高血压合并焦虑障碍患者血糖、血脂及血尿酸水平与降压疗效的关系

The Relation between Blood Glucose and Lipids and Uric Acid Level in Hypertensive Patients with Anxiety Disorder and the Effect of Hypotension

目的:探讨高血压合并焦虑障碍患者血糖、血脂及血尿酸水平与降压疗效的关系。方法:选择原发性高血压患者234例,治疗前测量血压,检测空腹血糖(FPG)、甘油三酯(TG)、血尿酸(UA)及记录焦虑评分(SAS),将患者分为FPG升高合并焦虑组(A1组),TG升高合并焦虑组(A2组),UA升高合并焦虑组(A3组),FPG、TG、UA正常有焦虑组(B组)以及FPG、TG、UA正常无焦虑组(C组),对所有患者采取一线降压药降压治疗,观察各组患者治疗3周后时的血压和SAS评分。结果:治疗3周时,A1、A2、A3组的收缩压均高于B组和C组(P <0. 05),且B组收缩压高于C组(P <0. 05);治疗后各分组间的舒张压比较,差异均无统计学意义(P>0. 05); A1、A2、A3组及B组治疗前后的SAS评分比较,差异均无统计学意义(P> 0. 05)。结论:FPG、TG及UA升高明显降低了原发性高血压合并焦虑障碍患者降压药物治疗的疗效,合并焦虑障碍患者降压疗效也较单纯高血压患者低,且都主要影响收缩压。

Objective：To investigate the relation between the effect of hypotension and blood glucose, lipids and uric acid level in hypertensive patients with anxiety disorder. Methods： A total of 234 patients with primary hypertension were selected and treated with five categories of first-line hypertensive drugs（ACEI, ARB, β receptor blocker, diuretics and calcium channel blocker）. Blood pressure, fasting blood glucose （FPG）, triglyceride （TG）, and serum uric acid （UA） were measured and self-rating anxiety score （SAS） was recorded before treatment. The patients were then divided into 52 cases of an elevated FPG with anxiety group （A1）, 45 cases of an elevated TG with anxiety group （A2）, and 40 cases of an elevated UA with anxiety group （A3） respectively; 47 cases of the simple anxiety group （B） and 50 cases of the simple hypertension group （C）. All patients were treated with first-line antihypertensive drugs and blood pressure and self-rating anxiety score （SAS） were observed after 3 weeks＇ treatment for each group. Results： After 3 weeks＇ treatment, the groups with elevated FPG, TG or UA with anxiety disorder had higher systolic blood pressure than the simple anxiety and the simple hypertension group （ P 〈0.05）, and systolic pressure of the simple anxiety group was higher than that of the simple hypertension group （ P 〈0.05）. No significant change was observed in diastolic pressure of all groups, and the SAS scores in all 4 anxiety groups was not significantly changed after treatment （ P 〉0.05）. Conclusions： Elevated FPG, TG and UA in primary hypertensive patients with anxiety disorder may significantly reduce The efficacy of hypertensive drugs, patients with anxiety disorder have a lower efficacy in hypertension compared to that in simple hypertension group especially in the control of systolic pressure. Simple hypertensive treatment can not improve anxiety symptoms of patients.