Background Elderly patients(age≥60 years)with ST-segment elevation myocardial infarction(STEMI)are at an elevated risk of mortality.This study aimed to investigate the association of the creatinine to ejection fracti...Background Elderly patients(age≥60 years)with ST-segment elevation myocardial infarction(STEMI)are at an elevated risk of mortality.This study aimed to investigate the association of the creatinine to ejection fraction ratio(CER)with in-hospital and 1-year death in elderly patients with STEMI.Methods A total of 753 consecutive elderly patients(age≥60 years)with STEMI undergoing percutaneous coronary intervention(PCI)were enrolled and divided into three groups according to the tertiles of CER at admission:<1.5(n=250),1.5-2.2(n=249)and>2.2(n=254).Multivariate analyses were performed to evaluate the prognostic value of CRE for short-term death in this population.Results The in-hospital and 1-year mortality reached 6.0%and 13.3%,respectively.Patients with higher CER exhibited a higher in-hospital mortality(0.8%vs.2.8%vs.14.2%,P<0.001).An optimal cut-off value of 2.5 for CER was identified for predicting in-hospital death by receiver operating characteristic curve analysis,yielding a sensitivity of 77.8%and a specificity of 76.1%[area under curve(AUC):0.791,95%confidence interval(CI):0.734-0.847,P<0.001].Multivariate regression analyses revealed that CER>2.5 was an independent risk factor for both in-hospital[adjusted odds ratio(OR):9.006,95%CI:2.707-29.967,P<0.001]and 1-year mortality[adjusted hazard ratio(HR):5.082,95%CI:2.462-10.490,P<0.001].Conclusions Elevated CER is associated with adverse short-term mortality in elderly STEMI patients undergone PCI,offering valuable insights for the early identification and management of high-risk individuals in clinical practice.展开更多
Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the go...Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the gold standard diagnostic method at present. Recently, the spot urinary protein-to-creatinine ratio (P/C ratio) has been used to detect suspected preeclampsia, because it can be used to estimate the amount of 24-hour urinary protein. The aim of this study is to investigate whether an increase in P/C ratio precedes emergence of hypertension among inpatients with preeclampsia. Method: The P/C ratio in normotensive (systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) pregnant women was measured during regular prenatal checkups and in inpatients with preeclampsia between April 1, 2013 and March 31, 2014. Results: We included in this study 4074 normotensive pregnant women. The 95th percentile values for the trimester of pregnancy were 0.100, 0.157, and 0.195, respectively. The 95th percentile value for each trimester of pregnancy and gestational age were determined as criterion (Y) and predictive variables (X), respectively. In a simple regression analysis, the regression line was calculated as Y = 0.0035X + 0.0849 (R2 = 0.9913). Twenty-one women were diagnosed with preeclampsia. In 14 patients with preeclampsia, the timing of the increase in P/C ratio to higher than the regression line preceded the emergence of hypertension. Six patients had no data on P/C ratio, and 1 patient had hypertension before the increase in P/C ratio. Conclusions: An increase in P/C ratio to higher than the 95th percentile value can be a useful predictor of preeclampsia.展开更多
The volume of contrast media to the creatinine clearance （V/CrCl） ratio correlate with the contrast-induced nephropathy （CIN）. The chronic kidney disease （CKD） more likely to develop CIN after primary percutaneo...The volume of contrast media to the creatinine clearance （V/CrCl） ratio correlate with the contrast-induced nephropathy （CIN）. The chronic kidney disease （CKD） more likely to develop CIN after primary percutaneous coronary intervention （PCI）. Objectiv has been shown to patients would be e To determine a relatively safe V/CrCl cutoff value to avoid CIN in CKD patients undergoing primary PCI. Methods We enrolled a total of 114 patients with CKD and calculated V/CrCl. Receiver-operator