高血压和糖尿病患者餐后状态血压及脉压变化特征的研究

目的：研究高血压病、2型糖尿病和高血压合并糖尿病患餐后状态血压和脉压变化的特点，探讨其可能机制。方法：328例住院患，分为高血压病组（EH组，116例）、2型糖尿病组（DM组，100例）和高血压伴糖尿病组（EH＋DM组，112例），行24小时态血压（ABPM）检测，其中30例患再行有创桡动脉压测量，观察餐前和餐后收缩压（SBP）、舒张压（DBP）和脉压（PP）变化特点。结果：EH组餐后SBP和DBP升高（P＜0．01），而以SBP升高更明显，列后PP升高（P＜0．01）。DM组SBP和DBP均下降（P＜0．05），但餐后PP无明显变化（P＞0．05）。结论：EH＋DM组和DM组患各餐后SBP和DBP降低，其中EH＋DM组餐后DBP下降较显，餐后PP也增大。而H组患餐后SBP和DBP升高，而以SBP升高较显，餐后PP也增大。DM组患各餐后SBP和DBP降低幅度相似，其餐后PP无明显变化。三组患餐后血压和脉压变化各有其特征，其机制可能与大动脉硬化程度、外周血管舒缩功能及糖尿病自主神经病变等因素有关。

Characterization of postprandial blood pressure and pulse pressure in essential hypertension and type 2 diabetes milltus

Objective To study the status of postprandial blood pressure and pulse pressure in patients with essential hypertension (EH)?type 2 diabets mellitus(DM) and hypertensive DM Methods Three hundred and twenty eight subjects were divided into:EH ( n =116); type 2 DM( n =100)and hypertensive DM ( n =112) Ambulatory blood pressure monitor (ABPM)and invasive arterial blood pressure were examined before and after prandial Results Postprandial blood pressure (BP) were significantly higher in EH( P <0 01) On contrast ,postprandial BP were significantly decreased in type 2 DM and hypertensive DM( P <0 05; P <0 01) Postprandial pulse pressure (PP)was significantly increased in EH and hypertensive DM ( P <0 01),but not in type 2 DM alone( P >0 05) Conclusion Postprandial BP and PP were higher in EH, but postprandial BP were decreased in type 2 DM and hypertensive DM Postprandial PP was significantly increased in hypertensive DM, but not in type 2 DM alone Prandial status has different effects on postprandial BP and PP in type 2 DM and EH The changes of postprandial BP and PP may be related to the stiffness of large arteries?peripheral arterial resistance and autonomic neuropathy