| 糖尿病合并高血压患者血糖、血压水平与动脉硬化的相关性研究 |
| 投稿时间：2016-12-29 修订日期：2017-01-09 点此下载全文 |
| 引用本文：杨燕芬,曹亚英,孙可欣,刘志科,项骁,隽娟,宋菁,黄少平,刘晓芳,李娜,唐迅,李劲,吴涛,陈大方,胡永华.糖尿病合并高血压患者血糖、血压水平与动脉硬化的相关性研究[J].医学研究杂志,2017,46(9):25-30 |
| DOI：
10.11969/j.issn.1673-548X.2017.09.008 |
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| 基金项目:国家自然科学基金资助项目（81230066，81102177，81473043） |
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| 中文摘要:目的 探讨糖尿病合并高血压患者血糖血压水平与动脉硬化的关系。方法 以北京某农村社区40岁及以上糖尿病合并高血压患者为研究对象，对患者进行问卷调查、体格检查、肱踝脉搏波传导速度（baPWV）检测和血样检测。根据患者糖化血红蛋白（HbA1c）、收缩压（SBP）及舒张压（DBP）水平进行分组，采用Logistic回归模型分析血糖血压水平与动脉硬化的关系。结果 共纳入1214例患者，其中动脉硬化异常（baPWV≥1700cm/s）有637人，占52.47%。相关性分析显示baPWV与HbA1c （rs=0.174，P=0.000）、SBP （rs=0.481，P=0.000）及DBP （rs=0.167，P=0.000）均呈正相关。Logistic回归分析显示，调整其他危险因素后，HbA1c和SBP每增加1个四分位数间距动脉硬化异常风险分别为1.41倍（95% CI：1.16~1.70）和3.71倍（95% CI：2.80~4.91）。结论 糖尿病合并高血压患者baPWV与HbA1c及SBP显著相关，同时控制血糖和血压可能有利于降低动脉硬化异常发生风险。 |
| 中文关键词:肱踝脉搏波传导速度 糖尿病2型 高血压 血红蛋白A 糖基化 血压 |
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| Relationship between Arterial Stiffness and Blood Glucose/Blood Pressure in Diabetic Patients with Hypertension |
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| Abstract:Objective To investigate the relationship between arterial stiffness and blood glucose or blood pressure in community patients with diabetes mellitus and hypertension. Methods Diabetic patients with hypertension aged 40 or above were enrolled from rural communities of Beijing. Every patient completed a standardized questionnaire and underwent physical examinations, brachial-ankle pulse wave velocity (baPWV) measurements, blood tests. Patients were divided into groups according to the level of glycated hemoglobin (HbA1c), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Analyses were performed by using multiple logistic regression model to explore the relationship between baPWV and blood glucose/blood pressure. Results Among 1214 patients enrolled, the detection rate of arterial stiffness (baPWV ≥ 1700cm/s) was 52.47%. Correlation analysis showed baPWV was positively associated with HbA1c (rs=0.174, P=0.000), SBP (rs=0.481, P=0.000) and DBP (rs=0.167 P=0.000). After multivariable adjustment, an increase of one IQR (from 25th to the 75th percentile) in the HbA1c and SBP was associated with greater risk of arterial stiffness[HbA1c (an increase of 2%):OR=1.41 (95% CI:1.16-1.70); SBP (an increase of 23mmHg):OR=3.71 (95% CI:2.80-4.91)]. Conclusion The blood glucose/blood pressure was associated with baPWV among diabetic patients with hypertension. Combined efforts to improve both blood pressure and glycemic control may help to reduce the risk of arterial stiffness. |
| keywords:Brachial-ankle pulse wave velocity Type 2 diabetes mellitus Hypertension Hemoglobin A Glycosylated Blood pressure |
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