[1型糖尿病合并高血压患儿24小时动态血压监测(ABPM)、微量白蛋白尿和糖尿病自主神经病变的评估]。

Marek Kowalewski, Jadwiga Peczyńska, Barbara Głowińska, Mirosława Urban, Beata Urban, Bozena Florys
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引用次数: 0

摘要

1型糖尿病患儿的晚期并发症包括自主神经病变、肾病,多与高血压共存。该研究的目的是评估高血压和1型糖尿病儿童自主神经系统变化、24小时ABPM和每日白蛋白排泄之间的联系。材料:72例糖尿病患者(糖尿病病程6.5+/-1.5年)。该组34例患者有高血压。对照组由30名按年龄、性别匹配的健康儿童组成。结论:1型糖尿病儿童高血压与自主神经病变、HbA1c水平升高、心率变异性参数降低有关。
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[The assessment of 24-hour ambulatory blood pressure monitoring (ABPM), microalbuminuria and diabetic autonomous neuropathy in children with type 1 diabetes and hypertension].

Introduction: The late complications of diabetes consisted of autonomic neuropathy, nephropathy, which more often coexist with hypertension in children with type 1 diabetes mellitus. THE AIM OF THE STUDY was to assess the connections between changes in the autonomous nervous system, 24-hour ABPM and daily albumin excrection in children with hypertension and type 1 diabetes mellitus.

Material: The group consisted of 72 patients with diabetes (diabetes duration time 6.5+/-1.5 years). 34 patients of that group have hypertension. The control group consisted of 30 healthy children matched according to age and sex.

Results: In children with hypertension we found significantly often occurrence of microalbuminuria (13/34 i 1/38, p<0.001). In 17 patients from the group with hypertension and 17 patients without hypertension we affirm signs of autonomic neuropathy. The values of heart rate variability (HRV) were significantly decreased in the group with hypertension as compared to the control group. A stepwise multiple regression analysis with hypertension as a dependent variable and diabetes duration time, microalbuminuria, HbA1c level, HRV parameters and a presence of autonomous neuropathy as predictors proved that hypertension is associated with higher HbA1c level (b=0.35), the presence of autonomous neuropathy (b=0.28), and lower HF values (b=0.41) (p<0.01).

Conclusions: Hypertension in children with type 1 diabetes mellitus is correlated with the presence of autonomous neuropathy, higher HbA1c level and lowered values of heart rate variability parameters.

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