原发性高血压合并2型糖尿病患者血压昼夜节律及血压晨峰的变化

摘要

Objective To investigate the changes of morning blood pressure surge and circadian rhythm of blood pressure in type 2 diabetes mellitus patients with primary hypertension.Methods 140 primary hypertensive patients in Guang'anmen Hospital from September 2010 to December 2011 were selected and divided into group A and group B,with 70 cases in each group.Patients with primary hypertension and type 2 diabetes mellitus were divided into group A,patients with simple primary hypertension were divided into group B.Ambulatory blood pressure monitoring for 24 hours were carried out in all patients; average blood pressure day and night,nighttime blood pressure decreased percentage,morning blood pressure surge were observed.Results In the group A,the night mean systolic blood pressure and the mean diastolic blood pressure [(138.79±12.85),(78.20±7.99) mm Hg,1 mm Hg=0.133 kPa] were significantly higher than those in group B [(128.63±13.47),(66.61±7.58) mm Hg] (P ＜ 0.01).The mean systolic blood pressure of 2 hours before and after getting up in the morning in group A [(144.13±14.55),(146.76±13.50) mm Hg] were also higher than those in group B [(137.20±17.51),(142.66±14.13) mm Hg] (P ＜ 0.05).The presence of morning blood pressure surge of getting up and before getting up in group A were higher than those in group B,the differences were statistically significant (P ＜ 0.05).Conclusion Nocturnal blood pressure,morning blood pressure surge in patients with primary hypertension and type 2 diabetes mellitus are higher than those in patients with simple primary hypertension,they have high risk with cardiovascular and cerebrovascular diseases.%目的 探讨2型糖尿病合并原发性高血压患者血压昼夜节律以及血压晨峰的变化.方法 选择2010年9月～2011年12月广安门医院高血压患者140例,按有无合并糖尿病分为A、B两组,每组各70例.其中A组为2型糖尿病合并原发性高血压患者,B组为单纯原发性高血压患者;患者均进行24 h无创性动态血压监测,观察患者的血压昼夜平均值、夜间血压下降百分率、血压晨峰.结果 A组夜间平均收缩压与舒张压[(138.79±12.85)、(78.20±7.99)mm Hg,1 mmHg=0.133 kPa]均明显高于B组[(128.63±13.47)、(66.61±7.58)mm Hg](P＜ 0.01),A组起床前后2h收缩压平均值[(144.13±14.55)、(146.76±13.50)mm Hg]也明显高于B组[(137.20±17.51)、(142.66±14.13)mm Hg](P＜ 0.05).A组起床晨峰血压和起床前晨峰血压高于正常值患者的比例均高于B组,差异有统计学意义(P＜0.05).结论 2型糖尿病合并原发性高血压病患者夜间血压、血压晨峰均高于单纯原发性高血压病患者,其心脑血管病变的危险性增高.