Objective To develop an onset risk prediction nomogram for patients with homocysteine-type(H-type)hypertension(HTH)based on pulse diagram parameters to assist early clinical prediction and diagnosis of HTH.Methods Pat...Objective To develop an onset risk prediction nomogram for patients with homocysteine-type(H-type)hypertension(HTH)based on pulse diagram parameters to assist early clinical prediction and diagnosis of HTH.Methods Patients diagnosed with essential hypertension and admitted to Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shang-hai Hospital of Traditional Chinese Medicine,and Shanghai Hospital of Integrated Tradition-al Chinese and Western Medicine from July 6th 2020 to June 16th 2021,and from August 11th 2023 to January 22nd 2024,were enrolled in this retrospective research.The baselines and clinical biochemical indicators of patients were collected.The SMART-I TCM pulse instru-ment was applied to gather pulse diagram parameters.Multivariate logistic regression was adopted to analyze the risk factors for HTH.RStudio was employed to construct the nomo-gram model,receiver operating characteristic(ROC)curve,and calibration curve(bootstrap self-sampling 200 times),and clinical decision curve were drawn to evaluate the model’s dis-crimination and clinical effectiveness.Results A total of 168 hospitalized patients with essential hypertension were selected and di-vided into non-HTH group(n=29)and HTH group(n=139).Compared with non-HTH group,HTH group had a lower body mass index(BMI),and higher proportions of male pa-tients and drinkers(P<0.05).The ventricular wall thickening(VWT)could not be deter-mined.The proportions of left common carotid intima-media wall thickness(LCCIMWT)and serum creatinine(SCR)were higher in HTH group(P<0.05).The pulse diagram parameter As was significantly higher,and H4/H1 and T1/T were lower in HTH group(P<0.05).Gender,al-cohol consumption,serum creatinine,and the pulse diagram parameter H4/H1 were identi-fied as independent risk factors for HTH(P<0.05).The nomogram’s area under the ROC curve(AUC)was 0.795[95%confidence interval(CI):(0.7066,0.8828)],with a specificity of 0.724 and sensitivity of 0.799.After 200 times repeated bootstrap self-samplings,the calibra-tion curve showed that the simulated curve fits well with the actual curve(x^(2)=9.5002,P=0.3019).The clinical decision curve indicated that the nomogram’s applicability was optimal when the threshold for predicting HTH was between 0.38 and 1.00.Conclusion The nomogram model could be valuable for predicting the onset risk of HTH and pulse diagram parameters can facilitate early screening and prevention of HTH.展开更多
目的探讨黄芪补血汤联合厄贝沙坦在伴脑梗死老年H型高血压病患者中的应用效果。方法2020年1月—2022年12月该院收治的60例老年H型高血压病伴脑梗死患者,根据随机数表法将其分为甲组和乙组,每组30例。甲组单纯予以厄贝沙坦治疗,乙组在甲...目的探讨黄芪补血汤联合厄贝沙坦在伴脑梗死老年H型高血压病患者中的应用效果。方法2020年1月—2022年12月该院收治的60例老年H型高血压病伴脑梗死患者,根据随机数表法将其分为甲组和乙组,每组30例。甲组单纯予以厄贝沙坦治疗,乙组在甲组基础上采用黄芪补血汤治疗。观察高血压病疗效、血管内皮功能、同型半胱氨酸(homocysteine,Hcy)水平及神经功能缺损情况。结果乙组总有效率明显高于甲组,差异有统计学意义(P<0.05);两组治疗后的血清一氧化氮(nitric oxide,NO)水平均高于治疗前,内皮素-1(endothelin 1,ET-1)水平均低于治疗前,且乙组NO水平高于甲组,ET-1水平低于甲组,差异有统计学意义(P<0.05);两组治疗后的Hcy水平及美国国立卫生研究院卒中量表(national Institutes of Health Stroke Scale,NIHSS)评分均低于治疗前,且乙组较甲组低,差异有统计学意义(P<0.05)。结论黄芪补血汤联合厄贝沙坦可显著改善老年H型高血压病伴脑梗死患者血压控制效果及血管内皮功能,同时可降低Hcy水平,减轻患者神经功能缺损。展开更多
