摘要
目的:探讨老年男性糖尿病患者血压控制水平、影响因素以及与血管并发症的关系。方法:将184例老年犤平均年龄(77±9)岁,平均糖尿病病程(13.9±11.5)年犦男性糖尿病患者依据血压状况分为4组。无高血压组、血压控制满意组、控制良好组和控制差组。观测不同血压组各种临床和生化指标的变化及其与并发症的关系。结果:184例患者中有高血压139例(75.5%);冠心病127例(69.0%),其中有心肌梗死17例(9.2%);有下肢血管病变73例(39.7%),有糖尿病肾病43例(23.4%)。在高血压患者中,血压达到理想控制水平者44例(31.7%),达到良好控制水平者28例(20.1%),控制差者67例(48.2%)。随着年龄的增长和高血压病史的延长,血压控制的达标水平降低,各种并发症的发生率增高。糖尿病病史、年龄、体质量指数、舒张压、射血分数、糖化血红蛋白、尿微量白蛋白排泄率、C反应蛋白、同型半胱氨酸与收缩压独立相关;射血分数、同型半胱氨酸、空腹胰岛素水平是影响舒张压的独立危险因素。结论:老年男性糖尿病伴有高血压患者血压控制不理想,糖尿病并发症的发生与血压控制水平相关,血压控制水平受多因素影响。
AIM:To explore the control level of blood pressure(BP) and its influencing factors,and the relationship between control level of BP and vascular complications in elderly male patients with diabetes. METHODS:Totally 184 elderly male patients with diabetes[mean age was(77±9) years old,the mean disease course was(13.9±11.5) years] were divided into 4 groups according to their blood pressure:normal BP group,good,general and bad BP control groups.Changes of clinical and biochemical indexes in different BP groups and the relationship between BP and complications were analyzed. RESULTS:Among all the 184 cases,139(75.5%) had hypertension and 127(69.0%) had coronary heart disease(CHD),including 17(9.2%) with myocardial infarction(MI),73(39.7%) with lower limbs vascular disease and 43(23.4%) with diabetic nephropathy.In the hypertensive patients,44 cases(31.7%) had good BP control,28(20.1%) with general BP control and 67(48.2%) had bad BP control.Along with the increasing of age and disease course of hypertension,the BP control level decreased,while the incidence rate of complications became higher.The systolic blood pressure was independently correlated with disease course of diabetes,age,body mass index,diastolic blood pressure(DBP),ejection fraction,glycosylated hemoglobin,urinary albumin excretion,C reactive protein and homocysteine,while ejection fraction,homocysteine and fasting insulin level were the independent factors of DBP. CONCLUSION:It is necessary to enforce the treatment of diabetes and rehabilitative intervention in elderly diabetic men with hypertension so as to reduce the incidence of complications.
出处
《中国临床康复》
CSCD
2004年第18期3540-3542,共3页
Chinese Journal of Clinical Rehabilitation
基金
专项保健基金资助项目(解A064)~~
