论文部分内容阅读
目的:探讨糖代谢异常对原发性高血压(EH)患者血管内皮损伤的影响。方法:对46例单纯EH患者(EH组)与33例EH合并2型糖尿病(T2DM)患者(EH+T2DM组)的血糖、血脂、体质指数(BMI)及血清同型半胱氨酸(Hcy)、尿微量白蛋白浓度进行测定、比较,同时分析血清Hcy及尿微量白蛋白浓度与血糖、血脂及BMI之间的相关性。结果:与EH组相比,EH+T2DM组的BMI、血糖[空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c),血脂[甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及载脂蛋白B(ApoB)]水平均显著升高(P<0.05或<0.01),而且血清Hcy[(12.78±2.51)μmol/L比(16.26±2.91)μmol/L]及尿微量白蛋白水平[(19.45±5.24)mg/L比(33.65±10.70)mg/L]升高更加显著(P<0.01);Pearson相关分析显示,在EH+T2DM组患者,血清Hcy水平分别与BMI、FBG、HbA1c、LDL-C、ApoB及尿微量白蛋白水平显著正相关(r=0.667～0.906,P均<0.01),而尿微量白蛋白水平则分别与BMI、HbA1c、LDL-C、ApoB及血清Hcy水平显著正相关(r=0.566～0.685,P均<0.01)。结论:糖代谢异常可加重原发性高血压患者的血管内皮及肾微血管损伤,而且这与血糖代谢异常程度密切相关;控制血糖水平可减轻血管损伤,进而延缓心血管疾病及肾脏并发症的病理进展。
Objective: To investigate the effect of abnormal glucose metabolism on vascular endothelial injury in patients with essential hypertension (EH). Methods: The levels of blood glucose, blood lipid, body mass index (BMI) and serum homocysteine (Hcy) in 46 EH patients (EH group) and 33 EH patients with type 2 diabetes mellitus (T2DM) , Urine microalbumin concentration were measured, compared, simultaneous analysis of serum Hcy and urine microalbumin concentration and blood glucose, blood lipids and BMI correlation between. RESULTS: Compared with EH group, BMI, blood glucose [fasting blood glucose (FBG), postprandial 2h blood glucose (2hPBG), HbA1c, blood lipid [triglyceride], low density lipoprotein (P <0.05 or <0.01), and the levels of serum Hcy [(12.78 ± 2.51) μmol / L vs (16.26 ± 2.91) μmol / L ] And urinary albumin levels (19.45 ± 5.24 mg / L vs 33.65 ± 10.70 mg / L] (P <0.01). Pearson correlation analysis showed that in patients with EH + T2DM, serum Hcy (R = 0.667-0.906, P <0.01), while urinary microalbuminuria levels were positively correlated with BMI, HbA1c, LDL-C, ApoB and urine microalbumin -C, ApoB and serum Hcy levels (r = 0.566 ~ 0.685, P <0.01). Conclusion: Abnormal glucose metabolism can aggravate the vascular endothelial and renal microvascular injury in patients with essential hypertension, and this is closely related to the degree of abnormal glucose metabolism; controlling blood glucose level can reduce the vascular injury, and then delay the pathology of cardiovascular disease and renal complications progress.