摘要
目的调查和分析不同程度和不同类型的高血压对糖尿病患者眼、肾及心脏并发症的影响。方法将1994-2006年确诊的5841名糖尿病患者按不同血压水平和高血压类型分组,研究糖尿病眼、肾并发症及心电图异常率与血压控制的关系。结果5841名患者中,1006人(17.22%)有眼底病变;其中背景性眼底病变898人(15.37%),增生性眼底病变108人(1.85%);微量尿白蛋白1145人(19.60%);心电图异常1077人(18.44%)。随着血压升高,视网膜、肾脏并发症及心电图异常的发生率明显增加,SBP和DBP均高的患者有更严重的眼底病变、白蛋白尿和更高的心电图异常率。经服降压药血压控制良好的糖尿病患者,眼底、白蛋白尿和心电图异常率与血压正常的糖尿病患者相似。结论高血压促发和加重糖尿病患者眼底、肾脏并发症和心电图异常。严格控制血压能降低这些异常的发病率。
Objective To investigate the impact of different type and severity of hypertension on diabetic retinopathy, nephropathy and abnormal ECG. Methods 5841 patients from the diabetic complication assessment database from 1994 to 2006 were divided into the eight groups.- group A （GA,n=3580, BP〈140/〈90 mmHg）, group B （GB,n=456, BP〈140/〈90 mmHg, with hypotensive agents）, group C （GC,n=1271, BP=140-159/90- 99 mmHg）, group D （GD, n = 396, BP = 160-179/100-109 mmHg）, group E （GE, n = 138, BP≥ 180 /110 mmHg）, group 3 （G3,n= 1262, systolic hypertension only）, group 4 （G4,n= 103, diastolic hypertension only） and group 5 （GS,n=440, both systolic and diastolic hypertension）. Results Of these patients, 1006 patients had retinopathy, including 898 （15.37%） with background retinopathy and 108 （1.85%） with proliferative retinopathy; 1145 had elevated urine albumin excretion, 1077 had abnormal ECG. The prevalences of retinopathy, nephropathy and the abnormal ECG were increased from 15.0%, 17. 20, 29. 9% in group A to 34. 8 %, 54. 5 %, 66. 7% in group E. No differences in the prevalence of retinopathy and nephropathy between group A and group B （15. 0 % vs. 17. 8 % ; 17. 2 % vs. 16. 3 % respectively）. There were significant differences in the ECG abnormalities between different groups （29. 9 % for group A, 37. 4% for group B, 40. 5% for group C, 49.4 % for group D and 66. 7 % for group E）. There were significant differences in the prevalence of retinopathy, nephropathy and ECA3 abnormalities among group 3 （21.6 %, 46.7 %, 42.3 %）, group 4 （11. 0g, 36.6%, 45.0g）, and group 5 （22. 8%, 47. 3%, 49. 5%） respectively. Conclusions Hypertension aggravates retinopathy, nephropathy and ECG abnormalities in the diabetic patients. Reasonably controlled blood pressure significantly decreases the prevalence of diabetic retinopathy, alhuminuria and ECG abnormalities.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2008年第10期611-613,616,共4页
Chinese Journal of Diabetes
