老年2型糖尿病合并高血压患者的临床特征观察

摘要

目的 探讨老年2型糖尿病合并高血压患者的临床特征,为2型糖尿病合并高血压提供诊断参考.方法 选择2016年1月-2017年4月在华中科技大学同济医学院附属梨园医院就诊的老年2型糖尿病患者187例作为研究对象,根据是否合并高血压将患者分为观察组和对照组,观察组为糖尿病合并高血压患者,对照组为糖尿病未合并高血压患者.观察各组患者糖化血红蛋白(HbAlC)与N端前脑钠肽(NT-proBNP)水平、血糖值、血压值和左心功能等,并进行统计学分析.结果 观察组HbAlC、空腹血糖、餐后2h血糖、收缩压、舒张压和NT-proBNP水平均显著高于对照组(均P＜0.05).观察组LVMI显著高于对照组,LVEF和E/A显著低于对照组,差异均有统计学意义(均P＜0.05).Pearson相关分析显示,观察组HbAlC与LVMI和NT-proBNP均呈显著正相关(r=0.643、0.814,均P＜0.05),与LVEF和E/A均呈显著负相关(r=-0.582、-o.614,均P＜0.05):NT-proBNP与LVMI和HbAlC均呈显著正相关(r=0.695、0.814,均P＜0.05),与LVEF和E/A均呈显著负相关(r=-0.654、-0.688,均P＜0.05);空腹血糖与LVMI、HbAlC和NT-proBNP均呈正相关(r=0.457、0.741、0.623,均P＜0.05),与LVEF和E/A均呈负相关(r=-0.372、-o.482,均P＜0.05);餐后2h血糖与LVMI、HbAlC和NT-proBNP均呈正相关(r=0.508、0.809、0.704,均P＜0.05),与LVEF和E/A均呈负相关(r=-0.433、-0.405,均P＜0.05).结论 根据老年糖尿病合并高血压患者临床特征,发现NT-proBNP水平对老年糖尿病合并高血压患者左心室肥厚具有较高预测价值,糖化血红蛋白水平与NT-proBNP具有较高相关性,且检测方法简单,易于推广,可望用于糖尿病合并高血压患者左心功能筛查,具有一定的临床应用价值.%Objective To observe the clinical features in the elderly with diabetes type 2 complicated with hypertension.Methods 187 elderly patients in Liyuan Hospital during the period from Jan.,2016 to April,2017 were selected and divided into 2 groups:observation group (complicated with hypertension) and control group (with no hypertension);the levels of glycosylated hemoglobin (HbA1C),NT-proBNP,blood glucose,blood pressure and left ventricular function of the elderly in both groups were observed and a statistical study was made.Results The HbAlC level,fasting blood glucose,2h postprandial blood glucose,systolic blood pressure,diastolic blood pressure and the NT-proBNP level of the elderly in observation group were much higher than those of the elderly in control group (P＜0.05);the LVMI in observation group was obviously higher but LVEF and E/A were obviously lower than those in control group,and the differences were of statistical significance (P＜ 0.05);Pearson correlation analysis indicated that,in observation group,the level of HbAlC was in positive correlation with LVMI and NT-proBN (r=0.643,0.814,P＜0.05) but in negative correlation with LVEF and E/A (r=-0.582,-0.614,P＜0.05);NT-proBNP was in obvious correlation with LVMI and HbA1C (r=0.695,0.814,P＜0.05) but in obvious negative correlation with LVEF and E/A (r=-0.654,-0.688,P＜0.05);fasting blood glucose was positively correlated to LVMI,NT-proBNP (r=0.457,0.741,0.623,P＜0.05) but negatively correlated to LVEF and E/A (r=-0.372,-0.482,(P＜0.05);2h postprandial blood glucose was positively correlated to LVMI,HbAlC and NT-proBNP (r=0.508,0.809,0.704,P＜0.05) but negatively correlated to LVEF and E/A (r=-0.433,-0.405,P＜0.05).Conclusions The level of NT-proBNP is of higher predictive value of left ventricular hypertrophy of the elderly with diabetes complicated with hypertension;the level of HbAlC is in higher correlation with that of NT-proBNP;the detection is simple and easy in performance and wider application,and is expected to be used in left ventricular function screen in the elderly with diabetes complicated with hypertension.