基金National Natural Science Foundation of China (81973749 and 8143594)State Administration of Traditional Chinese Medicine High-level Chinese Medicine Key Discipline Construction Project (zyyzdxk-2023069)。
文摘Objective To develop an onset risk prediction nomogram for patients with homocysteine-type(H-type)hypertension(HTH)based on pulse diagram parameters to assist early clinical prediction and diagnosis of HTH.Methods Patients diagnosed with essential hypertension and admitted to Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shang-hai Hospital of Traditional Chinese Medicine,and Shanghai Hospital of Integrated Tradition-al Chinese and Western Medicine from July 6th 2020 to June 16th 2021,and from August 11th 2023 to January 22nd 2024,were enrolled in this retrospective research.The baselines and clinical biochemical indicators of patients were collected.The SMART-I TCM pulse instru-ment was applied to gather pulse diagram parameters.Multivariate logistic regression was adopted to analyze the risk factors for HTH.RStudio was employed to construct the nomo-gram model,receiver operating characteristic(ROC)curve,and calibration curve(bootstrap self-sampling 200 times),and clinical decision curve were drawn to evaluate the model’s dis-crimination and clinical effectiveness.Results A total of 168 hospitalized patients with essential hypertension were selected and di-vided into non-HTH group(n=29)and HTH group(n=139).Compared with non-HTH group,HTH group had a lower body mass index(BMI),and higher proportions of male pa-tients and drinkers(P<0.05).The ventricular wall thickening(VWT)could not be deter-mined.The proportions of left common carotid intima-media wall thickness(LCCIMWT)and serum creatinine(SCR)were higher in HTH group(P<0.05).The pulse diagram parameter As was significantly higher,and H4/H1 and T1/T were lower in HTH group(P<0.05).Gender,al-cohol consumption,serum creatinine,and the pulse diagram parameter H4/H1 were identi-fied as independent risk factors for HTH(P<0.05).The nomogram’s area under the ROC curve(AUC)was 0.795[95%confidence interval(CI):(0.7066,0.8828)],with a specificity of 0.724 and sensitivity of 0.799.After 200 times repeated bootstrap self-samplings,the calibra-tion curve showed that the simulated curve fits well with the actual curve(x^(2)=9.5002,P=0.3019).The clinical decision curve indicated that the nomogram’s applicability was optimal when the threshold for predicting HTH was between 0.38 and 1.00.Conclusion The nomogram model could be valuable for predicting the onset risk of HTH and pulse diagram parameters can facilitate early screening and prevention of HTH.
文摘目的探讨黄芪补血汤联合厄贝沙坦在伴脑梗死老年H型高血压病患者中的应用效果。方法2020年1月—2022年12月该院收治的60例老年H型高血压病伴脑梗死患者,根据随机数表法将其分为甲组和乙组,每组30例。甲组单纯予以厄贝沙坦治疗,乙组在甲组基础上采用黄芪补血汤治疗。观察高血压病疗效、血管内皮功能、同型半胱氨酸(homocysteine,Hcy)水平及神经功能缺损情况。结果乙组总有效率明显高于甲组,差异有统计学意义(P<0.05);两组治疗后的血清一氧化氮(nitric oxide,NO)水平均高于治疗前,内皮素-1(endothelin 1,ET-1)水平均低于治疗前,且乙组NO水平高于甲组,ET-1水平低于甲组,差异有统计学意义(P<0.05);两组治疗后的Hcy水平及美国国立卫生研究院卒中量表(national Institutes of Health Stroke Scale,NIHSS)评分均低于治疗前,且乙组较甲组低,差异有统计学意义(P<0.05)。结论黄芪补血汤联合厄贝沙坦可显著改善老年H型高血压病伴脑梗死患者血压控制效果及血管内皮功能,同时可降低Hcy水平,减轻患者神经功能缺损。
