摘要
目的探讨代谢综合征患者餐后状态血压和脉压变化及其与心血管及肾脏病变的关系。方法233例住院患者,分为高血压病(EH)组、2型糖尿病(DM)组和代谢综合征(MS)组,检测24h动态血压、颈动脉粥样斑块发生率(CAPR)、颈动脉内膜厚度(IMT)、左室重量指数(LVMI)、左室舒张早期充盈峰值流速(EPFV)与心房收缩期充盈峰值流速(APFV)比值(E/A值)和内生肌酐清除率(CcR)及24h尿微量白蛋白排泄量(MA)。结果(1)进餐前后SBP和PP差值≥10mm Hg(1mm Hg=0.133kPa)的高血压病患者,其CAPRI、MT、LVMI、MA明显高于差值<10mm Hg者(P<0.01),E/A和CcR明显低于差值<10mm Hg者(P<0.01)。(2)进餐前后PP差值≥10mm Hg代谢综合征患者,其CAPR、IMT、LVMI和MA均明显高于差值<10mm Hg者(P<0.01),而其E/A和CcR明显低于差值<10mm Hg者(P<0.01);进餐前后SBP差值≥10mm Hg、DBP差值≥5mm Hg者,其MA显著高于差值<10mm Hg和<5mm Hg者(P<0.05)。(3)进餐前后SBP差值≥10mm Hg、DBP差值≥5mm Hg的糖尿病患者,其MA明显高于差值<10mm Hg和<5mm Hg者(P<0.01)。(4)与靶器官损害相关分析显示:早餐后1h血压变化与心脏、颈动脉及肾脏病变呈显著相关。结论餐后血压和脉压是预测代谢综合征患者心脏、血管及肾脏损害的有价值指标。
Objective To investigate the relationship of postprandial blood pressure （BP） and pulse pressure（PP） with organ damages in metabolic syndrome. Methods Two hundreds and thirty-three patients were divided into essential hypertension （EH,85 cases）, type 2 diabetes mellitus （DM,75 cases）, and metabolic syndrome （MS,73 cases）. All patients were examined by 24h ambulatory blood pressure monitoring, carotid artery plaque rate（CAPR）, intimal medial thickness（IMT）, left ventricular mass index （LVMI） ,the ratio between early diastolic peak flow velocity and atrial peak flow velocity（E/A）, creatinine clearace rate（CcR）, 24h microalbuminuria（MA）. Results （1） In EH subjects, CAPR,IMT,LVMI, MA were increased in postprandial change in SBP or PP≥10mm Hg compared with SBP or PP〈10mm Hg（P〈0.01）. E/A and CcR were decreased in the former than latter（P〈 0.01 ）. （2） In MS subjects, CAPR, IMT, LVMI, MA were increased in postprandial change in PP≥10mm Hg compared with PP〈 10mm Hg（P〈0.01）. E/A and CcR were decreased in the former than latter（P〈0.01）. （3） In MS and DM groups, MA were increased in postprandial change in SBP≥10mm Hg and DBP≥Smm Hg compared with SBP〈10mm Hg and DBP〈5mm Hg（P〈 0.05, P〈0.01 ）. （4） In three groups, IMT, LVMI, MA significantly were correlated with postprandial SBP and PP at 1h. In MS and EH subjects, IMT,LVMI, MA significantly were correlated with 24h PP. Conclusion The postprandial BP and PP are the risk factors for the intimal medial thickness, left ventricular mass index, and 24h microalbuminuria of metabolic syndrome.
出处
《重庆医学》
CAS
CSCD
2006年第9期771-772,777,共3页
Chongqing medicine
基金
第三军医大学校管课题资助项目(XG200342)
