【摘要】 目的：探讨２型糖尿病高血压者尿儿茶酚胺（ＵＣＡ）与动态血压（ＡＢＰ）的关系。方法：用ＨＰＬＣＥＣＤ测定３０例糖尿病高血压者（ＨＤＭ组）及２５例糖尿病血压正常者（ＮＤＭ组）ＵＣＡ浓度［ｃ（ＵＣＡ）］昼夜ＵＣＡ包括去甲肾上腺素（ＮＥ）、肾上腺素（Ｅ）、多巴胺（ＤＡ），同时监测２４ｈＡＢＰ。结果：ＨＤＭ与ＮＤＭ２组间以及血压昼夜节律反转（ｎ＝１０）与非反转者（ｎ＝４３）间日、夜及２４ｈ尿的ＮＥ、Ｅ水平均无显著差异，ＵＣＡ与２４ｈＡＢＰ指标间亦无显著相关，而尿白蛋白排泄率（ｒｕａｅ）则ＨＤＭ组显著高于ＮＤＭ组，血压节律反转者高于非反转者；ＨＤＭ组日ＤＡ、２４ｈＤＡ均显著低于ＮＤＭ组，且日、夜及２４ｈＤＡ与ｒｕａｅ呈显著负相关。结论：交感神经肾上腺髓质系统活性在糖尿病高血压的发病及血压昼夜节律异常的产生机制中似不占主导地位，而糖尿病肾病变可能起重要作用；外周ＤＡ水平降低有可能参与糖尿病高血压及肾病变的发病更多还原

【Abstract】 Objective: To study the relationship of urinary catecholamines excretion to ambulatory blood pressure in type 2 diabetic patients. Methods:Daytime and nighttime urinary catecholamines [c(UCA)] including norepinephrine(NE), epinephrine(E) and dopamine(DA) were determined by HPLCECD in 30 hypertensive(HDM group)and 25 normotensive diabetic (NDM group) subjects.24 h ambulatory blood pressure(ABP) profiles were recorded on the same day while urine samples were collected. Results:Daytime NE and E, nighttime NE and E, 24 h NE and E in HDM group did not differ from NDM group. Similar results were obtained between subjects with paradoxical blood pressure rhythm (n=10) and the remaining patients (n=43). Canonical analysis showed no significant correlation between variables of UCA and indexes of 24 h ABP setting. However, urinary albumin excretion rate (ruae) was significantly increased in HDM group than in NDM group. UAERwas also increased in subjects with paradoxical blood pressure rhythm compared with the remaining patients. Another finding of this study showed that daytime DA and 24 h DA were significantly lower in HDM group than in NDM group . Linear correlation analysis showed that daytime, nighttime and 24 h DA were obviously correlated with ruae in all participants. Conclusions: Sympathoadrenomedullary systems seem to have little significant contribution to the pathogenesis of diabetic hypertension and dysregulation of circadian rhythm of blood pressure. Diabetic nephropathy might play an important role.Decreased peripheral DA might be involved in the genesis of diabetic hypertension and diabetic nephropathy.更多还原