NIDDM 患者心血管自主神经病变与红细胞山梨醇含量相关性及其影响

用Ｅｗｉｎｇ法和定量ＨＲＰＳ法同时测定９４例ＮＩＤＤＭ患者心血管自主神经病变（ＣＡＮＤ）程度，探讨其与红细胞山梨醇（ＲＢＣＳ）含量的关系。结果表明ＤＭ患者伴ＣＡＮＤ组的ＲＢＣＳ值显著高于无ＣＡＮＤ组，ＲＢＣＳ升高与ＣＡＮＤ严重程度，植物神经的改变，尤以副交感神经更易受影响，且与年龄、病程、ＦＢＧ、ＨｂＡ１Ｃ、血浆Ｆｇ、ＨＤＬＣ及亚类和血浆镁改变也显著相关；多元逐步回归分析显示ＲＢＣＳ是对ＣＡＮＤ有显著影响的重要因素，提示ＤＭ患者ＣＡＮＤ是多因素共同作用结果，其中高血糖所致山梨醇通路活性增高在其发生发展中起重要作用。

CHANGE IN AMBULATORY BLOOD PRESSURE AND ITS CLINICAL SIGNIFICANCE IN PATIENTS WITH DIABETES MELLITUS

This paper was conducted to study the changes in ambulatory blood pressure in the patients with diabetes mellitus and its relationship with autonomic neuropathy and nephropathy. Thirty NIDDM patients with normal blood pressure and 40 normal controls were studied. The NIDDM patients were divided into two groups according to whether or not they had neuropathy. The results showed that:(1)average 24_h SBP, night time SBP and load value of night time SBP were significantly increased in NIDDM patients as compared with the controls (P<0.01);(2)the percentage of reduction in the night time SBP and the difference in values of urine albumin excretion between day time and night time were significantly decreased in the group with neuropathy. It is suggested that circadian variation of blood pressure is reduced or disappeared in diabetes and the increase in night time BP may be related to diabetic nephropathy.