原发性高血压合并糖尿病患者心血管自主神经功能与血压形态的关系

摘要

目的：研究原发性高血压合并糖尿病患者心血管自主神经功能与血压形态的关系。方法：入选原发性高血压患者70例，其中合并糖尿病者35例为试验组（EH-DM组），血糖正常者35例为对照组（EH组）。两组患者均行标准心血管自主神经功能检查以及24 h动态血压监测。结果：EH-DM组自主神经功能评分显著高于EH组（P<0.05），昼夜收缩压下降率（ΔSBP%）显著低于EH组（P<0.05），具有更高的非杓型血压形态比例（P<0.05）。其中，昼夜收缩压下降率与自主神经病变评分呈负相关（r=-0.328，P<0.05）。结论：合并糖尿病的高血压病患者，心血管自主神经功能评分高，非杓型血压形态比例高，提示血糖可能通过损害心血管自主神经功能改变血压形态。%Objective:To explore the relationship between cardiac autonomic function and blood pressure circadian rhythm in diabetic hypertensive patients.Method:70 essential hypertensive patients were recruited, 35 complicate with diabetes as the experimental group (group EH-DM) and the other 35 with normal blood glucose as the control group (group EH).They underwent standard cardiovascular autonomic function tests (SCAFT) and ambulatory blood pressure monitoring(ABPM).Result:The SCAFT score was higher in the group EH-DM than in the group EH (P<0.05).The decline of SBP at night(ΔSBP%)was lower in the group EH-DM than in the group EH(P<0.05).The ratio of non-dipping circadian rhythm in the group EH-DM was higher than that in the group EH (P<0.05).The decline of SBP at night and SCAFT score appeared in an obvious negative correlation(r=-0.328,P<0.05).Conclusion:The diabetic hypertensive patients have higher SCAFT score and higher ratio of non-dipping circadian rhythm.Blood glucose may affect blood pressure circadian rhythm through impairing cardiovascular autonomic function.