社区2型糖尿病合并隐匿性高血压患者临床特征及影响因素分析

中国医药导刊 ›› 2023, Vol. 25 ›› Issue (2): 199-204.

社区2型糖尿病合并隐匿性高血压患者临床特征及影响因素分析

滕斌1，诸瑞月2，孟德清1，余倩云3，王旭4，王泰蓉5*

1.上海市黄浦区五里桥街道社区卫生服务中心全科医疗科，上海 200023；
2.上海市黄浦区五里桥街道社区卫生服务中心预防保健科，上海 200023；
3.上海市黄浦区五里桥街道社区卫生服务中心中医康复科，上海 200023；
4.上海交通大学医学院基础医学院病理学系，上海200025；
5.上海交通大学医学院附属瑞金医院卢湾分院健康管理科，上海 200020

收稿日期:2022-11-29 修回日期:2023-01-23 出版日期:2023-02-28 发布日期:2023-02-28
基金资助:
上海市科委浦江计划A类(项目编号：21PJ1409100；项目名称：基于单分子技术超灵敏检测疾病标志物)；黄浦区卫生健康委员会科研项目(项目编号：HKM201838；项目名称：社区2型糖尿病合并隐匿性高血压患者心血管危险因素特点分析)

Clinical Characteristics and Influencing Factors of Community T2DM Patients with Nasked Hypertension

1.General Department， Wuliqiao Street Community Health Service Center， Huangpu District， Shanghai 200023， China；
2.Department of Preventive Health Care， Wuliqiao Street， Community Health Service Center， Huangpu District， Shanghai 200023， China；
3.Department of TCM Rehabilitation， Wuliqiao street Community Health Service Center， Huangpu District， Shanghai 200023， China；
4.Department of Pathology， School of Basic Medicine， Shanghai Jiaotong University School of Medicine， Shanghai 200025， China；
5.Department of Health Management， RuiJin Hospital Luwan Branch， Shanghai Jiaotong University School of
Medicine， Shanghai 200020， China

Received:2022-11-29 Revised:2023-01-23 Online:2023-02-28 Published:2023-02-28

摘要/Abstract

摘要： 目的：探讨2型糖尿病(T2DM)合并隐匿性高血压(MH)患者的临床特征及影响因素。方法：选取在五里桥街道社区卫生服务中心就诊的未曾诊断高血压(HP)病的T2DM患者，根据24小时动态血压监测(ABPM)结果分为T2DM合并MH组和T2DM合并正常血压组，另外选取随访管理T2DM合并有HP病史的T2DM患者为T2DM合并HP组。观察各组患者一般资料、临床指标、ABPM的差异，分析临床生化指标与T2DM合并MH的相关性。结果：T2DM合并MH组与T2DM合并正常血压组相比，血尿酸(UA)、24 h尿微量白蛋白水平差异有统计学意义(P＜0.05)；T2DM合并正常血压组与T2DM合并HP组相比，肌酐（Cr）、UA、24 h尿微量白蛋白水平差异有统计学意义(P＜0.05)；T2DM合并MH组与T2DM合并HP组相比，一般临床资料及临床生化指标方面比较差异均无统计学意义(P＞0.05)。多因素Logistic回归分析显示，24 h尿微量白蛋白与T2DM合并MH患病有相关性（P＜0.05）。T2DM合并正常血压组与T2DM合并MH组、T2DM合并HP组相比，24小时平均收缩压(24 h average SBP)、24小时平均舒张压(24 h average DBP)、日间平均收缩压(daytime average SBP)、日间平均舒张压(daytime average DBP)、夜间平均收缩压(nighttime average SBP)、夜间平均舒张压(bighttime average DBP)、清晨SBP、清晨DBP比较差异均有统计学意义(P＜0.05)，T2DM合并MH组与T2DM合并HP组相比，夜间平均SBP、清晨SBP差异有统计学意义(P＜0.05)。T2DM合并MH组与T2DM合并正常血压组、T2DM合并HP组患者动脉硬化程度和心电图改变比较，差异均无统计学意义(P＞0.05)。结论：T2DM合并MH组比较T2DM合并正常血压组的临床生化指标显示出UA、24 h尿微量白蛋白水平的改变，而与T2DM合并HP组比较无显著差异；T2DM合并MH组血压升高更多出现在夜间和清晨，故社区T2DM随访中应重视对T2DM合并MH患者的检出，以减缓并发症的发生。

关键词: font-size:medium, ">糖尿病；隐匿性高血压；危险因素；相关性

Abstract: Objective：To analyze the clinical characteristics and influencing factors of patients with type 2 diabetes mellitus(T2DM) complicated with masked hypertension in community. Methods： Patients with T2DM who had not been diagnosed with hypertension(HP) were selected from Wuliqiao Street Community Health Service Center. According to the results of 24-hour ambulate blood pressure monitoring(ABPM)， the patients were divided into T2DM with MH group and T2DM with normal blood pressure group. In addition，T2DM with HP history was selected as T2DM with HP group. The differences of general data， clinical indicators and ABPM of the three groups of patients were observed. The correlation between clinical biochemical indexes and cardiovascular risk factors of T2DM patient with MH was analyzed. Results： There were significant differences in serum uric acid(UA) and 24 h urine microalbumin between T2DM with MH group and T2DM with normal blood pressure group(P<0.05). T2DM patients with normal blood pressure compared with T2DM patients with HP， the differences of the levels of Cr， UA and 24 h urinary microalbumin were statistically significant(P<0.05). T2DM with MH group compared with T2DM with HP group， there were no significant differences in general clinical data and clinical biochemical indexes(P>0.05). Multivariate Logistic regression analysis showed that 24 h urinary microalbumin was correlated with T2DM with MH (P<0.05). T2DM with normal blood pressure group compared with T2DM with MH group and T2DM with HP group 24 h average SBP， 24 h average DBP， daytime average SBP， daytime average DBP nighttime average SBP， nighttime average DBP， morning SBP and mconing DBP were significantly different(P<0.05). T2DM with MH group compared with T2DM with HP group， nighttime average SBP and morning SBP were significantly different(P<0.05). Comparison of atherosclerosis degree and ECG changes in T2DM patients with MH， T2DM patients with normal blood pressure and T2DM patients with HP， there was no statistical significance(P>0.05). Conclusion： The clinical biochemical indexes of T2DM with MH group compared with those of the normal blood pressure group showed the changes of UA and 24h urinary microalbuminm， and there was no significant difference compared with T2DM with HP group. The eleration of blood pressure in MH patients was more frequent at night and early in the morning. Therefore， attention should be paid to the detection of T2DM patients with MH during the follow-up of T2DM in the community， to slow the occurrence of complications.

Key words: font-size:medium, ">Diabetes； Masked hypertension； Risk factors； Correlation

中图分类号:

滕斌, 诸瑞月, 孟德清, 余倩云, 王旭, 王泰蓉. 社区2型糖尿病合并隐匿性高血压患者临床特征及影响因素分析[J]. 中国医药导刊, 2023, 25(2): 199-204.

TENG Bin, ZHU Ruiyue, MENG Deqing, YU Qianyun, WANG Xu, WANG Tairong. Clinical Characteristics and Influencing Factors of Community T2DM Patients with Nasked Hypertension[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2023, 25(2): 199-204.

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