天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (6): 624-627.doi: 10.11958/20170392

• 临床研究 • 上一篇    下一篇

高血压病患者血糖水平与血压变异性关系的临床研究

顾力，余意君△，徐艳玲，吴慧君，郑伟，周志云   

  1. 武汉市普爱医院心电生理科（邮编 430033）
  • 收稿日期:2017-03-31 修回日期:2017-05-11 出版日期:2017-06-15 发布日期:2017-07-05
  • 通讯作者: △通讯作者 E-mail: yu_yijun88@sina.com E-mail:734267256@qq.com
  • 作者简介:顾力（1979），女，主治医师，本科，主要从事心电生理领域的研究

Clinical study on blood glucose level and blood pressure variability in hypertensive patients

GU Li, YU Yi-jun△, XU Yan-ling, WU Hui-jun, ZHENG Wei, ZHOU Zhi-yun   

  1. Department of ECG Science, Wuhan Puai Hospital, Hubei 430033, China
  • Received:2017-03-31 Revised:2017-05-11 Published:2017-06-15 Online:2017-07-05
  • Contact: △Corresponding Author E-mail: yu_yijun88@sina.com E-mail:734267256@qq.com

PDF (PC)

4334

摘要： 目的 探讨高血压病患者血糖水平与血压变异性之间的关系。方法 回顾性分析 2015 年 5 月—2016 年 10 月在我院心血管内科住院的高血压病患者 125 例，根据患者是否合并糖尿病，分为高血压合并糖尿病组（59 例） 和高血压未合并糖尿病组（66 例），对 2 组血压水平、血压变异性及与血糖水平之间的关系进行分析。结果 （1）高 血压合并糖尿病组高脂血症史，低密度脂蛋白胆固醇水平低于高血压未合并糖尿病组，糖化血红蛋白（HbA1c）、24 h 舒张压变异系数（24 hDBPCV）、白天收缩压变异系数（dSBPCV）和白天舒张压变异系数（dDBPCV）高于高血压未合并 糖尿病组（P<0.05）。（2）对高血压病是否合并糖尿病与血压变异性各指标之间的 Spearman 相关分析显示，高血压病 合并糖尿病与 24 hDBPCV、dSBPCV 和 dDBPCV 呈正相关。（3）HbA1c 诊断高血压病患者非杓型血压的 ROC 曲线显 示，HbA1c 的 cut-off 值为 5.85%，曲线下面积为 0.692（P<0.05），敏感度为 71.1%，特异度为 63.7%。结论 高血压伴 血糖升高患者血压变异性增加，HbA1c 水平对高血压病患者非杓型血压诊断有着潜在的临床价值。

关键词: 高血压, 糖尿病, 血压变异性, 非杓型血压

Abstract: Objective To explore the relationship between blood glucose level and blood pressure variability in hypertensive patients. Methods A total of 125 hypertensive patients hospitalized in the department of cardiology in our hospital during May 2015 to October 2016 were retrospectively analyzed. Patients were divided into hypertension with diabetes mellitus group (n=59) and hypertension without diabetes mellitus groups (n=66). Data of blood pressure, blood pressure variability and blood glucose levels were analyzed in the two groups. Results (1) Hyperlipidemia, low density lipoprotein and cholesterol levels were significantly lower in the hypertension with diabetes mellitus group than those of hypertension without diabetes mellitus group. Level of glycosylated hemoglobin (HbA1c), 24 h diastolic pressure variability coefficient (24 hDBPCV), daytime systolic blood pressure variability coefficient (dSBPCV), and daytime diastolic pressure variability coefficient (dDBPCV) were significantly higher in the hypertension with diabetes mellitus group than those of hypertension without diabetes mellitus group (P<0.05). (2) Spearman correlation analysis showed that hypertension with diabetes mellitus was positively correlated with 24 hDBPCV, dSBPCV and dDBPCV. (3) ROC curves of HbA1c for diagnosis of non-dipper blood pressure in hypertensive patients showed that the cut-off value of HbA1c was 5.85% and the area under curve was 0.692 (P<0.05). The sensitivity was 71.1% and the specificity was 63.7% . Conclusion The present results demonstrate that blood pressure variability is increased in hypertension patients with higher blood glucose. HbA1c level has potential clinical value for diagnosis of non-dipper blood pressure in hypertensive patients.

Key words: hypertension, diabetes mellitus, blood pressure variability, non-dipper blood pressure