论文部分内容阅读
目的:探讨住院2型糖尿病(T2DM)患者短期血压控制效果及影响因素。方法:169例伴发高血压的T2DM患者给予降压等综合治疗,以出院时血压130/80mmHg(1mmHg=0.133kPa)为界限分为达标组(97例)及未达标组(72例),比较2组入院时临床及实验室指标,并通过回归分析观察各种因素对出院时平均动脉压(MAP)水平的影响。结果:全组T2DM入院时收缩压(SBP)为(143±15)mmHg,舒张压(DBP)为(78±8)mm-Hg,控制达标率仅17.8%;出院时血压达标率57.4%,降压药物种类平均增加0.8种。未达标组患者入院时SBP[(151±15)∶(137±12)mmHg,P<0.01]、DBP[(80±9)∶(77±7)mmHg,P<0.01]均高于达标组,且TC及24h尿白蛋白排泄率(UAE)显著升高。回归分析显示MAP与入院时SBP、DBP、TC及高血压病程显著正相关,与年龄呈负相关;MAP与UAE显著正相关(r=0.303,P<0.01)。并发糖尿病肾病(DN)患者随UAE增多而SBP显著升高,大量蛋白尿者需要多种降压药物联合且血压难以控制。结论:T2DM患者门诊血压控制达标率低,住院短期治疗明显改善了血压控制水平;住院T2DM患者血压控制受入院时血压水平、高血压病程、高胆固醇血症、高UAE等因素影响;UAE增加可能是并发DN患者血压难以控制的直接原因。
Objective: To investigate short-term blood pressure control effect and its influencing factors in hospitalized type 2 diabetes mellitus (T2DM). Methods: One hundred and ninety-nine patients with T2DM with hypertension were given antihypertensive treatment. The patients were divided into two groups according to the standard of discharge: 130 / 80mmHg (1mmHg = 0.133kPa) The clinical and laboratory indexes of two groups were compared, and the effects of various factors on mean arterial pressure (MAP) at discharge were observed by regression analysis. Results: The SBP was (143 ± 15) mmHg and the mean DBP was (78 ± 8) mm-Hg at admission. The compliance rate was only 17.8%. The compliance rate of discharge at discharge was 57.4% Antihypertensive drugs increased by an average of 0.8 species. SBP [(151 ± 15): (137 ± 12) mmHg, P <0.01], DBP [(80 ± 9): (77 ± 7) mmHg, P <0.01] , And urinary albumin excretion rate (UAE) increased significantly at TC and 24h. Regression analysis showed that MAP was significantly and positively correlated with the course of SBP, DBP, TC and hypertension on admission, and negatively correlated with age. There was a significant positive correlation between MAP and UAE (r = 0.303, P <0.01). Patients with diabetic nephropathy (DN) increased with UAE and SBP was significantly higher, a large number of proteinuria need a variety of antihypertensive drugs and blood pressure is difficult to control. Conclusions: The outpatient setting of blood pressure control rate is low in T2DM patients and short-term inpatient treatment significantly improves the control of blood pressure. The control of blood pressure in hospitalized patients with T2DM is influenced by factors such as blood pressure level, course of hypertension, hypercholesterolemia and high UAE during hospital admission. It is difficult to control the blood pressure of patients with DN as a direct cause.