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开发和外部验证白衣高血压的多变量预测模型
Shali Hao1, Xiaomei Zhang2, Lingxiao Li1
1Department of Cardiology, The Eighth Affiliated Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, China.
Journal of evidence-based medicine
|September 10, 2025
概括
一个新的预测模型使用临床数据帮助识别白衣高血压 (WCH) 和持续高血压 (SH). 这种工具有助于个性化血压管理,减少了对广泛的办公室外监测的需求.
科学领域:
- 心脏病学 心脏病学
- 高血压研究 高血压研究
- 临床预测建模模型
背景情况:
- 白袍高血压 (WCH) 诊断需要在办公室外监测血压 (BP),这是资源密集的.
- 使用随时可用的临床数据开发预测模型可以简化WCH识别.
研究的目的:
- 根据患者的临床特征,开发和验证用于识别白衣高血压 (WCH) 的预测模型.
- 创建一个工具,帮助临床医生区分WCH和持续高血压 (SH).
主要方法:
- 使用多变量逻辑回归对233名门诊患者的临床数据进行了预测模型的开发.
- 确定了WCH的独立预测因子,并构建了一个名ogram.
- 该模型在一个独立的研究站点对150名患者进行了外部验证.
主要成果:
- 确定了WCH的六个关键预测因素:办公室缩血压,体重指数,性别,总胆固醇,同氨酸和心率.
- 预测模型在训练组中达到0.792的AUC,在外部验证组中达到0.692的AUC.
- 校准和决策曲线分析证实了该模型在区分WCH和SH方面表现良好.
结论:
- 开发的预测模型有效地使用临床数据识别了WCH的个体.
- 这个工具可以指导针对异常血压的个性化管理策略.
- 它提供了一种更有效的方法,而不是仅仅依靠办公室外的BP监控.
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