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预测模型,用于持续高血压后手术干预的原发性阿尔多斯特主义
Zhuoying Li1, Yunfeng He2, Yao Zhang2
1Department of Urology, The Ninth People's Hospital of Chongqing, 69 Jialing Village, Beibei District, Chongqing, 400700, China.
Scientific reports
|July 22, 2023
概括
治疗原发性阿尔多斯顿症的手术后持续高血压仍然很常见. 使用手术前数据的新预测模型准确地识别了患有术后高血压风险的患者.
科学领域:
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 手术瘤学手术瘤学
背景情况:
- 原发性阿尔多斯特隆症 (PA) 是二次高血压的主要原因,并可能通过上腺手术治愈.
- 很大一部分患者经历持续高血压 (PHT) 即使在单边上腺切除术后.
研究的目的:
- 确定PA患者在单边上腺手术后与持续高血压相关的因素.
- 在这个人群中开发和验证术后PHT的预测模型.
主要方法:
- 353名接受单边上腺手术的PA患者 (2014-2021) 的回顾性研究.
- 用单变量和多变量分析分析临床和生化数据的分析.
- 开发一个基于nomogram的预测模型,并进行内部验证.
主要成果:
- 在手术后的PHT观察到46.2%的患者.
- PHT的独立预测因素包括BMI≥25,糖尿病,高血压持续时间,男性性别和阿尔多-氨酸比率 (ARR).
- 诺米图表显示出良好的预测准确性 (C指数培训:0.783,验证:0.769) 和校准.
结论:
- 整合手术前临床和生化数据的诺米图谱为预测PA患者单边上腺手术后PHT提供了可靠的工具.
- 这种模型可以帮助患者选择和管理策略,以改善外科手术结果.
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