The influence factors of blood pressure circadian rhythm in peritoneal dialysis patients and its relationship with residual renal function and cardiac function / 中华急诊医学杂志

Objective Observed the characteristics and influence factors of blood pressure circadian rhythm in continuous ambulatory peritoneal dialysis patients.To investigate the effect of residual renal function and cardiac function.Methods Prospectively collected 120 cases of continuous ambulatory peritoneal dialysis from June 2016 to March 2017 in Tangshan renal medicine dialysis centers,who combined with hypertension were treated with peritoneal dialysis for more than 3 months.According to the dynamic monitoring blood pressure circadian rhythm of blood pressure,120 cases were divided into the normal rhythm of blood pressure and the abnormal blood pressure rhythm group.Collected medical history;Tested related test index respectively;Cardiac ultrasound.According to the formula to calculate residual renal function,left ventricular mass index,Eingabe/Ausgabe,Ejection Fraction.Univariate and multivariate unconditional logistic regression analysis was used to analyze the risk factors of circadian rhythm of blood pressure.Stepwise multiple linear regression analysis was used to analyze the risk factors of residual renal function and cardiac function.Results CAPD patients with normal blood pressure rhythm in 14 cases(11.7％),abnormal blood pressure rhythm in 106 cases(88.3％),Among them,non dipper blood pressure accounted for 75 cases(62.5％).Single factor and multiple factors unconditioned logistic regression analysis revealed that after the comparison of gender and age,Risk factors for abnormal circadian rhythm of blood pressure were:UA(OR=1.197,95％CI:1.099-1.441),CRP(OR=1.170,95％CI:1.061-1.331),RRF(OR=1.389,95％CI:1.160-1.779).Using stepwise multiple linear regression analysis of dangerous factors affecting residual renal function and cardiac function,we found:Residual renal function negatively correlated with left ventricular myocardial mass index,systolic blood pressure drops at night rate,and ultrafiltration volume;LVMI (cardiac function) Positively correlated with 24 h average systolic blood pressure,and negatively correlated with systolic blood pressure drop ratio and residual renal function at night.Abnormal circadian rhythm of blood pressure may lead to the decline of residual renal function and cardiac function.Conclusions UA,CRP and RRF may affect the CAPD patients blood pressure circadian rhythm.At the same time,abnormal circadian rhythm of blood pressure may lead to the decline of residual renal function and cardiac function.Therefore,pay attention to the monitoring and control of ABPM,can better protect the residual renal function and improve cardiac function,so as to prolong and improve the survival time and quality of life of patients with CAPD.

The establishment of ischemic stroke recurrence prediction model and its application value / 中华老年医学杂志

Objective To establish a prediction model for 3-years recurrence after initial ischemic stroke by Cox proportional hazards regression and individual prognostic Index(PI)equation, and to evaluate its application value and external reality. Methods The inpatients with cerebral ischemic stroke hospitalized in Neurology Department in North China University of Science and Technology Affiliated Hospital were finally internalized between January 2013 and December 2013.Follow-up study on recurrence was carried out between January 2016 and December 2016.The recurrence prediction model was constructed by the Cox proportional hazards regression model.During January 2016 and December 2016,data of patients with ischemic stroke were prospectively continuously collected.And PI equation was used to verify its external reality in ischemic stroke patients. Results A total of 184 cases had stroke recurrence during the follow-up period.The Cox proportional hazards regression model analysis showed that age(RR=1.303,95% CI:1.019-1.666),history of heart disease(RR=1.788,95% CI:1.127-2.836),hypertension(RR=1.897,95% CI:1.097-3.280),diabetes(RR= 1.674,95% CI:1.015-2.760)and total cholesterol(RR= 2.136,95% CI:1.396-3.266)were the independent risk factors for stroke recurrence.The established recurrence model was correlated with individual PI equation,which was PI = 0.265X1+ 0.581X2+ 0.640X3+ 0.515X4+0.759X5.By the validation study of PI equation to predict stroke recurrence among patients admitted later, the sensitivity was 0.719,specificity was 0.769,and accuracy was 0.800. Conclusions Age,history of heart disease,hypertension,diabetes,and total cholesterol are independent risk factors for recurrence of ischemic stroke.And the PI for predicting stroke recurrence within 3 years after initial stroke is successfully established,which is good and helpful for predicting ischemic stroke recurrence.

Cox regression analysis of risk factors and establishment of prediction model for recurrent acute ischemic stroke in 3-years follow-up / 中华行为医学与脑科学杂志

Objective To investigate the risk factors and establish the Cox's regression model and the personal prognosis index for the recurrence of ischemic stroke in 3-year follow-up.methods 1058 patients were retrospectively reviewed consecutively diagnosed with ischemic stroke admitted to the Neurology Department of the Hebei united University Affiliated Hospital from January 1,2013 to December 31,2013.Cases were followed up since the onset of ischemic stroke.The follow-up was finished in January 1,2016.Kaplan-Meier methods were used for recurrence rate description.Monovariant and multivariate Cox's proportional hazard regression model were used to analyze risk factors associated with recurrence.Thus,a recurrence model was set up.Result sDuring the period of follow-up,184 cases relapsed.The 1-year recurrence rate was 29.9 person-year,2-year recurrence rate was 46.6 person-year,3-year recurrence rate was 52.7 person-year.Monovariant and multivariant Cox's proportional hazard regression model showed that the independent risk factors associated with recurrence were age(X1)(RR=1.303;95%CI:1.019~1.666)history of heart disease(X2)(RR=1.788;95%CI:1.127~2.836),hypertension(X3)(RR=1.897;95%CI:1.097~3.280),diabetes(X4)(RR=1.674;95%CI:1.015~2.760),total cholesterol(X5)(RR=2.136;95%CI:1.396~3.266).The personal prognosis index(PI)of recurrence model was as the following: PI=0.265X1+0.581X2+0.640X3+0.515X4+0.759X5.Conclusion sAge,history of heart disease,hypertension,disease progression,and total cholesterol are the independent risk factors associated with recurrence of ischemic stroke.The recurrence model and the personal prognosis index equation are successful constructed.