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2型糖尿病合并糖尿病足综合征女性患者的动脉高血压患病率

[Prevalence of arterial hypertension in women with type 2 diabetes mellitus and diabetic foot syndrome].

作者信息

Onuchin S G, Elsukova O S, Onuchina E L

出版信息

Klin Med (Mosk). 2009;87(1):45-9.

Abstract

The aim of the study was to evaluate prevalence of arterial hypertension (AH), efficiency of preceding therapy, and quality of life (QL) in 50 women with type 2 diabetes mellitus (DM) and diabetic foot syndrome (DFS) and 139 DM patients without DFS. The analysis included individual outpatient medical records, results of AH verification (WHO, RSC, 2004), parameters of carbohydrate and lipid metabolism, insulin resistance (IR) index, and QL data (SF-36 questionnaire). The patients were above 55 years of age. Active detection of AH revealed it in 98% of the patients with DFS and in 97% without it (p < 0.05). Detection of AH preceded diagnosis of LM. The lack of adequate IR correction (inefficient treatment with metformin, absence of thiazolidinedione therapy), irregular use of statins (in 4 and 8% of patients with and without DFS respectively, p = 0.541), inadequate antihypertensive therapy (absence of treatment at AP 130-139/80-89 mm Hg), rare application of ACE inhibitors, modification or withdrawal of prescribed therapy) resulted in decompensation of DM, dyslipidemia, poor control of AP, social and psychological problems in women with DM. Those having DFS suffered dyslipidemia, elevated AP, further progress of DFS manifestations and vascular complications, reduced QL in the absence of strict control of glycemia.

摘要

本研究旨在评估50例2型糖尿病(DM)合并糖尿病足综合征(DFS)的女性患者以及139例无DFS的DM患者的动脉高血压(AH)患病率、前期治疗效果和生活质量(QL)。分析内容包括个体门诊病历、AH核查结果(世界卫生组织,俄罗斯心脏病学会,2004年)、碳水化合物和脂质代谢参数、胰岛素抵抗(IR)指数以及QL数据(SF - 36问卷)。患者年龄均在55岁以上。主动检测AH发现,DFS患者中有98%存在AH,无DFS患者中有97%存在AH(p < 0.05)。AH的检测先于下肢动脉病变(LM)的诊断。缺乏足够的IR纠正(二甲双胍治疗无效、未使用噻唑烷二酮类药物治疗)、他汀类药物使用不规律(分别有4%和8%的有DFS和无DFS患者使用,p = 0.541)、抗高血压治疗不足(血压在130 - 139/80 - 89 mmHg时未治疗)、ACE抑制剂使用较少、修改或停用规定治疗导致DM失代偿、血脂异常、血压控制不佳、DM女性患者出现社会和心理问题。患有DFS的患者存在血脂异常、血压升高、DFS表现和血管并发症进一步进展,在血糖未严格控制的情况下QL降低。

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