高每搏输出量变异是血液透析期间血压下降的独立预测因素。
High Stroke Volume Variation Is an Independent Predictor for Decreased Blood Pressure During Hemodialysis.
作者信息
Yoshihara Fumiki, Kishida Masatsugu, Ogawa Koji, Nishigaki Takayuki, Nakasaki Hironori, Ishizuka Azusa, Koezuka Ryo, Matsuo Miki, Hayashi Teruyuki, Nakamura Satoko
机构信息
Division of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Clinical Engineering Department, National Cerebral and Cardiovascular Center, Osaka, Japan.
出版信息
Ther Apher Dial. 2017 Apr;21(2):166-172. doi: 10.1111/1744-9987.12511. Epub 2017 Mar 10.
It currently remains unclear whether stroke volume variation (SVV) before hemodialysis (HD) is an independent predictor of decreased blood pressure (BP) during HD. Fifty-two patients were divided into two groups (Decreased BP during HD group: N = 10, Non-decreased BP group: N = 42). Fractional shortening was lower, and mean arterial pressure (MAP) and SVV were higher in the Decreased BP during HD group. A multiple logistic regression analysis identified low fractional shortening, high MAP, and high SVV as independent predictors of decreased BP during HD. The areas under the ROC curves were as follows: 0.849 for MAP, 0.712 for SVV, and 0.893 for MAP and SVV. Optimal threshold values were 93.0 mm Hg for MAP and 17.3 % for SVV. A multivariate regression analysis identified anemia and a longer dialysis vintage as independently related factors for higher SVV. Our results suggest that high SVV is an independent predictor for decreased BP during HD.
目前尚不清楚血液透析（HD）前的每搏输出量变异（SVV）是否是HD期间血压（BP）降低的独立预测因素。52例患者分为两组（HD期间血压降低组：N = 10，血压未降低组：N = 42）。HD期间血压降低组的左室短轴缩短率较低，平均动脉压（MAP）和SVV较高。多因素logistic回归分析确定低左室短轴缩短率、高MAP和高SVV是HD期间血压降低的独立预测因素。ROC曲线下面积如下：MAP为0.849，SVV为0.712，MAP和SVV联合为0.893。MAP的最佳阈值为93.0 mmHg，SVV的最佳阈值为17.3%。多因素回归分析确定贫血和较长的透析龄是SVV升高的独立相关因素。我们的结果表明，高SVV是HD期间血压降低的独立预测因素。
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