新诊断糖尿病合并H型高血压患者不同部位血管受损情况

doi:10.3969/j.issn.1004-583X.2017.03.012

临床荟萃

新诊断糖尿病合并H型高血压患者不同部位血管受损情况

1.上海交通大学医学院附属第九人民医院奉城分院内分泌科，上海 201411；
2.上海市交通大学医学院附属第六人民医院南院呼吸内科，上海 201499

出版日期:2017-03-05 发布日期:2017-03-06
通讯作者: 通信作者：黄国兰，Email:junbowyg@163.com

Investigation of different vascular injuries in newly diagnosed diabetic patients with Htype hypertension

1.Department of Endocrinology，Fengcheng Branch of Shanghai Ninth People's Hospital， Shanghai Jiaotong
University School of Medicine， Shanghai 201411， China; 2.Department of Respiratory Medicine，
Shanghai Jiaotong University Affiliated Sixth People's Hospital South Campus， Shanghai 201499， China

Online:2017-03-05 Published:2017-03-06
Contact: Corresponding author:Huang Guolan，Email:junbowyg@163.com

摘要/Abstract

摘要： 目的观察新诊断糖尿病合并H型高血压患者不同部分血管的受损情况。方法选取新诊断2型糖尿病（T2DM）患者379例，根据是否合并H型高血压分为单纯T2DM组159例、T2DM+H型高血压组110例及T2DM+非H型高血压110例。采用超声心动图检测左心室结构，计算左心室质量指数（LVMI）；彩色多普勒超声仪检测颈动脉，测量颈动脉内中膜厚度（carotid artery intimamedia thickness， CIMT）或颈动脉粥样硬化斑块形成情况。收集晨尿，计算尿微量白蛋白/肌酐比值（UAlb/UCr），并计算内生肌酐清除率（CCr）。结果①T2DM+H型高血压组和T2DM+非H型高血压组收缩压(SBP)、舒张压(DBP)及同型半胱氨酸(Hcy)水平均较单纯T2DM组升高，高密度脂蛋白胆固醇(HDLC)较单纯T2DM组降低。T2DM+H型高血压组Hcy水平高于T2DM+非H型高血压组，HDLC低于T2DM+非H型高血压组（P＜0.05或＜0.01）；②T2DM+H型高血压组和T2DM+非H型高血压组LVEF＜50%、脑损害、颈动脉增厚发生率高于单纯T2DM组，T2DM+H型高血压组左心室肥厚和肾功能损害发生率高于单纯T2DM组（P＜0.05或＜0.01）；③T2DM+H型高血压组和T2DM+非H型高血压组LVMI、UAlb/UCr及CIMT水平均较单纯T2DM组升高，LVEF水平较单纯T2DM组降低（P＜0.05或＜0.01），T2DM+H型高血压组LVMI、CCr、UAlb/UCr及CIMT水平较T2DM+非H型高血压组升高，LVEF水平较单纯T2DM组降低（P＜0.05）。结论糖尿病患者在新诊断时，不同部位的血管即已经存在损伤，合并H型高血压的新诊断糖尿病患者血管损伤更严重。

关键词: 糖尿病, 2型, 高血压, 高同种半胱氨酸血症, 血管系统损伤

Abstract: ObjectiveTo observe different vascular injuries in diabetic patients with Htype hypertension. MethodsA total of 379 patients with newly diagnosed T2DM were divided into three group according to whether with Htype hypertension: T2DM+Htype hypertension group (n=110)， T2DM+nonHtype hypertension group (n=110) and T2DM group (n=159). The left ventricular structure， CIMT or with carotid atherosclerotic plaque formation were tested by ultrasonic cardiogram and color flow Doppler sonography. The LVMI， UAlb/UCr and CCr were counted. Results①The levels of SBP， DBP and Hcy in T2DM+Htype hypertension group and T2DM+nonHtype hypertension group were higher than those in T2DM group， HDLC was lower than that in T2DM group. Hcy level was higher in T2DM+Htype hypertension group than in T2DM+nonHtype hypertension group， and HDLC was significantly lower (P＜0.05 or P＜0.01); ②Compared with T2DM group， the rates of LVEF＜50%， brian damage and IMT in T2DM+Htype hypertension group and T2DM+nonHtype hypertension group were significantly increased (P＜0.05 or P＜0.01)， incidence of LVH and impaired renal function in T2DM+Htype hypertension were significantly increased (P＜0.05 or P＜0.01). The levels of LVMI， UAlb/UCr and CIMT in T2DM+Htype hypertension group and T2DM+nonHtype hypertension group were significantly higher than those in T2DM group， but the LVEF was significantly lower （P＜0.05 or P＜0.01）， the levels of LVMI， CCr， UAlb/UCr and CIMT were significantly higher in T2DM+Htype hypertension group than those in T2DM+nonHtype hypertension group， and LVEF level was significantly lower (P＜0.05). ConclusionWhen patients are newly diagnosed with diabetes， vascular injury in different parts has formed， and Htype hypertension will aggravate the damage degree.

Key words: diabetes mellitus, type 2, hypertension, hyperhomocysteinemia；vascular system injuries

黄国兰1，杨卫红1，浦柳美2. 新诊断糖尿病合并H型高血压患者不同部位血管受损情况[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2017.03.012.

Huang Guolan1， Yang Weihong1， Pu Liumei2. Investigation of different vascular injuries in newly diagnosed diabetic patients with Htype hypertension[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2017.03.012.

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https://huicui.hebmu.edu.cn/CN/Y2017/V32/I3/228

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新诊断糖尿病合并H型高血压患者不同部位血管受损情况

Investigation of different vascular injuries in newly diagnosed diabetic patients with Htype hypertension

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