连续测量脉冲到达时间,以识别血液压力变化在接受血液透析的患者 - - 一项可行性研究
Michael Wunderle1, Martin Bachler2, David Stadler1
1Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Nephrology, Munich, Germany.
Clinical kidney journal
|November 11, 2025
概括
脉冲到达时间 (PAT) 可以可行地跟踪血液透析患者的血压变化,可能有助于早期检测内透析性低血压 (IDH). 需要进一步的研究来证实其对IDH的普遍适用性和预测价值.
科学领域:
- 生物医学工程 生物医学工程
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管监测 心血管监测
背景情况:
- 静脉透析性低血压 (IDH) 是血液透析过程中常见和危险的并发症.
- 目前的IDH监测方法缺乏对预防性干预的及时警告信号.
- 持续的,非侵入性的血压监测可以实现早期IDH检测.
研究的目的:
- 探索使用脉冲到达时间 (PAT) 来跟踪血液压力 (BP) 变化在血液透析患者的可行性.
- 评估PAT作为血液动力学变化的非侵入性,持续监测方法的潜力.
- 调查血液透析期间PAT和BP变化之间的相关性.
主要方法:
- 一项可行性研究涉及44名接受血液透析的末期病患者.
- 使用心电图 (ECG) 和光电图 (PPG) 进行连续的,非侵入性的PAT测量.
- 统计分析包括相关性,同等性测试 (TOST) 和PAT和BP变化的分类分析.
主要成果:
- 在PAT和BP变化之间发现了反向关联,具有显著的相关性 (SBP/DBP r = -0.45,P < .001;DBP r = -0.25,P = .003).
- 在PAT和SBP/DBP (P值<.037) 的反转变化之间证明了等价性.
- 分类分析显示了对血压变化进行分类的中度结果 (F1分数 = 0.67,AUC = 0.70).
结论:
- 在血液透析患者中通过PAT追踪血压变化是可行的,这为早期IDH检测提供了潜力.
- PAT测量的可靠性因患者而异,这表明其普遍适用性有限.
- 反向PAT-BP关联突出了其补充传统监测的潜力,为IDH预测提供了进一步的验证.
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