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目的 分析高血压患者的糖代谢状况与血压、肥胖、肾功能以及心脑血管事件的关系.方法 采用横断面调查的方法,对我国18省市,年龄在18 ～75岁之间的10 173例接受或未接受降压药物治疗的无糖尿病病史的原发性高血压(EH)患者进行横断面凋查,通过简化糖耐量试验筛查出合并糖代谢异常的患者.结果 (1)糖代谢异常的EH患者3167例中1297例收缩压达标,达标率为41.0％,低于糖代谢正常EH患者46.4％(3254例/7006例)的达标率(P =0.000).(2)EH患者白蛋白尿排出以及估算的肾小球滤过率(eGFR)水平随着糖代谢异常的加重,异常率明显增加.(3)logistic提示,EH患者的腰围异常、eGFR降低和白蛋白尿阳性与糖代谢异常独立相关.与糖代谢正常者相比,糖代谢异常的EH患肯有更多的心脑血管事件发生率(P=0.000,OR L.133,95％ CI1.138 ～1.560).结论 中国EH患者有较高的糖代谢异常发生率,伴有糖代谢异常的EH患者血压控制更差,合并有更多的临床风险.

Objective To investigate glucose metabolism status and its relationship with blood pressure,obesity,renal function and cardio-cerebral vascular events in Chinese essential hypertensive patients.Methods Essential hypertensive patients without diabetic history were enrolled in this crosssectional survey.All patients filled in questionnaires and received physical examination and laboratory tests.Oral glucose tolerance test (OGTT,fasting and 2 hours glucose level after drinking the 75 g glucose solution) was performed in patients who signed the informed consent.Results (1) The control rate of systolic BP was lower in patients with dysglycaemia than in patients without dysglycaemia (41.0％ vs.46.4％,P =0.000).(2) The albuminuria detection rate and the abnormal rate of estimated glumerular filtration rate (eGFR) increased significantly with the deterioration of glucose metabolism.(3) Multifactoranalysis showed that abnormal waist circumference,decreased eGFR and presence of albuminuria were independent risk factors for abnormal glucose metabolism.Cardiovascular events was significantly higher in patients with abnormal gbucose metabolism than patients with normal glucose metabolism.Conclusion Abnormal glucose metabolism is common in Chinese essential hypertensive patients.When complicated with abnormal glucose metabolism,essential hypertensive patients had poor blood pressure control rate and were related to higher cardiovascular risk.