本文關(guān)鍵詞：纈沙坦對高血壓合并糖尿病患者血清脂聯(lián)素的影響　出處：《青島大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 纈沙坦 高血壓合并糖尿病 血清脂聯(lián)素

【摘要】：背景:目前有研究表明,糖尿病患者近些年來在全球范圍內(nèi)的人數(shù)正在快速的增加,已經(jīng)高達(dá)2.85億人,同時(shí)依然以一個(gè)較為驚人的增長速度在逐年的增長。我國是世界上的一個(gè)人口大國,人口數(shù)量極其龐大,根據(jù)中華醫(yī)學(xué)會(huì)糖尿病分會(huì)對我國14個(gè)省市的調(diào)查發(fā)現(xiàn),年齡大于20歲以上的糖尿病患者,高達(dá)9.7%,患病的人數(shù)共9300萬人。此外,英國一些較為權(quán)威的機(jī)構(gòu)對于糖尿病的研究結(jié)果顯示,38%的糖尿病患者均同時(shí)患有高血壓并發(fā)癥。WHO的相關(guān)研究結(jié)果報(bào)道,高血壓疾病在糖尿病患者中是一種極其常見的并發(fā)癥,患病率高達(dá)30%左右,我國的糖尿病并發(fā)高血壓的患者患病率高達(dá)45%左右,高過英國的10%左右。同時(shí),根據(jù)CDS對糖尿病慢性并發(fā)癥的研究調(diào)查結(jié)果表明,在三甲醫(yī)院進(jìn)行住院治療的患者糖尿病并發(fā)癥中腦血管疾病的患病率為13%,高血壓疾病的患病率40%,下肢血管疾病的患病率4%,心血管疾病的患病率為19%,由以上的調(diào)查研究結(jié)果可以看出,高血壓是糖尿病患者最為常見且發(fā)病率最高的并發(fā)癥。目的:糖尿病和高血壓作為臨床中兩種常見的疾病,多為合并存在。尤其是高血壓合并糖尿病的發(fā)生,將患者大動(dòng)脈的粥樣硬化加速。高血糖、高血壓以及動(dòng)脈粥樣硬化,不僅僅有著共同的遺傳性,同時(shí)也存在一定的生化代謝基礎(chǔ),基于胰島素的抵抗過程,同樣也是病理生理的關(guān)鍵環(huán)節(jié)。研究表明,高血壓伴糖尿病患者血清脂聯(lián)素水平,處于不斷降低的狀態(tài),同時(shí)患者高血清脂聯(lián)素水平不僅僅對代謝紊亂有著有益作用,同時(shí)對于心血管疾病也有著一定的積極作用。本研究旨在對高血壓合并糖尿病患者應(yīng)用纈沙坦治療前后血清脂聯(lián)素的變化情況進(jìn)行觀察,并對高血壓合并糖尿病應(yīng)用纈沙坦治療效果進(jìn)行醫(yī)學(xué)科學(xué)的論證。方法:回顧性分析我院收治的合格的高血壓合并糖尿病患者的病歷資料,隨機(jī)的分為兩組,也即是纈沙坦組和氨氯地平組。兩組患者治療前,對兩組患者的血壓心率以及脂聯(lián)素等進(jìn)行檢測,纈沙坦組應(yīng)用纈沙坦治療,氨氯地平組應(yīng)用氨氯地平治療,兩組患者均至少治療兩個(gè)月,治療后對兩組患者心率以及血壓和脂聯(lián)素水平進(jìn)行復(fù)查。得到的結(jié)果均應(yīng)用統(tǒng)計(jì)學(xué)SAS8.1進(jìn)行統(tǒng)計(jì)學(xué)分析,對兩組患者治療前后指標(biāo)變化情況確定。結(jié)果:纈沙坦患者治療后的收縮壓和舒張壓,和治療前比較,明顯處于降低的狀態(tài),P0.05,有統(tǒng)計(jì)學(xué)意義。同時(shí)纈沙坦患者治療后德旺血清脂聯(lián)素水平和治療前比較,明顯升高,P0.05,有統(tǒng)計(jì)學(xué)意義。纈沙坦患者治療后血糖和胰島素抵抗水平和治療前比較,明顯較低,P0.05,有統(tǒng)計(jì)學(xué)意義。氨氯地平患者治療前后的各指標(biāo)比較,無明顯變化,P0.05,無統(tǒng)計(jì)學(xué)意義,但有可比性;在CRP的變化方面,組內(nèi)比較,治療后兩組患者的Hs-CRP水平均顯著低于治療前,P0.05;組間比較,治療前后兩組患者的Hs-CRP水平之間的差異均不顯著,P0.05。結(jié)論:對比分析試驗(yàn)結(jié)果,研究發(fā)現(xiàn),高血壓合并糖尿病患者應(yīng)用纈沙坦治療,血清脂聯(lián)素水平處于升高的狀態(tài),同時(shí)高血清脂聯(lián)素水平不僅對代謝紊亂有著有益作用,同時(shí)對于心血管疾病也有著積極作用。研究中纈沙坦治療高血壓合并糖尿病患者對血清脂聯(lián)素的影響,為以后的研究提供了理論依據(jù)。同時(shí)纈沙坦降低患者血壓的同時(shí),不僅僅將患者血清脂聯(lián)素水平升高,同時(shí)對于胰島素抵抗也有著積極改善作用,并實(shí)現(xiàn)降壓外良好的代謝過程。
[Abstract]:Background: the current studies have shown that, in recent years the number of patients with diabetes worldwide is increasing rapidly, has reached 285 million people, while still in a more amazing growth rate increase year by year. China is a country with a large population of the world population is extremely large, according to the Chinese Medical Association to the survey of 14 provinces in China Diabetes Society, older than diabetic patients over the age of 20, up to 9.7%, in the total number of 93 million people. In addition, some of the more British authority for diabetes research results showed that 38% of patients were suffered from hypertension complications related to.WHO results reported hypertension is a common complication in patients with diabetes, the prevalence rate of up to about 30%, the patients with diabetes mellitus complicated with hypertension prevalence rate as high as 45%, higher than the UK About 10% of the country. At the same time, according to the results of a survey of chronic complications of diabetes CDS, were hospitalized patients with diabetic complications of cerebral vascular disease prevalence rate was 13% in the hospital, hypertension prevalence rate of 40%, lower extremity vascular disease prevalence rate was 4%, the prevalence of cardiovascular disease was 19%, by investigation and study the above results can be seen in patients with diabetes mellitus hypertension is the most