糖尿病对高血压患者动态血压及血压变异性的影响

目的 探讨2型糖尿病（T2DM）对原发性高血压（EH）患者动态血压（ambulatory blood pressure，ABP）及血压变异性（blood pressure variability，BPV）的影响。方法 选取36例单纯EH及33例合并T2DM的EH患者，行24hABP监测，对2组患者的ABP及BPV进行对比分析。结果 与单纯EH患者相比，合并T2DM的EH患者日间平均收缩压（dmSBP）（P〈0，05）、日间脉压（dmPP）（P〈0.01）、日间收缩压标准差（dSBPSD）（P〈0.01）及日间收缩压标准差变异系数（dSBPCV）（P〈0．05）显著增大。结论 T2DM加重EH患者心血管系统的结构与功能异常，引起ABP及BPV增大；改善其体内糖代谢状况，将有助于改善其心血管系统血流动力学，从而减少心血管并发症。

Effects of type 2 diabetes mellitus on ambulatory blood pressure and blood pressure variability in essential hypertensive patients

Objective To explore the effects of type 2 diabetes mellitus(T2DM) on ambulatory blood pressure(ABP) and blood pressure variability(BPV) in essential hypertensive(EH) patients. Methods Twenty-four-hour recordings of ambulatory blood pressure were performed in 36 EH patients and 33 EH patients with T2DM, and comparative analysis of ABP and BPV was made between the two groups. Results Mean daytime systolic blood pressure(dmSBP)(P<0.05), mean daytime pulse pressure(dmPP)(P<0.01), daytime SBP standard deviation(dSBPSD)(P<0.01) and its coefficient of variance(dSBPCV)(P<0.05)of EH patients with T2DM were all significantly higher than those of EH patients without T2DM respectively. Conclusions T2DM could aggravate hypertension-induced abnormality in both structure and function of cardiovascular systems, and then increase ABP and BPV. Therefore, improvement of insulin sensitivity in those EH subjects with impaired glucose metabolism might restore cardiovascular hemodynamics, thus stabilizing the blood pressure fluctuation and reducing the possibility of cardiovascular complications.