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初诊高血压患者的系统性免疫炎症指数与反杓型昼夜节律模式之间的关系。

The relationship between the systemic immune-inflammation index and reverse-dipper circadian pattern in newly diagnosed hypertensive patients.

机构信息

Department of Cardiology, Kafkas University School of Medicine, Kars, Turkey.

出版信息

J Clin Hypertens (Greenwich). 2023 Aug;25(8):700-707. doi: 10.1111/jch.14688. Epub 2023 Jul 18.

Abstract

Although hypertension is considered high intravascular pressure, impairing circadian blood pressure (BP) has been shown to potentially contribute to poor clinical outcomes. Systemic immune-inflammation index (SII), based on platelet, neutrophil, and lymphocyte counts, has been established as a strong prognostic marker in cardiovascular disease. The role of inflammation in the pathogenesis of hypertension is a well-known issue and inflammatory markers are associated with BP variability. We aimed to investigate whether there is a relationship between circadian BP changes and SII in newly diagnosed hypertensive patients. The study population consisted of 196 newly diagnosed hypertensive patients without LVH. In total, 76 (38%) patients had a dipper BP pattern, 60 (31%) patients had a non-dipper BP pattern, and 60 (31%) patients had a reverse-dipper BP pattern. SII was calculated according to Multivariate logistic regression analysis revealed SII and HDL-C as an independent predictors of reverse-dipper circadian pattern in newly diagnosed hypertensive patients. The cut-off value of the SII for reverse-dipper hypertension in a ROC curve analysis was >639.73 with 63.3% sensitivity and 84.2% specificity. Our study showed that the SII level was higher in the reverse-dipper hypertension patient group than in the dipper and non-dipper hypertension groups. Furthermore, SII was an independent predictor of newly diagnosed reverse-dipper hypertensive patients. The high SII value in newly diagnosed hypertensive patients can be used as an early warning parameter to identify reverse-dipper hypertension patients.

摘要

虽然高血压被认为是高血管内压,但已表明损害昼夜血压(BP)可能导致不良临床结局。基于血小板、中性粒细胞和淋巴细胞计数的全身免疫炎症指数(SII)已被确立为心血管疾病的强有力预后标志物。炎症在高血压发病机制中的作用是一个众所周知的问题,炎症标志物与 BP 变异性相关。我们旨在研究新诊断的高血压患者中昼夜血压变化与 SII 之间是否存在关系。研究人群包括 196 名无左室肥厚的新诊断高血压患者。共有 76 名(38%)患者存在杓型血压模式,60 名(31%)患者存在非杓型血压模式,60 名(31%)患者存在反杓型血压模式。根据多元逻辑回归分析计算 SII,结果显示 SII 和 HDL-C 是新诊断高血压患者反杓型昼夜模式的独立预测因子。ROC 曲线分析中 SII 对反杓型高血压的截断值为>639.73,敏感性为 63.3%,特异性为 84.2%。我们的研究表明,反杓型高血压患者组的 SII 水平高于杓型和非杓型高血压患者组。此外,SII 是新诊断反杓型高血压患者的独立预测因子。新诊断高血压患者中 SII 值较高可用作识别反杓型高血压患者的早期预警参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7af/10423764/aadf6d8378d6/JCH-25-700-g001.jpg

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