characteristic methods were used to identify the optimal sensitivity and specificity for the observed range of V/CrCl for CIN. We used multivariable logistic regression to assess the predictive value of V/CrCl for the risk of CIN in CKD patients. Results Overall, there were 24 cases （21%） of CIN. The baseline mean and median V/CrCl values were significantly greater among patients with CIN （mean 5.08 ±2.01, median 4.81, and interquartile range 3.53-6.33） than among those without CIN （mean 3.35 ±1.48, median 3.12, and interquartile range 2.27-4.14, P 〈 0.001）. The receiveroperator characteristic curve analysis indicated that a V/CrCl ratio of 3.62 was a fair discriminator for CIN （Cstatistic of 0.75） in CKD patients. After adjusting for other known predictors of CIN,a V/CrCl ratio 〉3.62 remained significantly associated with CIN in CKD patients（odds ratio 8.46,95% confidence interval 2.37-30.19, P 〈 0.001）. medium dose Conclusions based on the AV/CrCl ratio〉3.62 is a simple,useful indicator for determining the safe contrast pre-PCI CrCl values in CKDs.展开更多
In patients with diabetes mellitus, urinary albumin-creatinine-ratio (ACR) predicts progressive kidney disease. In order to determine the better urine sample for detecting ACR, we estimated ACR in three modes of urine...In patients with diabetes mellitus, urinary albumin-creatinine-ratio (ACR) predicts progressive kidney disease. In order to determine the better urine sample for detecting ACR, we estimated ACR in three modes of urine sample. Two hundred patients of uncontrolled diabetes mellitus with proteinuria irrespective of age and sex were studied for urinary ACR in all the three types of samples over a period of 2 years. The statistical analysis showed that first morning ACR (r = 0.999, p > 0.001) of the subjects was more significantly correlated with their 24 hour urine sample ACR than spot urine (r = 0.995,展开更多
To estimate the rate of excretion of urinary calcium, a 24-hour sample of urine is required and this is not always easy to collect accurately in infant and children. So, random urine calcium to creatinine ratio (Ca/Cr...To estimate the rate of excretion of urinary calcium, a 24-hour sample of urine is required and this is not always easy to collect accurately in infant and children. So, random urine calcium to creatinine ratio (Ca/Cr ratio) has been developed. But as the ratio varies worldwide, reference values of the parameter in paediatric population are not developed. To determine reference value, the present study was conducted in healthy paediatric population in Burdwan district, West Bengal. This study was performed on 693 healthy paediatric subjects, aged between 3 months to 18 years and divided into five groups. Early morning non-fasting urine samples from all study groups were analyzed for Ca/Cr ratio. A negative correlation was observed between age and urinary Ca/Cr ratio, but there was no significant difference of urinary Ca/Cr ratio between two sexes. Considering 97.5th percentile of the underlying distribution of values as the upper limit of reference range, upper reference values of urinary Ca/Cr ratio for age groups展开更多
Fifteen cases of fresh fractures have been studied, including 14 cases of tubu-lar bone fractures with age from 28 to 60 years and one case of vertebral fracture ofdorsolumbar region, 16 years of age. There were 13 ma...Fifteen cases of fresh fractures have been studied, including 14 cases of tubu-lar bone fractures with age from 28 to 60 years and one case of vertebral fracture ofdorsolumbar region, 16 years of age. There were 13 male and 2 female patients. Theyhad no endocrine disturbances or other bone diseases. The ratio ofhydroxyproline/creatinine (HP/Cr) in these cases increased gradually within 20-30 daysafter fracture and then reached the peak value which was about 3-4 times of normal, thepeak value maintained for a long time. If the trauma was mild or the patient was young,the peak began to decline on the 60th day after fracture. While in those severe cases withprolonged confinement to bed, the peak only began to come down about 110th dayafter fracture. The ratio of HP/Cr decreased rapidly from the peak at first, then pursueda slow course. Generally, the ratio of HP/Cr returned to normal on the 240th to 310thday. Bone union began at a time when peak value started to decline, and with completionof the remodelling process, the HP/Cr value returned to normal.展开更多
