糖尿病、高血脂对高血压患者动脉僵硬度的影响

摘要

Objective To investigate the effect of diabetes, hyperlipoidemia on arterial stiffness in patients with hypertension. Methods 726 patients with hypertension were enrolled from 6 community health centers of Baoshan District. The related history information was collected. The carotid-femoral pulse wave velocity (C-F PWV), carotid-radial pulse wave velocity (C-R PWV), carotid artery-dorsalis pedis pulse wave velocity (C-D PWV) were measured. 672 patients were followed up for 1 years again after the determination of pulse wave velocity. All eligible patients were divided into hypertension group (n=357), hypertension and hyperlipoidemia group (n=108), hypertension with diabetes mellitus (DM) group (n=142), hypertension complicated with hyperlipoidemia + DM group (n=65). Results There was no significant difference of PMV among four groups. In the follow-up study, the C-F PWV was increased in the four groups. There was no significant difference of C-F PWV and C-R PWV in hypertension group before and after follow-up (P>0.05). The C-F PWV and C-R PWV in hypertension patients with diabetes or hyperlipidemia were significantly different before and after follow-up (P<0.05). There was no significant difference in C-D PWV between the four groups (P>0.05). The cross-sectional study showed that PWV values in hypertensive patients with hyperglycemia or hyperlipidemia were not significantly different from those in the hypertension group (P>0.05). However, in the follow-up study, the increasing of PWV in hypertensive patients with hyperglycemia or hyperlipidemia was significantly different from those in the hypertension group (P<0.05). Conclusion Hyperglycemia and hyperlipidemia have less effect on arterial stiffness than hypertension, but can accelerate the progression of arteriosclerosis in hypertensive patients.%目的 探讨糖尿病、高血脂对高血压患者动脉僵硬度的影响.方法 从上海市宝山区6家社区卫生中心及上海交通大学医学院附属第九人民医院入选726例高血压患者,收集相关病史信息,检测患者颈-股动脉脉搏波速度(C-F PWV),颈动脉-桡动脉脉搏波速度(C-R PWV)、颈动脉-足背动脉脉搏波速度(C-D PWV),672例患者随访1年后再次测定脉搏波传导速度,将患者分成单纯高血压组(n=357)、高血压合并高血脂组(n=108)、高血压合并糖尿病组(n=142)、高血压合并高血脂+糖尿病组(n=65)四组.结果 单纯高血压组、高血压合并高血脂组、高血压合并糖尿病组、高血压合并高血脂+糖尿病组四组间PWV差异无统计学意义(P＞0.05),但组间均值比较提示高血压合并高血脂+糖尿病组患者较其他3组C-F PWV和C-D PWV均值高,但组间进行两两比较差异均无统计学意义(P＞0.05).随访研究中四组的C-F PWV均有所增加,其中单纯高血压组患者前后两年C-F PWV、C-R PWV比较差异无统计学意义(P＞0.05),而合并糖尿病或高血脂的患者组前后两年C-F PWV、C-R PWV比较差异有统计学意义(P＜0.05);四组前后两年C-D PWV比较均无统计学差异(P＞0.05).横断面研究显示,单纯合并高血糖或高血脂的高血压患者中,其PWV值与单纯高血压组比较无统计学差异(P＞0.05),而在随访研究中两组PWV的增高与单纯高血压组比较显示出统计学差异(P＜0.05).结论 高血糖、高血脂相对高血压对动脉僵硬度影响较小,但可加速高血压患者动脉硬化的进程.