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目的观察青中年Ⅱ型糖尿病合并高血压患者的动态血压特点及其颈动脉内-中膜厚度(IMT)的变化。方法随机选取青中年Ⅱ型糖尿病合并高血压组50例,青中年原发性高血压组50例,比较夜间收缩压负荷值、夜间血压下降百分率及颈动脉内-中膜厚度(IMT)的变化,分析之间的相关性。结果Ⅱ型糖尿病合并高血压组较原发性高血压组夜间收缩压负荷值升高,夜间血压下降百分率降低,颈动脉粥样硬化的发生率增加。两组患者的夜间收缩压负荷值和颈动脉IMT呈正相关,夜间血压下降百分率和颈动脉IMT呈负相关。结论青中年Ⅱ型糖尿病合并高血压时容易出现夜间收缩压负荷值升高,昼夜节律异常,对颈动脉IMT影响更为明显。夜间收缩压负荷值升高、昼夜节律异常可能是青中年Ⅱ型糖尿病合并高血压患者颈动脉粥样硬化的原因之一。
Objective To observe the changes of ambulatory blood pressure (BP) and carotid intima-media thickness (IMT) in patients with type 2 diabetes mellitus complicated with hypertension. Methods Fifty patients with type 2 diabetes mellitus with hypertension and 50 middle - aged and young patients with essential hypertension were randomly selected. The systolic blood pressure at night, the percentage of nocturnal hypotension and carotid intima - media thickness (IMT) The changes analyzed the correlation between them. Results Compared with the patients with type 2 diabetes mellitus, the nighttime systolic blood pressure load increased, the nighttime blood pressure decreased, and the incidence of carotid atherosclerosis increased. The nighttime systolic blood pressure load was positively correlated with carotid IMT in both groups, and the percentage of nocturnal decline in blood pressure was negatively correlated with carotid IMT. Conclusions In young middle-aged patients with type 2 diabetes mellitus complicated with hypertension, the value of nighttime systolic blood pressure load increases easily, and the circadian rhythm is abnormal. The effect on carotid IMT is more obvious. Nighttime systolic blood pressure value increases, circadian rhythm may be middle-aged young people with type 2 diabetes mellitus in patients with carotid atherosclerosis one of the reasons.