扩张压血压的变化预测了CKD的心血管结果,特别是在晚期
Shan Ma1, Yanqing Hu2, Yuanting Zhu1
1Department of Cardiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Kidney medicine
|February 3, 2026
概括
扩张性血压变化 (DBPV) 独立预测慢性病 (CKD) 患者的心血管事件和死亡率. 较高的DBPV与增加的风险有关,特别是在晚期CKD阶段,提供超越缩变化的价值.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 高血压研究 高血压研究
背景情况:
- 慢性病 (CKD) 显著增加心血管事件的风险.
- 腹压血压变化 (DBPV) 在CKD的预后作用与静脉压血压变化 (SBPV) 相比,仍然不太了解.
研究的目的:
- 评估DBPV在预测CKD患者心血管不良结果方面的独立预后价值.
- 在这个人群中,比较DBPV与SBPV的预测能力.
主要方法:
- 一项回顾性队列研究包括1245名成年CKD患者 (G3a-G5阶段).
- 24小时的门诊血压监测评估了DBPV参数 (例如,24小时的DBP标准偏差).
- 考克斯的比例危险模型分析了与所有原因死亡率,心血管死亡和心力衰竭住院治疗的关联,并对混因素进行了调整.
主要成果:
- 较高的24小时DBP标准偏差独立地与增加的全因死亡率 (HR 1.08) 和心血管死亡 (HR 1.11) 相关.
- 一个不浸泡的DBP模式与更高的心力衰竭住院风险相关 (HR 1.42).
- 在心血管死亡方面,DBPV比SBPV具有增量预测价值 (IDI 0.023,P=0.004),特别是在晚期CKD阶段.
结论:
- 在CKD患者中,DBPV是不良心血管结果的独立预测因子.
- 在晚期CKD (G4-5) 中,DBPV的预后意义更加明显.
- 在CKD患者的风险分层方面,DBPV为SBPV提供了附加值.
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