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目的:探讨原发性高血压患者糖代谢异常状况及其对动态血压变化规律的影响。方法:测量151例原发性高血压(EH)患者空腹血糖(FBG)、餐后2h血糖(2hPBG)和24h动态血压,根据FBG和2hPBG水平将151例原发性高血压患者分为糖耐量正常(NGT)、糖耐量受损(IGR)和2型糖尿病(T2DM)3组,对3组间的动态血压参数和糖代谢异常情况进行分析。结果:72%的EH患者存在糖代谢异常,以2hPBG增高为主。联合检测FBG及2hPBG后,糖代谢异常检出率明显增加。NGT组、IGR组和T2DM组间非杓型血压、24h收缩压及舒张压均值、白天收缩压及舒张压负荷值、夜间收缩压及舒张压负荷值、24h平均脉压(24hMPP)均无明显差别。相关分析示24hMPP与FBG呈正相关(r=0.175,P=0.032)。结论:EH患者易合并2hPBG升高糖代谢异常,联合检测FBG及2hPBG可提高异常检出率;同时控制好FBG有利于减小脉压。
Objective: To investigate the abnormal glucose metabolism in patients with essential hypertension and its impact on the dynamic changes of blood pressure. Methods: Fasting blood glucose (FBG), postprandial 2h blood glucose (2hPBG) and ambulatory blood pressure (BPH) were measured in 151 patients with essential hypertension (EH). According to FBG and 2hPBG levels, 151 patients with essential hypertension were divided into three groups: Normal (NGT), impaired glucose tolerance (IGR) and type 2 diabetes mellitus (T2DM). The dynamic blood pressure parameters and abnormal glucose metabolism were analyzed among the three groups. Results: 72% of patients with EH had abnormal glucose metabolism, with the increase of 2 hPBG. Joint detection of FBG and 2hPBG, the detection rate of abnormal glucose metabolism increased significantly. Non-dipper blood pressure, 24h systolic and diastolic blood pressure, daytime systolic and diastolic blood pressure, nocturnal systolic and diastolic blood pressure, 24h mean pulse pressure (24hMPP) were not significantly different between NGT group, IGR group and T2DM group difference. Correlation analysis showed that 24hMPP was positively correlated with FBG (r = 0.175, P = 0.032). CONCLUSION: EH patients complicated with 2hPBG may have abnormal glucose metabolism. Combined detection of FBG and 2hPBG can improve the detection rate of anomaly. Controlling FBG is helpful to decrease pulse pressure.