高血压和糖尿病患者餐后状态血压及脉压变化特征的研究

Characterization of postprandial blood pressure and pulse pressure in essential hypertension and type 2 diabetes milltus

目的 研究高血压病、2型糖尿病和高血压合并糖尿病患者餐后状态血压和脉压变化的特点 ,探讨其可能机制。方法 32 8例住院患者 ,分为高血压病组 (EH组 ,116例 )、2型糖尿病组(DM组 ,10 0例 )和高血压伴糖尿病组 (EH +DM组 ,112例 ) ,行 2 4小时态血压 (ABPM)检测 ,其中 30例患者再行有创桡动脉压测量 ,观察餐前和餐后收缩压 (SBP)、舒张压 (DBP)和脉压 (PP)变化特点。结果 EH组餐后SBP和DBP升高 (P <0 0 1) ,而以SBP升高更明显 ,餐后PP也升高 (P <0 0 1)。EH +DM组餐后SBP和DBP下降 (P <0 0 1) ,而以DBP下降明显 ,餐后PP升高 (P <0 0 1)。DM组SBP和DBP均下降 (P <0 0 5 ) ,但餐后PP无明显变化 (P >0 0 5 )。结论 EH +DM组和DM组患者各餐后SBP和DBP降低 ,其中EH +DM组餐后DBP下降较显著 ,餐后PP也增大。而EH组患者餐后SBP和DBP升高 ,而以SBP升高较显著 ,餐后PP也增大。DM组患者各餐后SBP和DBP降低幅度相似 ,其餐后PP无明显变化。三组患者餐后血压和脉压变化各有其特征 ,其机制可能与大动脉硬化程度、外周血管舒缩功能及糖尿病自主神经病变等因素有关。

Objective To study the status of postprandial blood pressure and pulse pressure in patients with essential hypertension (EH)?type 2 diabets mellitus(DM) and hypertensive DM Methods Three hundred and twenty eight subjects were divided into:EH ( n =116); type 2 DM( n =100)and hypertensive DM ( n =112) Ambulatory blood pressure monitor (ABPM)and invasive arterial blood pressure were examined before and after prandial Results Postprandial blood pressure (BP) were significantly higher in EH( P <0 01) On contrast ,postprandial BP were significantly decreased in type 2 DM and hypertensive DM( P <0 05; P <0 01) Postprandial pulse pressure (PP)was significantly increased in EH and hypertensive DM ( P <0 01),but not in type 2 DM alone( P >0 05) Conclusion Postprandial BP and PP were higher in EH, but postprandial BP were decreased in type 2 DM and hypertensive DM Postprandial PP was significantly increased in hypertensive DM, but not in type 2 DM alone Prandial status has different effects on postprandial BP and PP in type 2 DM and EH The changes of postprandial BP and PP may be related to the stiffness of large arteries?peripheral arterial resistance and autonomic neuropathy