老年男性非杓型高血压合并糖尿病对血压昼夜节律及靶器官损害的影响

目的探讨老年男性非杓型高血压合并糖尿病对血压昼夜节律形态及心、肾靶器官损害的影响。方法入选老年男性原发性非杓型高血压患者656例,根据是否合并2型糖尿病,分为合并糖尿病组(n=366)与非糖尿病组(n=290)。采用全自动生化分析仪测定空腹血糖(FBG),总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C),氨基末端脑利钠肽前体(NT-proBNP),肌钙蛋白T(TnT),并依据MDRD公式计算肾小球滤过率(eGFR);行心脏超声检查,计算左室质量指数(LVMI)。分析两组患者上述指标差别。结果与非糖尿病组比较,合并糖尿病组患者血红蛋白(132.3±15.62)mmol/L vs.(131.14±12.32)mmol/L]、TG(1.52±1.09)mmol/L vs.(1.35±0.69)mmol/L]、HDL-C(1.15±0.32)mmol/L vs.(1.20±0.33)mmol/L]、T3(4.05±0.69)nmol/L vs.(4.27±0.85)nmol/L]、TnT(0.05±0.18)μg/L vs.(0.02±0.02)μg/L]、LVMI(179.82±44.83)g/m2 vs.(168.21±32.16)g/m2]、24h收缩压(125.00±12.14)mmHg vs.(123.00±11.11)mmHg]、白昼收缩压(127.00±13.09)mmHg vs.(125.30±12.29)mmHg]、夜间收缩压(128.12±16.28)mmHg vs.(125.34±14.59)mmHg]、夜间血压与白天血压比值(0.99±0.05)mmHg vs.(0.98±0.04)mmHg]有统计学意义(P均0.05)。结论老年男性原发性非杓型高血压合并糖尿病患者收缩压升高更为严重,血压昼夜节律消失更为明显,心功能损害加重。

Influences of non-dipper hypertension complicating diabetes on circadian rhythm of blood pressure and ;target organ damage in male elderly patients

Objective To investigate the influences of non-dipper hypertension complicating diabetes on circadian rhythm of blood pressure and target organ damage in male elderly patients. Methods The patients （n=656） were chosen and divided into diabetes group （n=366） and non-diabetes group （n=290） according to whether they had complicating diabetes or not. The changes of FBG, TC, TG, LDL-C, HDL-C, NT-proBNP and TnT were detected by using automatic biochemical analyzer, and eGFR was calculated according to MDRD formula. The patients were given cardiac ultrasound examinations for computing LVMI. The difference in all above indexes was analyzed in 2 groups. Results The difference in the levels of Hb （132.3±15.62） mmol/L vs. （131.14±12.32） mmol/L], TG （1.52 ±1.09） mmol/L vs. （1.35±0.69） mmol/L], HDL-C （1.15±0.32） mmol/L vs. （1.20±0.33） mmol/L], T3 （4.05±0.69） nmol/L vs. （4.27±0.85） nmol/L], TnT （0.05±0.18）μg/L vs. （0.02±0.02）μg/L], LVMI （179.82±44.83） g/m2 vs. （168.21±32.16） g/m2], 24-h SBP （125.00±12.14） mmHg vs. （123.00±11.11） mmHg], daytime SBP （127.00 ±13.09） mmHg vs. （125.30±12.29） mmHg], nighttime SBP （128.12±16.28） mmHg vs. （125.34±14.59） mmHg], and ratio of daytime SBP to nighttime SBP （0.99±0.05） mmHg vs. （0.98±0.04） mmHg] had statistical significance compared between 2 groups （all P〈0.05）. Conclusion The increase of SBP is more serious, disappearance of circadian rhythm is more obvious, and heart function damage is more exacerbated in male elderly patients with non-dipper hypertension complicating diabetes.