目的探讨晨尿白蛋白/肌酐比值(albumin-to-creatinine ratio,ACR)与24 h尿总蛋白(24-hour urine total protein,24 h UTP)之间的定量关系并探讨其在慢性肾脏病(chronic kidney disease,CKD)患者的临床应用价值。方法选取2023年10月至202...目的探讨晨尿白蛋白/肌酐比值(albumin-to-creatinine ratio,ACR)与24 h尿总蛋白(24-hour urine total protein,24 h UTP)之间的定量关系并探讨其在慢性肾脏病(chronic kidney disease,CKD)患者的临床应用价值。方法选取2023年10月至2024年9月住院CKD患者169例,按照CKD诊断标准将患者分为6期,检测晨尿ACR和24 h UTP并进行相关性分析;分析估算肾小球滤过率(estimated glomerular filtration rate,eGFR)、性别、年龄对二者相关性的影响;采用ROC曲线分析晨尿ACR预测24 h UTP最佳临界点。结果CKD患者未予分期时,晨尿ACR与24 h UTP呈显著正相关(r=0.854,P<0.000)。按照CKD诊断标准分为6期后两者也呈正相关,但相关性存在组间差异(CKD 2、3期患者两者高度相关、CKD 1、4、5期患者两者中度相关),性别、年龄对二者的相关性没有影响。应用受试者工作特征(ROC)曲线确定CKD患者晨尿ACR相对应于24 h UTP≥150 mg、≥1000 mg、≥3500 mg的诊断界值分别为80.14 mg/g、274.15 mg/g、1007.67 mg/g,其敏感度和特异度最佳。结论晨尿白蛋白/肌酐比值用于监测慢性肾脏病患者的尿蛋白排泄情况优于24 h尿蛋白监测,具有较好的应用前景。展开更多
目的:探讨血清白蛋白/肌酐比值(serum albumin to creatinine ratio,ACR)对ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者PCI术后短期临床结局的预测价值。方法:回顾性队列研究纳入2020年1月至2024年6月...目的:探讨血清白蛋白/肌酐比值(serum albumin to creatinine ratio,ACR)对ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者PCI术后短期临床结局的预测价值。方法:回顾性队列研究纳入2020年1月至2024年6月间在安徽医科大学第二附属医院接受PCI治疗的892例STEMI患者,按ACR四分位数分为4组。主要终点为30d全因死亡率,次要终点包括对比剂肾病、支架血栓形成、充血性心力衰竭及复发性心肌梗死。采用Logistic回归分析评估ACR与临床结局的关联,并绘制受试者工作特征(ROC)曲线评估ACR的预测价值。进行多种因素的亚组分析以验证结果稳健性。结果:多因素分析结果显示,ACR与STEMI患者30d全因死亡率呈显著负相关(OR=0.60,95%CI:0.45~0.81,P<0.001),表现为明显的剂量-反应关系(P趋势<0.001)。较高ACR还与对比剂肾病(OR=0.71,95%CI:0.60~0.85,P<0.001)和充血性心力衰竭(OR=0.72,95%CI:0.60~0.86,P<0.001)风险降低相关。ROC曲线分析表明,ACR(AUC=0.744)在预测30d全因死亡率方面优于单独的血清肌酐(AUC=0.643)或白蛋白(AUC=0.615)。亚组分析显示,合并高血压患者中ACR与死亡率关联更为显著(交互P=0.007)。结论:较高的ACR与STEMI患者PCI后30d全因死亡率、对比剂肾病及充血性心力衰竭风险降低显著相关,可作为评估STEMI患者短期预后的有效预测工具。展开更多
目的:探究妊娠期高血压(Hypertensive Disorders of Pregnancy,HDP)合并糖尿病患者的心率变异性、血压水平与尿蛋白/肌酐比值的相关性。方法:选取2022年6月至2024年6月本院收治的妊娠期高血压合并糖尿病患者106例为研究组,另选取同期本...目的:探究妊娠期高血压(Hypertensive Disorders of Pregnancy,HDP)合并糖尿病患者的心率变异性、血压水平与尿蛋白/肌酐比值的相关性。方法:选取2022年6月至2024年6月本院收治的妊娠期高血压合并糖尿病患者106例为研究组,另选取同期本院妊娠期高血压患者106例为HDP组;及同期本院106例正常孕妇为对照组;比较三组患者的血压水平、心率变异性与尿蛋白/肌酐比值的差异,皮尔逊分析其相关性;ROC分析诊断的价值。结果:研究组患者的24h舒张压(Diastolic Blood Pressure,DBP)、24h收缩压(Systolic Blood Pressure,SBP)、日间DBP与SBP、夜间DBP与SBP均高于HDP组、对照组,差异有统计学意义(P<0.05)。研究组患者的NN间期均值标准差(Standard Deviation of the Average of All Normal NN Intervals,SDANN)、NN间期差值个数百分比(Proportion of NN50 divided by total number of NNs,PNN50)、相邻NN间期差值均方根值(Root Mean Square of the Standard Deviation of All NN Intervals,RMSSD)、NN间期标准差(Standard Deviation of NN Intervals,SDNN)均低于HDP组与对照组,ACR高于HDP组与对照组;差异有统计学意义(P<0.05)。皮尔逊相关性显示ACR与24hDBP、24hSBP互呈正相关(r=0.755、0.724,P<0.05);24hDBP与PNN50互呈负相关(r=-0.259,P<0.05);24hSBP与SDANN、PNN50、RMSSD、SDNN互呈负相关(r=-0.213、-0.355、-0.194、-0.256,P<0.05)。ROC曲线分析显示,尿蛋白/肌酐比值、血压水平、心率变异性诊断妊娠期高血压合并糖尿病的AUC分别为0.885、0.991、0.931;敏感度分别为89.6%、99.1%、90.6%;特异性分别为70.8%、90.6%、88.7%。结论:妊娠期高血压合并糖尿病患者的心率变异性降低与血压升高负相关,同时ACR与血压升高正相关;强调心率变异性、血压水平与ACR在评估病情及预测并发症中的重要性,为临床提供参考。展开更多
文摘Background Elderly patients(age≥60 years)with ST-segment elevation myocardial infarction(STEMI)are at an elevated risk of mortality.This study aimed to investigate the association of the creatinine to ejection fraction ratio(CER)with in-hospital and 1-year death in elderly patients with STEMI.Methods A total of 753 consecutive elderly patients(age≥60 years)with STEMI undergoing percutaneous coronary intervention(PCI)were enrolled and divided into three groups according to the tertiles of CER at admission:<1.5(n=250),1.5-2.2(n=249)and>2.2(n=254).Multivariate analyses were performed to evaluate the prognostic value of CRE for short-term death in this population.Results The in-hospital and 1-year mortality reached 6.0%and 13.3%,respectively.Patients with higher CER exhibited a higher in-hospital mortality(0.8%vs.2.8%vs.14.2%,P<0.001).An optimal cut-off value of 2.5 for CER was identified for predicting in-hospital death by