。结论 :HDM患者夜间血压升高、昼夜节律异常且与糖尿病肾病密切相关。

Objective: To explore the changes of ambulatory blood pressure monitoring (ABPM), circadian rhythm and relationship to UAER in patients with type 2 diabetes mellitus and hypertension (HDM). Methods: 24h ABPM profiles were recorded in all participants and UAER measured in patients with HDM. Results: Nocturnal blood pressure was significantly elevated in patients with HDM compared to patients with essential hypertension (control group) ( P <0.05), the percentage of Day-night blood pressure variation was significantly decreased compared with control group ( P <0.01), circadian rhythm was also abnormal. Among patients with HDM, nocturnal blood pressure was positive correlated to UAER ( P <0.05) and the percentage of day-night blood pressure variation was negative correlated to UAER ( P <0.01). Conclusions: Patients with HDM often have elevated nocturnal blood pressure and abnormal circadian rhythm, which is closely related to diabetic nephropathy.