摘要
目的 探讨维持性血液透析(MHD)患者血压变异性与并发急性心肌梗死的关系。方法 选取2019年7月至2022年1月在汝州市第一人民医院接受MHD治疗的174例患者为研究对象,根据是否并发急性心肌梗死将其分为心梗组与无心梗组。比较两组一般资料与血压变异性,分析血压变异性与并发急性心肌梗死的关系。采用受试者工作特征(ROC)曲线评估血压变异性对MHD患者并发急性心肌梗死的预测价值。结果 随访1年内,急性心肌梗死并发率为14.94%;心梗组年龄、透析病程及C反应蛋白(CRP)、氨基末端脑钠肽前体(NT-proBNP)、同型半胱氨酸(Hcy)、尿酸(UA)、收缩压变异标准差(SBP-SD)、舒张压变异标准差(DBP-SD)、收缩压变异系数(SBP-CV)、舒张压变异系数(DBP-CV)均大于无心梗组(P<0.05);多因素Logistic回归分析显示年龄、透析病程、CRP、NT-proBNP、Hcy、UA、SBP-SD、DBP-SD、SBP-CV、DBP-CV均是MHD患者并发急性心肌梗死的危险因素(P<0.05);ROC曲线显示SBP-SD、DBP-SD、SBP-CV、DBP-CV联合预测MHD患者并发急性心肌梗死的灵敏度(96.15%)与曲线下面积(AUC)(0.925)均高于各自单独预测(P<0.05)。结论 高SBP-SD、DBP-SD、SBP-CV与DBP-CV均可增加MHD患者并发急性心肌梗死发生风险,联合对急性心肌梗死具有较高的预测价值。
【Objective】To explore the relationship between blood pressure variability and acute myocardial infarction in maintenance hemodialysis(MHD)patients.【Methods】Totally 174 patients who received MHD treatment in the First People's Hospital of Ruzhou City from July 2019 to January 2022 were selected as the study subjects.They were divided into myocardial infarction group and non-myocardial infarction group based on whether complicated with acute myocardial infarction.The general data and blood pressure variability between the two groups were compared,and the relationship between blood pressure variability and acute myocardial infarction was analyzed.The predictive value of blood pressure variability for acute myocardial infarction in MHD patients was evaluated by using receiver operating characteristic(ROC)curves.【Results】During one year follow-up,the complication rate of acute myocardial infarction was 14.94%.The age,duration of dialysis,C-reactive protein(CRP),N-terminal pro-brain natriuretic peptide(NT-proBNP),homocysteine(Hcy),uric acid(UA),standard deviation of systolic blood pressure variability(SBP-SD),standard deviation of diastolic blood pressure variability(DBP-SD),systolic blood pressure variation coefficient(SBP-CV)and diastolic blood pressure variation coefficient(DBP-CV)in the myocardial infarction group were all higher than those in the non-myocardial infarction group(P<0.05).Multivariate logistic regression analysis showed that age,duration of dialysis,CRP,NT-proBNP,Hcy,UA,SBP-SD,DBP-SD,SBP-CV and DBP-CV were all risk factors for acute myocardial infarction in MHD patients(P<0.05).The ROC curve showed that the sensitivity(96.15%)and area under curve(AUC)(0.925)of combined SBP-SD,DBP-SD,SBP-CV and DBP-CV in predicting acute myocardial infarction in MHD patients were higher than those predicted separately(P<0.05).【Conclusion】High levels of SBP-SD,DBP-SD,SBP-CV and DBP-CV can all increase the risk of acute myocardial infarction in patients with MHD,and the combination of them has a high pre
作者
焦亚彬
朱佳佳
吴茜彤
JIAO Yabin;ZHU Jiajia;WU Xitong(Department of Nephrology,the First People's Hospital of Ruzhou City,Pingdingshan,Henan 467599,China)
出处
《中国医学工程》
2023年第12期42-47,共6页
China Medical Engineering
关键词
急性心肌梗死
维持性血液透析
血压变异性
acute myocardial infarction
maintenance hemodialysis
blood pressure variability
