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目的研究隐匿性高血压(MH)对2型糖尿病患者肾脏损害的影响。方法收集2015年3月至2016年3月第三军医大学大坪医院住院期间接受过24 h动态血压监测(ABPM)且临床数据齐全的2型糖尿病(T2DM)患者131例,根据动态血压监测结果分为MH组(n=70)和正常血压(NT)组(n=61),根据24 h尿微量白蛋白定量结果对两组患者肾脏损害情况进行比较。结果住院2型糖尿病患者中MH发生率为53%;两组间年龄、病程、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、吸烟史、饮酒史、体脂率差异无统计学意义;MH组体重指数(BMI)大于NT组(24.72±3.12对23.57±2.86,P=0.031),MH组微量白蛋白尿(MAU)发生率较NT组高(24.3%对4.9%,P=0.002);回归分析显示微量白蛋白尿与夜间动态平均收缩压(SBP)与糖尿病病程呈正相关(P=0.021,0.024)。结论隐匿性高血压会加重2型糖尿病患者的肾脏损害。
Objective To investigate the effects of occult hypertension (MH) on renal damage in type 2 diabetic patients. Methods 131 cases of type 2 diabetes mellitus (T2DM) patients with 24-hour ambulatory blood pressure monitoring (ABPM) and complete clinical data during the period of hospitalization from March 2015 to March 2016 in Daping Hospital of the Third Military Medical University were collected. According to the results of ambulatory blood pressure monitoring For the MH group (n = 70) and normotensive group (n = 61), renal impairment was compared between the two groups according to the quantitative results of 24-hour urine microalbumin. Results The incidence of MH in hospitalized type 2 diabetic patients was 53%. The age, course of disease, fasting blood glucose (FPG), Hb A1c, total cholesterol (TC), triglyceride (TG), low density lipoprotein There was no significant difference in LDL-C, smoking history, alcohol consumption history and body fat percentage. The body mass index (MH) BMI was significantly higher in MH group than in NT group (24.72 ± 3.12 vs 23.57 ± 2.86, P = 0.031) The incidence of albuminuria (MAU) was higher than NT group (24.3% vs 4.9%, P = 0.002). Regression analysis showed that microalbuminuria and nocturnal mean systolic pressure (SBP) had a positive correlation with diabetes course (P = 0.021, 0.024). Conclusion Occult hypertension aggravates kidney damage in type 2 diabetic patients.