针对2型糖尿病合并高血压患者不同病程的情况影响血脂和血糖代谢的临床研究

Evaluating the lipids and glucose metabolism in type 2 diabetes mellitus patients with hypertension and its relationship with the duration of hypertension

目的:对于2型糖尿病合并的高血压患者,在不同高血压病程的情况下,使其血脂、血糖代谢情况和微环境产生不同影响的研究。方法:选取我院内分泌科的200例2型糖尿病患者,按照患者是否患有高血压来分类,分为正常血压组和高血压组。按糖尿病和高血压两种病程长短比较作为参考,将高血压组又分为糖尿病早于高血压组和糖尿病晚于高血压组。每组患者均需测量血脂四项、血肌酐、C肽、尿酸、血糖、果糖胺、胰岛素和尿微量白蛋白,由测量结果得出各自的胰岛素抵抗指数和利用眼底镜检查视网膜病变的情况,并综合各项指标进行分析探讨。结果:三组患者在年龄、性别等的各项指标均无明显差异(P>0.05),而两高血压组的HOMA指数、血压、血胆固醇、血肌酐、高血压病程、空腹胰岛素、尿微量白蛋白、餐后2h的血糖和C肽、视网膜病变情况均明显高于正常血压组,差异有统计学意义(P<0.05)。不同高血压病程的患者血脂和血糖代谢情况具有显著性差异(P<0.05)。结论:高血压及糖尿病可使微环境受到影响,从而导致了血脂和血糖代谢异常的现象。研究显示患者高血压病程越长,越发增加其血脂和血糖代谢异常的现象,因此针对2型糖尿病患者而言,对其进行血压监测和及时采取措施控制病程具有重要的临床意义。

Objective：To evaluate the effect of hypertension duration on the lipid and glucose metabolism, as well as micro-environment,in patients with type 2 diabetes mellitus. Methods：According to the presence or absence of hypertension in diabetic patients who received therapy in our hospital,we divided the 210 patients into normotensive （NT ） and hypertensive group （HT ）. According to the association of hypertensive duration and diabetes duration,we divided the HT group into diabetes was earlier than hypertension （HT1 group ） and hypertension was earlier than diabetic group （HT2 group）. Different groups of patients were measured on terms of lipids,creatinine, uric acid, C peptide, glucose, insulin, fructosamine and microalbuminuria. We also calculated the insulin resistance index （HOMA index ） and examined the retinopathy situation by ophthalmoscopy. Appropriate statistical analyses were conducted. Results：There were no significant difference between groups in patient′s age,sex and other basic indicators （P〉0. 05 ）,however,there were significant induce in the NT group than HT groups in the terms of blood pressure,duration of hypertension,HOMA index, serum cholesterol,serum creatinine,urinary albumin,fasting insulin,postprandial 2h plasma glucose and postprandial 2h C peptide and retinal lesions （P〈0. 05 ）. There were significant difference between different duration of hypertension （P〈0.05）. Conclusion：Both hypertension and diabetes can cause lipid and glucose metabolism by affecting the microenvironment. Clinical monitoring of related terms in diabetes patients is important to control the lipid and glucose metabolism.