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目的:对于2型糖尿病合并的高血压患者,在不同高血压病程的情况下,使其血脂、血糖代谢情况和微环境产生不同影响的研究。方法:选取我院内分泌科的200例2型糖尿病患者,按照患者是否患有高血压来分类,分为正常血压组和高血压组。按糖尿病和高血压两种病程长短比较作为参考,将高血压组又分为糖尿病早于高血压组和糖尿病晚于高血压组。每组患者均需测量血脂四项、血肌酐、C肽、尿酸、血糖、果糖胺、胰岛素和尿微量白蛋白,由测量结果得出各自的胰岛素抵抗指数和利用眼底镜检查视网膜病变的情况,并综合各项指标进行分析探讨。结果:三组患者在年龄、性别等的各项指标均无明显差异(P>0.05),而两高血压组的HOMA指数、血压、血胆固醇、血肌酐、高血压病程、空腹胰岛素、尿微量白蛋白、餐后2h的血糖和C肽、视网膜病变情况均明显高于正常血压组,差异有统计学意义(P<0.05)。不同高血压病程的患者血脂和血糖代谢情况具有显著性差异(P<0.05)。结论:高血压及糖尿病可使微环境受到影响,从而导致了血脂和血糖代谢异常的现象。研究显示患者高血压病程越长,越发增加其血脂和血糖代谢异常的现象,因此针对2型糖尿病患者而言,对其进行血压监测和及时采取措施控制病程具有重要的临床意义。
OBJECTIVE: To study the different effects of blood lipid, glucose metabolism and microenvironment in hypertensive patients with type 2 diabetes mellitus with different course of hypertension. Methods: Two hundred and twenty cases of type 2 diabetes mellitus in our hospital were divided into two groups: normal blood pressure group and high blood pressure group according to whether the patients had hypertension or not. Diabetes and hypertension according to the length of the two courses as a reference, the hypertension group is divided into diabetes earlier than hypertension and diabetes later than hypertension. Each group of patients need to measure the four blood lipids, serum creatinine, C-peptide, uric acid, blood glucose, fructosamine, insulin and urinary microalbumin. From the measurement results, the respective insulin resistance index and retinal pathological changes by ophthalmoscopy, And comprehensive analysis of the indicators to explore. Results: There were no significant differences in age, sex and other indexes between the three groups (P> 0.05). The HOMA index, blood pressure, blood cholesterol, serum creatinine, duration of hypertension, fasting insulin and urine microalbuminuria Albumin, 2h postprandial blood glucose and C peptide, retinopathy were significantly higher than the normal blood pressure group, the difference was statistically significant (P <0.05). Patients with different duration of hypertension had significant differences in blood lipid and glucose metabolism (P <0.05). Conclusion: Hypertension and diabetes can affect the microenvironment, resulting in the abnormal lipid metabolism and glucose metabolism. Research shows that patients with longer duration of hypertension, increased blood lipid and glucose metabolism abnormalities, so for patients with type 2 diabetes, its blood pressure monitoring and timely measures to control the course of disease has important clinical significance.