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目的:探讨老年男性糖尿病患者血压控制水平、影响因素以及与血管并发症的关系。方法:将184例老年犤平均年龄(77±9)岁,平均糖尿病病程(13.9±11.5)年犦男性糖尿病患者依据血压状况分为4组。无高血压组、血压控制满意组、控制良好组和控制差组。观测不同血压组各种临床和生化指标的变化及其与并发症的关系。结果:184例患者中有高血压139例(75.5%);冠心病127例(69.0%),其中有心肌梗死17例(9.2%);有下肢血管病变73例(39.7%),有糖尿病肾病43例(23.4%)。在高血压患者中,血压达到理想控制水平者44例(31.7%),达到良好控制水平者28例(20.1%),控制差者67例(48.2%)。随着年龄的增长和高血压病史的延长,血压控制的达标水平降低,各种并发症的发生率增高。糖尿病病史、年龄、体质量指数、舒张压、射血分数、糖化血红蛋白、尿微量白蛋白排泄率、C反应蛋白、同型半胱氨酸与收缩压独立相关;射血分数、同型半胱氨酸、空腹胰岛素水平是影响舒张压的独立危险因素。结论:老年男性糖尿病伴有高血压患者血压控制不理想,糖尿病并发症的发生与血压控制水平相关,血压控制水平受多因素影响。
Objective: To investigate the relationship between blood pressure control and influencing factors and vascular complications in elderly male patients with diabetes mellitus. Methods: One hundred and forty-four elderly patients with diabetes mellitus (mean age 77 ± 9 years) and average duration of diabetes (13.9 ± 11.5 years) were divided into 4 groups according to their blood pressure. No hypertension group, satisfactory blood pressure control group, well-controlled group and poor control group. Observation of different blood pressure group of various clinical and biochemical changes and its relationship with complications. Results: Among the 184 patients, there were 139 cases (75.5%) with hypertension, 127 cases (69.0%) with coronary heart disease, 17 cases (9.2%) with myocardial infarction, 73 cases (39.7%) with lower extremity vascular disease and diabetic nephropathy 43 cases (23.4%). In hypertensive patients, blood pressure reached the desired level of control in 44 cases (31.7%), to achieve a good level of control in 28 cases (20.1%), poor control in 67 cases (48.2%). With the growth of age and the history of hypertension, blood pressure control compliance level decreased, the incidence of various complications increased. Diabetes history, age, body mass index, diastolic blood pressure, ejection fraction, glycated hemoglobin, urinary albumin excretion rate, C-reactive protein, homocysteine and systolic pressure were independently correlated; ejection fraction, homocysteine , Fasting insulin level is an independent risk factor affecting diastolic blood pressure. Conclusion: The control of blood pressure in elderly men with diabetes mellitus is not satisfactory. The incidence of diabetic complications is related to the control of blood pressure. The level of blood pressure control is affected by many factors.