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血压变异性与急性主动脉夹层手术患者术后急性肾损伤风险的关系:一项 11 年单中心研究。

Variability of blood pressure and risk of postoperative acute kidney injury in patients undergoing surgery for acute aortic dissection: A 11-year single-center study.

机构信息

Department of Cardiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, P.R. China.

Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong, P.R. China.

出版信息

J Clin Hypertens (Greenwich). 2023 May;25(5):463-469. doi: 10.1111/jch.14654. Epub 2023 Mar 27.

Abstract

In patients receiving surgery, increased blood pressure variability may contribute to the onset of acute kidney injury (AKI). However, the extent and significance of blood pressure variability in patients undergoing aortic dissection surgery have yet to be determined. The authors analyzed all patients operated for aortic dissection at Peking University Shenzhen Hospital from January 1, 2011 to December 31, 2021. Preoperative blood pressure variability was expressed as standard deviation, coefficient of variation (CV), and range. The primary outcome was postoperative AKI. After multivariate analysis, systolic blood pressure variability was found to be independently associated with AKI after aortic dissection surgery. The odds ratios and 95% confidence intervals for standard deviation, CV, and systolic blood pressure range were 1.232 (1.011-1.500), 1.451 (1.058-1.991), and 1.138 (0.986-1.288) for postoperative AKI, respectively. However, there was no significant relationship between diastolic blood pressure variability and AKI after aortic dissection surgery. Finally, in patients undergoing surgery for aortic dissection, the variability of systolic blood pressure is actually an important factor in the development of AKI.

摘要

在接受手术的患者中,血压变异性增加可能导致急性肾损伤(AKI)的发生。然而,主动脉夹层手术患者的血压变异性的程度和意义尚未确定。作者分析了 2011 年 1 月 1 日至 2021 年 12 月 31 日期间在北京大学深圳医院接受主动脉夹层手术的所有患者。术前血压变异性表示为标准差、变异系数(CV)和范围。主要结局是术后 AKI。多因素分析后发现,主动脉夹层手术后收缩压变异性与 AKI 独立相关。术后 AKI 的标准差、CV 和收缩压范围的比值比和 95%置信区间分别为 1.232(1.011-1.500)、1.451(1.058-1.991)和 1.138(0.986-1.288)。然而,主动脉夹层手术后舒张压变异性与 AKI 之间没有显著关系。最后,在接受主动脉夹层手术的患者中,收缩压的变异性实际上是 AKI 发展的一个重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d273/10184486/2d75607d26b7/JCH-25-463-g002.jpg

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