common and the highest incidence of complications. Objective: diabetes and hypertension as two common clinical diseases, mostly associated. Especially high blood pressure diabetes, the atherosclerosis of large arteries in patients with accelerated. Hyperglycemia, hypertension and atherosclerosis. Not only have a genetic in common, there are also some basic biochemical metabolism, insulin resistance is also based on key pathophysiology Link. The study shows that the serum adiponectin levels in diabetic patients with hypertension, in the reduced state, while the high level of serum adiponectin in patients with metabolic disorders not only to have a beneficial effect on cardiovascular disease at the same time, also has a positive role. This study aims at observation on hypertension with valsartan in diabetic patients before and after treatment, serum adiponectin the changes of hypertension and diabetes treatment effect of Valsartan for medical scientific demonstration. Methods: a retrospective analysis of our hospital qualified hypertension and diabetes patients, were randomly divided into two groups, namely the Valsartan group and amlodipine group. Two groups of patients before treatment were detected the two groups of patients with blood pressure and heart rate of adiponectin, valsartan group, valsartan, amlodipine group application of amlodipine treatment, Two groups of patients were treated for at least two months after treatment, review the two groups of patients with blood pressure and heart rate and adiponectin levels. The results were analyzed with SAS8.1 statistics, to determine the changes of the index of two groups before and after treatment. Results: after treatment with valsartan systolic and diastolic blood pressure, and treatment first, obviously in the reduced state, P0.05, have statistical significance. At the same time, patients treated with valsartan treatment and serum adiponectin levels increased significantly compared to that before Wang, P0.05, was statistically significant. Blood glucose and insulin resistance level before treatment and treatment of patients with valsartan, significantly lower P0.05, compare the index was statistically significant. Before and after amlodipine treatment of patients with no obvious change, P0.05, no statistical significance, but comparable; changes in the CRP, the comparison group, Hs-CRP of the two groups of patients after treatment The level was significantly lower than that before treatment, P0.05; comparison between groups, the difference between the Hs-CRP level of two groups of patients before and after treatment were not significant, P0.05. conclusion: comparative analysis of the test results, the study found that hypertensive patients with diabetes with valsartan treatment, serum adiponectin levels increased in the state, while the high levels of serum adiponectin not only on metabolism the disorder of beneficial effects on cardiovascular disease, but also has a positive effect. Valsartan treatment effect on serum adiponectin in patients with hypertension and diabetes research, research provided the theory basis for the later. At the same time valsartan reduce blood pressure of patients at the same time, not only will increase the level of serum adiponectin in insulin resistance patients, at the same time also has a positive to improve the role of metabolic process and to achieve good blood pressure.

【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R544.1;R587.1

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