密集的血压控制和IgA脏病的进展:使用边缘结构模型的队列研究
Chen Tang1,2,3, Pei Chen1,2,3, Feng-Lei Si1,2,3
1Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China.
概括
在IgA病中强化血压控制可能会减缓脏疾病的进展. 然而,这项研究发现了一个U形的关联,表明风险与非常低和高的缩血压.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管医学 心血管医学
- 临床研究 临床研究
背景情况:
- 目前的慢性病指南建议静缩血压 (SBP) 低于120mmHg.
- 强化降低免疫球蛋白A脏病 (IgAN) 的血压的脏保护作用尚未得到充分证实.
- 这项研究研究了密集血压控制对IgAN进展的影响.
研究的目的:
- 为了确定密集血压控制对IGAN进展的影响.
- 分析Igan患者基线和时间更新的血压和结局之间的关系.
主要方法:
- 在北京大学第一医院招收了1530名Igan患者.
- 综合结结果被定义为末期病 (ESKD) 或估计膜过率 (eGFR) 的30%下降.
- 用多变量因果危险模型和边际结构模型 (MSM) 来分析基线和时间更新的BP数据.
主要成果:
- 在时间更新的SBP和复合结局之间观察到U形关联.
- 与SBP 110-119 mmHg相比,SBP <110 mmHg (HR 1.48) 和SBP ≥140 mmHg (HR 2.91) 的风险增加.
- 这种趋势在蛋白尿 ≥1 g/天和eGFR ≥60 mL/min/1.73 m2的患者中更为明显;对于腹痛血压,没有发现类似的趋势.
结论:
- 在治疗期间强化血压控制可能会减缓Igan患者病的进展.
- 对于SBP,存在一个U形关系,表明低水平和高水平的风险.
- 潜在的低血压风险需要在管理IGAN患者时仔细考虑.
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