摘要
目的探讨糖尿病、高血脂对高血压患者动脉僵硬度的影响。方法从上海市宝山区6家社区卫生中心及上海交通大学医学院附属第九人民医院入选726例高血压患者,收集相关病史信息,检测患者颈-股动脉脉搏波速度(C-F PWV),颈动脉-桡动脉脉搏波速度(C-R PWV)、颈动脉-足背动脉脉搏波速度(C-D PWV),672例患者随访1年后再次测定脉搏波传导速度,将患者分成单纯高血压组(n=357)、高血压合并高血脂组(n=108)、高血压合并糖尿病组(n=142)、高血压合并高血脂+糖尿病组(n=65)四组。结果单纯高血压组、高血压合并高血脂组、高血压合并糖尿病组、高血压合并高血脂+糖尿病组四组间PWV差异无统计学意义(P>0.05),但组间均值比较提示高血压合并高血脂+糖尿病组患者较其他3组C-F PWV和C-D PWV均值高,但组间进行两两比较差异均无统计学意义(P>0.05)。随访研究中四组的C-F PWV均有所增加,其中单纯高血压组患者前后两年C-F PWV、C-R PWV比较差异无统计学意义(P>0.05),而合并糖尿病或高血脂的患者组前后两年C-F PWV、C-R PWV比较差异有统计学意义(P<0.05);四组前后两年C-D PWV比较均无统计学差异(P>0.05)。横断面研究显示,单纯合并高血糖或高血脂的高血压患者中,其PWV值与单纯高血压组比较无统计学差异(P>0.05),而在随访研究中两组PWV的增高与单纯高血压组比较显示出统计学差异(P<0.05)。结论高血糖、高血脂相对高血压对动脉僵硬度影响较小,但可加速高血压患者动脉硬化的进程。
Objective To investigate the effect of diabetes, hyperlipoidemia on arterial stiffness in patients with hypertension. Methods 726 patients with hypertension were enrolled from 6 community health centers of Baoshan District. The related history information was collected. The carotid-femoral pulse wave velocity（C-F PWV）, carotid-radial pulse wave velocity（C-R PWV）, carotid artery-dorsalis pedis pulse wave velocity（C-D PWV） were measured. 672 patients were followed up for 1 years again after the determination of pulse wave velocity. All eligible patients were divided into hypertension group（n=357）, hypertension and hyperlipoidemia group（n=108）, hypertension with diabetes mellitus（DM） group（n=142）, hypertension complicated with hyperlipoidemia ＋ DM group（n=65）. Results There was no significant difference of PMV among four groups. In the follow-up study, the C-F PWV was increased in the four groups. There was no significant difference of C-F PWV and C-R PWV in hypertension group before and after follow-up（P〈0.05）. The C-F PWV and C-R PWV in hypertension patients with diabetes or hyperlipidemia were significantly different before and after follow-up（P〉0.05）. There was no significant difference in C-D PWV between the four groups（P〉0.05）. The cross-sectional study showed that PWV values in hypertensive patients with hyperglycemia or hyperlipidemia were not significantly different from those in the hypertension group（P〉0.05）. However, in the follow-up study, the increasing of PWV in hypertensive patients with hyperglycemia or hyperlipidemia was significantly different from those in the hypertension group（P〈0.05）. Conclusion Hyperglycemia and hyperlipidemia have less effect on arterial stiffness than hypertension, but can accelerate the progression of arteriosclerosis in hypertensive patients.
作者
周静
沈英豪
戎鑫
张彩兰
顾庆
郭华
张俊峰
Zhou Jing, Shen Yinhao, Rong Xin, Zhang Cailan, Gu Qing, Guo Hua, Zhang Junfeng.(Department of Cardiology, Shanghai Ninth People＇s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201900, China)
出处
《中国循证心血管医学杂志》
2018年第5期562-564,568,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
上海申康市级医院适宜技术推广项目(SHDC12012210)
关键词
糖尿病
高血脂
高血压
动脉僵硬度
脉搏波速度
Diabetes mellitus
Hyperlipoidemia
Hypertension
Arterial stiffness
Pulse wave velocity
