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目的了解2型糖尿病人群体位性低血压的患病率,并探讨其相关的危险因素。方法以2010年8月—2011年4月256例30～80岁住院2型糖尿病患者作为调查对象,采用直立倾斜床连接心电监护仪测量静息状态下患者坐位、卧位以及立位即刻、1、2、3及5min末的血压、心率;并记录详细病史、检测生化指标及进行自主神经功能检查等。结果住院2型糖尿病人群体位性低血压患病率为31.1%,多因素Logistic逐步回归分析提示,2型糖尿病患者合并体位性低血压风险与糖尿病肾病(OR=3.979,95%CI:1.606～9.859)、HbA1C水平(OR=1.222,95%CI:1.005～1.486)、卧位收缩压(OR=1.073,95%CI:1.021～1.128)呈正相关,与坐位收缩压(OR=0.929,95%CI:0.888～0.971)呈负相关。结论体位性低血压在住院2型糖尿病人群中有较高的患病率,其危险因素包括合并糖尿病肾病、HbA1C水平升高、卧位收缩压升高等,故应尽早控制好血糖、保护肾功能,阻止和延缓体位性低血压的发生及改善糖尿病患者的预后。
Objective To understand the prevalence of orthostatic hypotension in type 2 diabetes mellitus and to explore the related risk factors. Methods From August 2010 to April 2011, 256 patients with type 2 diabetes mellitus aged 30 to 80 years in hospital were enrolled in this study. The patients were placed in sitting position, supine position and standing position with resting incline bed connected with ECG monitor. 1,2,3 and 5min end of the blood pressure, heart rate; and record the detailed history, detection of biochemical indicators and autonomic nervous system function tests. Results The prevalence of orthostatic hypotension was 31.1% in hospitalized patients with type 2 diabetes. Logistic regression analysis showed that the risk of orthostatic hypotension was associated with diabetic nephropathy in type 2 diabetic patients (OR = 3.979, 95% CI: 1.606 ~ (OR = 1.059, 95% CI: 1.021-1.128), and systolic blood pressure (OR = 0.929, 95% CI 9.8-9), HbA1C level (OR = 1.222,95% CI 1.005-1.486) CI: 0.888 ~ 0.971) was negatively correlated. Conclusions Postural hypotension has a higher prevalence in hospitalized type 2 diabetic patients. The risk factors include diabetic nephropathy, elevated HbA1C and increased systolic blood pressure in the supine position. Therefore, blood sugar should be controlled as soon as possible to protect renal function , Prevent and delay the occurrence of orthostatic hypotension and improve the prognosis of diabetic patients.