荷兰急诊室的高血压视网膜病变:一个多中心的回顾性队列分析
Arrien Blokland1, Vivienne de Smet2, Riemke Mars3
1Emergency Department, Rijnstate Hospital, Arnhem, the Netherlands. arrienblokland@gmail.com.
Internal and emergency medicine
|August 30, 2025
概括
这项研究发现,对疑似高血压紧急情况的基底镜检查的遵守率很低,视网膜病变的发生率也很低. 口服抗高血压药物显示血压逐渐降低且并发症很少.
科学领域:
- 心脏病学
- 紧急医疗
- 眼科 眼科
背景情况:
- 疑似高血压的紧急情况在急诊室很常见.
- 高血压视网膜病变是高血压中介器官损伤 (HMOD) 的一个关键标志.
- 对高血压紧急情况的临床定义和治疗策略仍在争论中,这影响了患者的护理.
研究的目的:
- 评估是否遵守欧洲心脏病学会 (ESC) 在疑似高血压紧急情况中进行脑膜扫描的指南.
- 确定三级/四级高血压视网膜病变的发生率.
- 评估这些患者目前的临床实践和治疗策略,包括口服抗高血压药物治疗.
主要方法:
- 在荷兰ED中对1057名怀孕的非怀孕患者进行了回顾性多中心队列研究 (2019-2020年).
- 主要结局:进行后视镜的比例和III/IV级视网膜病变的发生率.
- 二次结局:口服抗高血压药物对血压和神经复杂症的影响.
主要成果:
- 在有指示的患者中,基底镜检查率为40. 2%,有III/ IV级视网膜病变的患者为10. 4%.
- 60. 7% 的患者服用口服抗高血压药物,导致血压降低 < 25%.
- 观察到并发症率较低 (ED患者1例,退院后30天内7例).
结论:
- 目前的指导方针和实践在高血压紧急情况中存在差距.
- 观察到部分遵循指南,视网膜病变的发病率较低.
- 口服抗高血压药似乎对ED患者的血压逐渐降低是安全的,并发症率较低.
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