血压正常的2型糖尿病患者血压昼夜节律变化与左室肥厚的关系

目的探讨血压正常的2型糖尿病(DM)患者血压昼夜节律变化与左心室肥厚的关系，为防治2型DM患者心脏损害提供依据。方法经彩色多普勒超声心动图及心电图或活动平板运动试验、血压检查筛选排除合并冠心病等其它心脏病、高血压病，无糖尿病肾病的60例2型DM患者并据彩色多普勒超声心动图将患者分成左室肥厚组(LVH组共28例)及非左室肥厚组(NLVH组共32例)。监测他们的24h动态血压。结果显示LVH组与NLVH组相比，在平均24h收缩压、平均白天收缩压、平均24h舒张压、平均白天舒张压在统计学上无显著性差异。而在平均夜间收缩压、平均夜间舒张压、夜间收缩压下降百分率、夜间舒张压下降百分率在统计学上有显著性差异。结论正常血压的2型DM患者血压昼夜节律变化可能是致2型DM患者左室肥厚的一个原因。

Study on the Relationship between 24 Hours Blood Pressure Regulation and Left Venfricular Hypertrophy in Type 2 Diabetes Patients with Normal Blood Pressure

Objective To investigate the relationship of 24 hour blood pressure regulation and left venfricular hypertrophy in type 2 diabetes patients with normal blood pressure and provide a clinical bases for prevention of cardiac dysfunction. Methods Based on the color dopple echocardiography and electrocardiogram or treadmill test, 60 cases of 2 DM patients were ruled out to have coronary heart disease, other heart diseases, hypertension, and diabetic nephropath. These 60 cases were divided into left ventricular hypertrophy group(LVH group in 28 type 2 DM) and no left ventricular hypertrophy group(NLVH group in 32 type 2 DM) according to color dopple echo cardiography diagnosis. 24 hour blood pressure profile was monitored. Results There were no significant differences between the LVH group and NLVH group on the 24h ABPS, ABPS in daytime, 24h ABPD, and ABPD in daytime. But ABPS in nighttime, ABPD in nighttime, amplitude of decrease in PS and PD in nightime were obviously higher in LVH group than those in NLVH group.Conclusion In the type 2 DM patients with normal blood pressure, the change in 24 hour blood pressure may be one of the factor contribute to the left ventricular hypertrophy.