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目的探讨糖尿病合并高血压患者血糖血压水平与动脉硬化的关系。方法以北京某农村社区40岁及以上糖尿病合并高血压患者为研究对象,对患者进行问卷调查、体格检查、肱踝脉搏波传导速度(ba PWV)检测和血样检测。根据患者糖化血红蛋白(Hb A1c)、收缩压(SBP)及舒张压(DBP)水平进行分组,采用Logistic回归模型分析血糖血压水平与动脉硬化的关系。结果共纳入1214例患者,其中动脉硬化异常(ba PWV≥1700cm/s)有637人,占52.47%。相关性分析显示ba PWV与Hb A1c(r_s=0.174,P=0.000)、SBP(r_s=0.481,P=0.000)及DBP(r_s=0.167,P=0.000)均呈正相关。Logistic回归分析显示,调整其他危险因素后,Hb A1c和SBP每增加1个四分位数间距动脉硬化异常风险分别为1.41倍(95%CI:1.16~1.70)和3.71倍(95%CI:2.80~4.91)。结论糖尿病合并高血压患者ba PWV与Hb A1c及SBP显著相关,同时控制血糖和血压可能有利于降低动脉硬化异常发生风险。
Objective To investigate the relationship between the level of blood glucose and blood pressure and atherosclerosis in diabetic patients with hypertension. Methods A survey of 40 hypertensive patients with diabetes mellitus aged 40 years and older in a rural community of Beijing was conducted. Questionnaires, physical examinations, ba PWV and blood samples were performed on the patients. Hb A1c, SBP and DBP were grouped according to the patient’s condition. Logistic regression model was used to analyze the relationship between blood glucose and blood pressure and arteriosclerosis. Results A total of 1214 patients were included, of whom 637 were abnormal atherosclerosis (ba PWV ≥ 1700 cm / s), accounting for 52.47%. Correlation analysis showed that ba PWV was positively correlated with Hb A1c (r_s = 0.174, P = 0.000), SBP (r_s = 0.481, P = 0.000) and DBP (r_s = 0.167, P = 0.000). Logistic regression analysis showed that the risk of atherosclerosis was increased by 1.41 times (95% CI: 1.16-1.70) and 3.71 times (95% CI: 2.80) for each additional 1 quartile of Hb A1c and SBP after adjusting for other risk factors ~ 4.91). Conclusions ba PWV is significantly associated with Hb A1c and SBP in patients with diabetes mellitus and hypertension, and controlling blood sugar and blood pressure may be helpful to reduce the risk of atherosclerosis.