高盐摄入对高血压合并糖尿病患者心脏损害研究

High salt intake exacerbates cardic damage in hypertensive and diabetic patients

目的研究高盐摄入对高血压合并糖尿病患者心脏损害的影响。方法收集2013年9月至2017年9月第三军医大学高血压代谢病中心500例住院的高血压和2型糖尿病患者的一般资料、24 h尿生化指标、糖化血红蛋白(HbA_1c)、室间隔厚度(IVST)、左室质量指数(LVMI)等。根据24 h尿钠并计算日均食盐摄入量,分析摄盐量及血糖状态与心脏损害的相关性,比较不同摄盐量及血糖状态下心脏损害的差异。结果高血压合并糖尿病患者的IVST、LVMI与摄盐量成正相关(P<0.0001),与糖化血红蛋白(Hb A1c)无明显相关性;高摄盐组中无论血糖高低,患者的血压水平较低摄盐及血糖正常的患者无明显差异或显著低于后者,但其IVST、LVMI均显著高于低摄盐及血糖正常的患者(P<0.05)。结论高血压合并糖尿病患者随着摄盐量的增加,其心脏重塑越显著,且高盐加重心脏重塑的作用独立于血压水平,在血糖控制较为平稳时,高盐摄入将抵消降糖带来的心脏保护效益。

Objective To study the effect of high salt diet on cardiac damage in 500 hypertensive patients with diabetes mellitus. Methods 24-hour urinary biochemical index, glycosylated hemoglobin（HbAlc）,interventricular septal thickness（IVST）,left ventricular mass index（LVM1） and general information were collected in S00 patients with hypertension and type 2 diabetes mellitus. Daily sodium intake was derived from 24-hour urinary sodium excretion.To analyze the correlation between salt intake and blood glucose status and left veutricular hypertrophy, and to compare the difference of left ventricular hypertrophy under different salt intake and blood glucose state. Results All hypertensive and diabetic patients＇IVST and LVMI were positively correlated with salt intake （P〈0.0001） ,which were not significant correlated with glycosylated hemoglobin （P〉0.05） .In the high-salt group, regardless of the level of blood glucose, patients＇blood pressure there was no significant difference or significantly lower than the low salt and normal blood glucose in patients, but their 1VST and LVMI were significantly higher than the low salt and normal blood glucose in patients （P〈0.05）. Conclution With the aggravation of salt intake in hypertensive with diabetic patients,their cardiac remodeling are more significant,and this effect of high salt is independent of blood pressure levels.Blood glucose control is relatively stable, high salt intake will offset the cardiogenic benefits of hypoglycemia.