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糖尿病患者的血压变异性

Blood pressure variability in patients with diabetes mellitus.

作者信息

Mokhtar Rafidah Hanim, Ayob Azizi, Mohd Noor Noriah

机构信息

International Islamic University of Malaysia, Bandar Indera Mahkota, Pahang, Malaysia.

出版信息

Asian Cardiovasc Thorac Ann. 2010 Aug;18(4):344-8. doi: 10.1177/0218492310375723.

Abstract

Reduced arterial compliance in patients with diabetes mellitus has been shown in several studies, but it has not been significantly associated with either atherosclerosis or vessel wall thickness. Blood pressure variability is still poorly explored in diabetic patients. The aim of this study was to compare blood pressure variability and arterial compliance in patients with type 2 diabetes mellitus and controls matched for sex, age, and weight. Arterial compliance was measured and noninvasive 24-h ambulatory blood pressure monitoring was performed in 18 diabetic patients and 18 controls. There was significantly higher 24-h systolic blood pressure variability (17.7 +/- 6.8 vs. 14.6 +/- 2.6 mm Hg), diastolic blood pressure variability (15.6 +/- 7.1 vs. 11.4 +/- 3.1 mm Hg), and mean arterial blood pressure variability (14.8 +/- 7.0 vs. 11.1 +/- 2.9) in diabetic patients. Systolic, diastolic, and mean arterial blood pressure variability was significantly higher during daytime but not night time in diabetic patients compared to controls. Diabetic patients also had significantly reduced small artery compliance, but no differences in large artery compliance, cardiac output, or systemic vascular resistance. The findings suggest that hyperglycemia may affect the compliance of the vascular system, resulting in high blood pressure fluctuations.

摘要

多项研究表明,糖尿病患者的动脉顺应性降低,但这与动脉粥样硬化或血管壁厚度均无显著关联。糖尿病患者的血压变异性仍未得到充分研究。本研究的目的是比较2型糖尿病患者与性别、年龄和体重相匹配的对照组的血压变异性和动脉顺应性。对18例糖尿病患者和18例对照者进行了动脉顺应性测量和无创24小时动态血压监测。糖尿病患者的24小时收缩压变异性(17.7±6.8 vs. 14.6±2.6 mmHg)、舒张压变异性(15.6±7.1 vs. 11.4±3.1 mmHg)和平均动脉血压变异性(14.8±7.0 vs. 11.1±2.9)显著更高。与对照组相比,糖尿病患者白天的收缩压、舒张压和平均动脉血压变异性显著更高,但夜间无差异。糖尿病患者的小动脉顺应性也显著降低,但大动脉顺应性、心输出量或全身血管阻力无差异。这些发现表明,高血糖可能会影响血管系统的顺应性,导致血压波动较大。

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