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II型糖尿病合并高血压患者动脉粥样硬化危险因素的累积

Accumulation of the risk factors of atherosclerosis in type-II diabetics with hypertension.

作者信息

Tkác I, Takác M

机构信息

School of Medicine, P.J. Safárik University, Kosice.

出版信息

Czech Med. 1990;13(1):9-17.

PMID:2350993
Abstract

The incidence of arterial hypertension and some clinical and biochemical parameters were followed in relation to hypertension in a group of 156 hospitalized Type-II diabetics. A significant correlation was demonstrated between the values of systolic blood pressure and cholesterol levels (r = 0.30, p less than 0.001), between systolic blood pressure and diabetes duration, and between systolic blood pressure and triglyceride levels in all our patients. Similarly, a significant correlation was found between diastolic blood pressure and the levels of cholesterol (r = 0.27, p less than 0.001), triglycerides and urea. Hypertension was diagnosed in 65% of the group of hospitalized diabetics. Hypertensive diabetics showed a significantly higher proportion of women and a higher mean cholesterol level (6.1 +/- 2.2 mmol/l) compared with the group of diabetics free of hypertension (4.8 +/- 1.4 mmol/l), with the same mean age, diabetes duration and weight. Of the complications of diabetes, the hypertensive group, compared with the control group, were found to have only a significantly higher incidence of cerebrovascular events (31% vs 6%, respectively). The incidence of myocardial infarction and proteinuria were only insignificantly higher in the hypertensive group. We can conclude, on the basis of our results, that the risk factors of atherosclerosis (hypertension, cholesterol, triglycerides) accumulate in the group of Type-II diabetics. This is apparently due to hyperinsulinaemia often present in Type-II diabetics with impaired glucose tolerance. Another factor possibly contributing to the increased incidence of hypertension is the increase in blood viscosity in hyperlipoproteinaemia.

摘要

对156名住院的II型糖尿病患者进行跟踪,观察动脉高血压的发病率以及一些与高血压相关的临床和生化参数。在我们所有患者中,收缩压值与胆固醇水平之间(r = 0.30,p < 0.001)、收缩压与糖尿病病程之间、收缩压与甘油三酯水平之间均显示出显著相关性。同样,舒张压与胆固醇水平(r = 0.27,p < 0.001)、甘油三酯和尿素之间也发现了显著相关性。在住院糖尿病患者组中,65%被诊断为高血压。与无高血压的糖尿病患者组相比,高血压糖尿病患者中女性比例显著更高,平均胆固醇水平也更高(6.1±2.2 mmol/L),而两组的平均年龄、糖尿病病程和体重相同。在糖尿病并发症方面,与对照组相比,高血压组仅脑血管事件的发生率显著更高(分别为31%和6%)。高血压组中心肌梗死和蛋白尿的发生率仅略高。基于我们的研究结果可以得出结论,动脉粥样硬化的危险因素(高血压、胆固醇、甘油三酯)在II型糖尿病患者组中积聚。这显然是由于糖耐量受损的II型糖尿病患者中常出现高胰岛素血症。另一个可能导致高血压发病率增加的因素是高脂蛋白血症时血液粘度的增加。

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