摘要
目的:探讨昼夜血压、左心室功能在不同阶段糖尿病肾病患者中的变化。方法:1998/2000福建医科大学附属第一医院内分泌科住院的糖尿病患者共890例,纳入标准:符合WHO糖尿病诊断标准且资料完整者。排除标准:资料不完整或合并有糖尿病急性并发症等。符合上述标准的糖尿病患者102例(糖尿病组),男56例,女46例。按尿白蛋白的排泄量分为下列3组:①正常蛋白尿(<30mg/24h)组58例。②微量蛋白尿(31～300mg/24h)组23例。③大量蛋白尿组(>300mg/24h)组21例。对照组为同期本院健康体检自愿者,排除标准:排除糖尿病、高血压、心脏病和肾病等疾患,并于非同日测量3次或以上血压值均<140/90mmHg,纳入32例,男17例,女15例。采用24h动态血压监护仪和彩色多普勒超声心动图仪检测对照组和糖尿病组患者,包括正常蛋白尿组58例、微量蛋白尿组23例、大量蛋白尿组21例。结果:蛋白尿正常组糖尿病患者已有夜间血压犤夜平均动脉压(84.14±15.45)mmHg,1mmHg=0.133kPa犦较对照组升高犤76.74±5.00)mmHg;t=2.788,P<0.01犦,昼夜血压下降幅度犤(5.34±5.47)%犦低于对照组犤(13.53±5.20)%犦(P<0.01);舒张期二尖瓣口充盈血流峰值速度A峰与E峰比值、室间隔厚度(interventricularseptalthickness,IVST)。
AIM:To probe into the changes of blood pressure and the function of left ventricle in diabetic nephropathy patients in various stages.METHODS:Totally 890 diabetes patients hospitalized in the Department of Endocrinology,First Affiliated Hospital of Fujian Medical University from 1998 to 2000 were selected.Inclusive criteria:in accordance with WHO diabetes diagnosis standard and complete data.Exclusive criteria:incomplete data or having acute diabetic complications,etc.A total of 102 diabetic patients were in accordance with the above criteria(diabetes group),including 56 men and 46 women.They were divided into 3 groups according to the excretion of urinary albumin:①normal albuminuria group(n=58) (less than 30 mg per 24 hours).②microalbuminuria group(n=23)(31 to 300 mg per 24 hours).③mass albuminuria group(n=21)(more than 300 mg per 24 hours).Healthy volunteers in our hospital were in the control group.Exclusive criteria:with the exception of diabetes,hypertension,cardiac disease and nephrosis,etc.A total of 32 patients,including 17 men and 15 women were included,whose blood pressure value were all above 140/90 mm Hg in separate 3 days.Controls and subjects in diabetes group were assayed with 24 hours dynamic blood pressure monitor and color Doppler ultrasonic cardiograph,including 58 cases in the normal albuminuria group,23 in the microalbuminuria group and 21 in the mass albuminuria group.RESULTS:The blood pressure at night [mean arterial blood pressure(84.14±15.45) mm Hg,1 mm Hg=0.133 kPa] of diabetes patients in the normal albuminuria group was higher than that in the control group[(76.74±5.00) mm Hg;t=2.788,P< 0.01],and the decreasing range of blood pressure between day and night[(5.34±5.47)%] was lower than that in the control group[(13.53±5.20)%](P< 0.01);The ratio of velocity of blood stream between peak A and E at mitral valve ostium during relaxing period, interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT) and left ventricle mass index were all higher than those in the control group(all P< 0.01).The active slope of anterior of bicuspidal valve was lower than that of the control group(P< 0.01);With the increase of proteinuria,the abnormality of the above indexes were worse and the ratio of IVST/LVPWT in the daytime were increased(P< 0.05).CONCLUSION:The increase of microalbuminuria is a risk signal of the heart damage in diabetic patients.
出处
《中国临床康复》
CAS
CSCD
2004年第33期7427-7429,共3页
Chinese Journal of Clinical Rehabilitation
