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目的:探讨糖耐量检查(OGTT)在高血压合并糖代谢异常中的诊断价值。方法:对600例住院高血压患者进行OGTT,统计新增糖尿病、餐后血糖受损、新增餐前血糖受损病例,检测空腹C肽水平、血脂等。同时按性别、年龄、是否糖尿病家族史、是否血脂异常进行亚组分析。结果:进行OGTT后,600例高血压患者糖尿病发现率由23%增至34%;单纯餐后血糖受损22%;餐前血糖受损由2%增至6%;总体糖代谢异常62%。亚组分析发现:男女高血压患者合并糖代谢异常无明显差异(63.8%︰61.0%,P=0.281);40岁以上患者糖代谢异常发病率明显高于40岁以下患者(73.6%︰52.2%,P=0.023);有糖尿病家族史患者糖代谢异常明显高于无家族史患者(83.5%︰43.1%,P=0.008);有血脂异常患者也容易患血糖代谢异常(70.4%︰63.6%,P=0.036)。糖代谢异常组C肽水平明显高于糖代谢正常组[(615±24)pmol/L︰(285±32)pmol/L,P=0.009]。结论:建议高血压患者常规行OGTT,特别是中老年、有糖尿病家族史和血脂异常患者。
Objective: To investigate the diagnostic value of glucose tolerance test (OGTT) in the abnormal glucose metabolism of hypertension. Methods: OGTT was performed on 600 inpatients with hypertension, with new diabetes mellitus, impaired postprandial blood glucose, new cases of impaired fasting glucose, and fasting C-peptide levels and blood lipids. At the same time, according to gender, age, family history of diabetes, whether dyslipidemia subgroup analysis. Results: After OGTT, the prevalence of diabetes in 600 hypertensive patients increased from 23% to 34%; the postprandial blood glucose was impaired by 22%; the premeal blood glucose was increased from 2% to 6%; the overall glucose metabolism was 62% . Subgroup analysis found that there was no significant difference in abnormal glucose metabolism between men and women with hypertension (63.8%: 61.0%, P = 0.281). The incidence of abnormal glucose metabolism in patients over 40 years old was significantly higher than that in patients under 40 (73.6%: 52.2% , P = 0.023). Patients with family history of diabetes had abnormal glucose metabolism more than those without family history (83.5%: 43.1%, P = 0.008). Patients with dyslipidemia were also susceptible to abnormal glucose metabolism (70.4%: 63.6% P = 0.036). The level of C-peptide in abnormal glucose metabolism group was significantly higher than that in normal glucose metabolism group [(615 ± 24) pmol / L: (285 ± 32) pmol / L, P = 0.009]. Conclusion: It is recommended that patients with hypertension routinely receive OGTT, especially in the elderly, with a family history of diabetes and dyslipidemia.