内部分析性低血压发作只是偶尔与不良症状相关
Sabrine Chaara1,2, Paul A Rootjes1,2,3, Miquéla I Y Bergtop1
1Division of Nephrology, Department of Internal Medicine, Amsterdam UMC, Amsterdam, The Netherlands.
无症状内透析性低血压 (IDH) 在血液透析 (HD) 和血液过 (HDF) 患者中很常见,通常会被基于症状的定义所遗漏. 患者报告的结果很少与IDH事件相关,这凸显了当前监测中的差距.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管医学 心血管医学
- 患者报告的结果
背景情况:
- 透析内低血压 (IDH) 是血液透析 (HD) 的常见并发症,但缺乏共识定义.
- 现有的指导方针通常需要症状或干预措施,但基于值的血压 (BP) 定义显示出更强的死亡率关联.
- 这项研究调查了HD和血液过 (HDF) 患者的IDH,重点关注实时症状和患者报告的结果.
研究的目的:
- 评估内透析性低血压 (IDH) 与实时症状和物理内透析患者报告的结果测量 (PID-PROMs) 之间的关联.
- 评估患有HD和HDF患者患有症状IDH (sIDH) 与无症状IDH (aIDH) 的发生率.
主要方法:
- 荷兰研究的二次分析,一个随机交叉试验,比较四种透析方式.
- 每15分钟和症状期间测量血压;症状实时记录,PID-PROMs收集后模式.
- IDH是值定义的 (静脉血压<90或<100 mm Hg),所有模式的数据都被汇总在一起.
主要成果:
- 观察到222个IDH发作 (20.1%的治疗),其中98%无症状.
- 实时症状发生在5.2%的会议中,只有4次会议符合门标准.
- IDH和PID-PROM之间的关联在很大程度上没有.
结论:
- 无症状IDH (aIDH) 显著超过症状IDH (sIDH),这意味着基于症状的定义低估了其发生率.
- 实时症状和PID-PROM仅偶尔与IDH事件相关.
- 当前的定义可能无法完全捕捉到IDH的负担,特别是无症状病例.
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