2型糖尿病合并正常高值血压血管重构的研究

Vascular remodeling in type 2 diabetic mellitus with prehypertension

目的探讨2型糖尿病合并正常高值血压患者血管重构情况。方法选择2011年7—10月在泰安市第四人民医院门诊就诊及住院的2型糖尿病患者182例,根据血压水平分组,A组:糖尿病合并正常高值血压组96例,B组:糖尿病合并理想血压组86例,所有研究对象均禁饮食12 h后清晨空腹静脉采血5 ml,测定空腹血糖、TC、TG、HDL-C及LDL-C水平,检测血清转化生长因子β(1transforming growth factorβ1,TGF-β1)和骨形态发生蛋白7(bone morphogenetic protein 7,BMP-7)。计量资料采用t检验,计数资料采用χ2检验,指标间相关性采用Pearson相关分析,P<0.05为差异有统计学意义。结果 A组收缩压[(124.62±10.51)mmHg(1mmHg=0.133kPa)]及舒张压[(86.04±3.62)mmHg]明显高于B组[(108.45±8.52)、(74.54±4.74)mmHg];A组TG[(2.49±1.19)mmol/L]、LDL-C[(2.90±0.17)mmol/L]、TGF-β1[(279.58±98.76)ng/L]水平明显高于B组[(2.07±0.97)、(2.82±0.14)mmol/L、(207.72±48.65)ng/L],HDL-C[(0.97±0.40)mmol/L]、BMP-7[(185.46±112.48)ng/L]水平明显低于B组[(1.09±0.33)mmol/L、(358.19±187.67)ng/L],两组比较差异均有统计学意义(均P<0.05)。A组血清TGF-β1水平与收缩压及空腹血糖、血脂间存在相关性,血清TGF-β1及BMP-7与空腹血糖、血脂间存在相关性。结论 2型糖尿病合并正常高值血压患者存在导致血管重构的危险因素,对2型糖尿病合并正常高值血压患者的血压、血糖、血脂早期干预可能有助于延缓血管病变的发生发展。

Objective To explore the expression of vascular remodeling in type 2 diabetes mellitus with prehypertention. Meth- ods 182 cases of type 2 diabetes mellitus with prehypertention were enrolled into this study who had received outpatient and inpatient treatment in the Fourth People＇s Hospital of Tai＇an from July to October in 2011.There were 96 cases of type 2 diabetes mellitus with prehypertention in group A and 86 cases of type 2 diabetes mellitus with normal blood pressure in group B.After a 12-h fasting,venous blood samples（5ml） were collected in all cases and measured for the level of fasting glucose,TC,TG,HDL-C and LDL-C,and TGF- ± ±,BMP-7 were detected as well.T-test was used for measurement data and Xz test for count data.The re- sult of P〈0.05 was statistically significant. Results Group A had a significantly higher SBP[（124.62 ± 10.51）ram Hg] and DBP [（86.04 ± 3.62）mm Hg] than group B [（108.45 ±8.52）,（74.54 ± 4.74）mm Hg].The level of TG,HDL-C and LDL-C,and TGF-β1 was [（2.49 ± 1. 19）mmollL],[（2.90 ± 0.17）mmol/L]and [（279.58±98.76）ng/L] respectively in group A, which was significantly higher than that in group B[（2.07 ± 0.97）,（2.82±0.14）mmol/L,（207.72 ± 48.65）ng/L].The level of HDL-C and BMP-7 was [（0.97 ± 0.40） mmol/L] and [（185.46 ± 112.48）ng/I,] respectively in group A,whieh was significantly lower than that in group B [（108.45 ± 8.52） mmol/L,（74.54 ± 4.74）mm Hg].Significant difference was fi±und between the two groups （P〈0.05）.Serum TGF- β1 levels were cor- related with SBP,fasting glucose and lipids.Serum TGF-[31 and BMP-7 levels were correlated with fasting glucose and lipids. Conclusion There are risk factors leading to vascular remodeling in type 2 diabetes with prehyperteution.Therefore, early inter- vention on blood pressure,blood glucose and blood lipids in type 2 diabetes with prehypertention may help to delay the occurrence and development of vascular lesions.