2型糖尿病合并高血压对自主及周围神经病变的影响研究

Impact of Complicated Hypertension in Type 2 Diabetes Mellitus on Autonomic and Peripheral Neuropathy

目的探讨2型糖尿病合并高血压对自主及周围神经病变的影响。方法选取2型糖尿病患者156例,根据高血压诊断标准,分为2型糖尿病合并高血压组76例与2型糖尿病未合并高血压组80例。选取同期在我院进行体检的健康体检者60例作为对照组。对3组研究对象进行一般资料收集、自主及周围神经功能检查。结果 (1)3组研究对象的心率变异性(HRV)各参数比较,差异均有统计学意义(P<0.05)。2型糖尿病合并高血压组、未合并高血压组的HRV各参数均小于对照组,差异均有统计学意义(P<0.05);2型糖尿病合并高血压组的各参数均小于未合并高血压组,差异亦均有统计学意义(P<0.05)。(2)3组研究对象的足部震动感觉阈值(VPT)各参数比较,差异均有统计学意义(P<0.05)。2型糖尿病合并高血压组、未合并高血压组的VPT各参数均大于对照组,差异均有统计学意义(P<0.05);但2型糖尿病合并高血压与未合并高血压组的VPT间差异无统计学意义(P>0.05)。结论 2型糖尿病合并高血压可能对自主神经功能有一定影响,对周围神经功能影响不大。并发高血压的2型糖尿病患者应尽早进行自主神经功能检查,积极控制血糖和血压。

Objective To investigate the impact of concurrent hypertension in patients with type 2 diabetes on autonomic and peripheral nerve lesions. Methods A total of 156 patients with type 2 diabetes mellitus were recruited. They were divided as hypertension group （ n = 76） and non - hypertension group （ n = 80） according to the hypertension diagnostic criteria, At the same period, 60 healthy persons in healthy medical examination were enrolled as control group. The general data of all the subjects were collected, and their autonomic and peripheral nerve functions were tested. Results （ 1 ） The heart rate variability （HRV） parameters of the three groups showed statistically significant difference （ P 〈 0. 05 ）. The HRV parameters were significantly lower in the hypertension and non - hypertension groups than in the control group （ P 〈 0.05 ） ; and the HRV parameters were significantly lower in the hypertension group than in the non - hypertension group （ P 〈 0. 05 ）. （2） The vibration perception threshold （VPT） parameters of the three groups showed statistically significant difference （P 〈 0. 05 ）. The VPT parameters were significantly higher in the hypertension and non - hypertension groups than in the control group （ P 〈 0. 05 ） ; however the VPT parameters between the hypertension group and the non - hypertension group showed no significantly difference （ P 〉 0.05 ）. Conclusion The hypertension complication in type 2 diabetes mellitus may have a certain influence on the autonomic nerve function, but have little effect on peripheral nerve function. So the type 2 diabetes patients complicated by hypertension need to be given autonomic nerve function test and active control of blood sugar and blood pressure as early as possible.