原发性高血压合并2型糖尿病患者血压昼夜节律及血压晨峰的变化

Changes of morning blood pressure surge and circadian rhythm of blood pressure in type 2 diabetes mellitus patients with primary hypertension

目的探讨2型糖尿病合并原发性高血压患者血压昼夜节律以及血压晨峰的变化。方法选择2010年9月～2011年12月广安门医院高血压患者140例,按有无合并糖尿病分为A、B两组,每组各70例。其中A组为2型糖尿病合并原发性高血压患者,B组为单纯原发性高血压患者;患者均进行24 h无创性动态血压监测,观察患者的血压昼夜平均值、夜间血压下降百分率、血压晨峰。结果 A组夜间平均收缩压与舒张压[(138.79±12.85)、(78.20±7.99)mm Hg,1 mm Hg=0.133 kPa]均明显高于B组[(128.63±13.47)、(66.61±7.58)mm Hg](P<0.01),A组起床前后2 h收缩压平均值[(144.13±14.55)、(146.76±13.50)mm Hg]也明显高于B组[(137.20±17.51)、(142.66±14.13)mm Hg](P<0.05)。A组起床晨峰血压和起床前晨峰血压高于正常值患者的比例均高于B组,差异有统计学意义(P<0.05)。结论 2型糖尿病合并原发性高血压病患者夜间血压、血压晨峰均高于单纯原发性高血压病患者,其心脑血管病变的危险性增高。

Objective To investigate the changes of morning blood pressure surge and circadian rhythm of blood pres sure in type 2 diabetes mellitus patients with primary hypertension.Methods 140 primary hypertensive patients in Guang′anmen Hospital from September 2010 to December 2011 were selected and divided into group A and group B,with 70 cases in each group.Patients with primary hypertension and type 2 diabetes mellitus were divided into group A,patients with simple primary hypertension were divided into group B.Ambulatory blood pressure monitoring for 24 hours were carried out in all patients;average blood pressure day and night,nighttime blood pressure decreased percentage,morning blood pressure surge were observed.Results In the group A,the night mean systolic blood pressure and the mean diastolic blood pressure [（138.79±12.85）,（78.20±7.99） mm Hg,1 mm Hg=0.133 kPa] were significantly higher than those in group B [（128.63±13.47）,（66.61±7.58） mm Hg]（P 0.01）.The mean systolic blood pressure of 2 hours before and after getting up in the morning in group A [（144.13 ±14.55）,（146.76±13.50） mm Hg] were also higher than those in group B [（137.20±17.51）,（142.66±14.13） mm Hg]（P 0.05）.The presence of morning blood pressure surge of getting up and before getting up in group A were higher than those in group B,the differences were statistically sig nificant（P 0.05）.Conclusion Nocturnal blood pressure,morning blood pressure surge in patients with primary hy pertension and type 2 diabetes mellitus are higher than those in patients with simple primary hypertension,they have high risk with cardiovascular and cerebrovascular diseases.