基于证据的血液测试用于监测初级保健中患有高血压的成年人:快速审查,例行数据分析和共识研究
Martha Maria Christine Elwenspoek1,2, Rachel O'Donnell3, Catalina Lopez Manzano3
1University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom martha.elwenspoek@bristol.ac.uk.
概括
建议对患有高血压的成年人进行最低限度的一组血液检查,包括估计的淋巴膜过率 (eGFR) 和糖化血红蛋白 (HbA1c),用于监测高血压. 这旨在改善患者护理,减少不必要的测试变化.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 一般实践 一般实践
背景情况:
- 在英国初级保健中高血压检测率的显著变化表明患者监测不足最佳.
- 需要建立基于证据的指导方针,以对高血压管理中必不可少的血液检查进行指导.
研究的目的:
- 建立一个最小的,基于证据的血液测试小组,用于监测成人高血压.
- 减少高血压患者的诊断测试中不必要的变化.
主要方法:
- 对高血压中16项例行测试的证据进行快速审查.
- 一项共识性研究,涉及临床医生和患者,根据证据选择测试.
- 分析初级保健记录和进一步审查以解决共识分歧.
主要成果:
- 一致的证据支持eGFR用于慢性病和HbA1c用于糖尿病检测.
- 没有或不一致的证据发现常规脂质,电解质,血红蛋白,甲状腺,凝血,,铁素,叶酸或维生素B12测试.
- 在常规肝功能,炎症或BNP监测方面没有证明有益处.
结论:
- 为了监测患有高血压的成年人,确定了eGFR,HbA1c,和的最小面板.
- 实施可以减少不合理的测试变化造成的伤害.
- 对于具有不一致证据和最佳测试频率的测试,需要进一步研究.
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