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目的探讨空腹血糖<7mmol/L的高血压患者,直接进行口服葡萄糖耐量试验(OGTT),早期发现糖代谢异常的价值及其安全性。方法纳入2013年6月1日至2016年7月20日于福建医科大学附属第一医院入院前1年体检空腹血糖<7mmol/L且无糖尿病症状的住院患者(n=364)直接进行OGTT,收集患者血糖、血脂及一般情况等。根据是否高血压分为:非高血压组、高血压组。分析糖调节受损、糖尿病检出率,分析2组年龄、体质量指数(BMI)、血糖、血脂等差异。结果 364例患者中糖调节受损141例(38.74%),糖尿病48例(13.19%)。检查中未发生糖尿病酮症酸中毒、高渗性昏迷等需紧急降糖处理病例。与非高血压组相比,高血压组年龄更大,BMI、餐后2h血糖、糖化血红蛋白、糖调节受损和糖尿病比例更高(均P<0.05)。空腹血糖<5.6mmol/L高血压患者OGTT筛查餐后2h血糖(n=158),糖调节受损检出率37.3%,糖尿病检出率9.5%。有序多分类Logistic回归分析发现,与非高血压患者相比较,高血压者发生糖调节受损及糖尿病的比值比为2.286(95%CI 1.457~3.589,P<0.01)。结论高血压患者常规进行OGTT,对早期发现高血压合并糖代谢异常和糖尿病具有重要的临床价值。
Objective To investigate the value and safety of oral glucose tolerance test (OGTT) in patients with hypertension with fasting blood glucose <7mmol / L and early detection of abnormal glucose metabolism. Methods The hospitalized patients (n = 364) with fasting blood glucose <7mmol / L and no diabetes mellitus were admitted to the First Affiliated Hospital of Fujian Medical University from June 1, 2013 to July 20, 2016. OGTT, Collect patient’s blood sugar, blood fat and general situation and so on. According to whether the hypertension is divided into: non-hypertension group, hypertension group. Analysis of impaired glucose regulation, diabetes detection rate, analysis of two groups of age, body mass index (BMI), blood glucose, blood lipids and other differences. Results Among the 364 patients, 141 (38.74%) impaired glucose regulation and 48 (13.19%) had diabetes mellitus. Check did not occur in patients with diabetic ketoacidosis, hyperosmolar coma need urgent hypoglycemic treatment cases. Hypertensive patients were older, BMI, postprandial blood glucose 2h, glycosylated hemoglobin, impaired glucose regulation and diabetes (P <0.05), compared with nonhypertensives. OGTT screening fasting blood glucose <5.6mmol / L hypertensive patients 2h postprandial blood glucose (n = 158), impaired glucose regulation detection rate of 37.3%, diabetes detection rate of 9.5%. Logistic regression analysis showed that the ratio of impaired glucose regulation and diabetes was 2.286 (95% CI 1.457 ~ 3.589, P <0.01) in patients with hypertension compared with non-hypertensive patients. Conclusions OGTT is routinely performed in hypertensive patients, which has important clinical value in the early detection of hypertension complicated with abnormal glucose metabolism and diabetes mellitus.