receiver operating characteristic curve analysis,yielding a sensitivity of 77.8%and a specificity of 76.1%[area under curve(AUC):0.791,95%confidence interval(CI):0.734-0.847,P<0.001].Multivariate regression analyses revealed that CER>2.5 was an independent risk factor for both in-hospital[adjusted odds ratio(OR):9.006,95%CI:2.707-29.967,P<0.001]and 1-year mortality[adjusted hazard ratio(HR):5.082,95%CI:2.462-10.490,P<0.001].Conclusions Elevated CER is associated with adverse short-term mortality in elderly STEMI patients undergone PCI,offering valuable insights for the early identification and management of high-risk individuals in clinical practice.
文摘Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the gold standard diagnostic method at present. Recently, the spot urinary protein-to-creatinine ratio (P/C ratio) has been used to detect suspected preeclampsia, because it can be used to estimate the amount of 24-hour urinary protein. The aim of this study is to investigate whether an increase in P/C ratio precedes emergence of hypertension among inpatients with preeclampsia. Method: The P/C ratio in normotensive (systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) pregnant women was measured during regular prenatal checkups and in inpatients with preeclampsia between April 1, 2013 and March 31, 2014. Results: We included in this study 4074 normotensive pregnant women. The 95th percentile values for the trimester of pregnancy were 0.100, 0.157, and 0.195, respectively. The 95th percentile value for each trimester of pregnancy and gestational age were determined as criterion (Y) and predictive variables (X), respectively. In a simple regression analysis, the regression line was calculated as Y = 0.0035X + 0.0849 (R2 = 0.9913). Twenty-one women were diagnosed with preeclampsia. In 14 patients with preeclampsia, the timing of the increase in P/C ratio to higher than the regression line preceded the emergence of hypertension. Six patients had no data on P/C ratio, and 1 patient had hypertension before the increase in P/C ratio. Conclusions: An increase in P/C ratio to higher than the 95th percentile value can be a useful predictor of preeclampsia.
基金supported by Guangdong Provincial Cardiovascular Clinical Medicine Research Fund support.Guangzhou,China(2009X41)
文摘The volume of contrast media to the creatinine clearance （V/CrCl） ratio correlate with the contrast-induced nephropathy （CIN）. The chronic kidney disease （CKD） more likely to develop CIN after primary percutaneous coronary intervention （PCI）. Objectiv has been shown to patients would be e To determine a relatively safe V/CrCl cutoff value to avoid CIN in CKD patients undergoing primary PCI. Methods We enrolled a total of 114 patients with CKD and calculated V/CrCl. Receiver-operator characteristic methods were used to identify the optimal sensitivity and specificity for the observed range of V/CrCl for CIN. We used multivariable logistic regression to assess the predictive value of V/CrCl for the risk of CIN in CKD patients. Results Overall, there were 24 cases （21%） of CIN. The baseline mean and median V/CrCl values were significantly greater among patients with CIN （mean 5.08 ±2.01, median 4.81, and interquartile range 3.53-6.33） than among those without CIN （mean 3.35 ±1.48, median 3.12, and interquartile range 2.27-4.14, P 〈 0.001）. The receiveroperator characteristic curve analysis indicated that a V/CrCl ratio of 3.62 was a fair discriminator for CIN （Cstatistic of 0.75） in CKD patients. After adjusting for other known predictors of CIN,a V/CrCl ratio 〉3.62 remained significantly associated with CIN in CKD patients（odds ratio 8.46,95% confidence interval 2.37-30.19, P 〈 0.001）. medium dose Conclusions based on the AV/CrCl ratio〉3.62 is a simple,useful indicator for determining the safe contrast pre-PCI CrCl values in CKDs.
文摘In patients with diabetes mellitus, urinary albumin-creatinine-ratio (ACR) predicts progressive kidney disease. In order to determine the better urine sample for detecting ACR, we estimated ACR in three modes of urine sample. Two hundred patients of uncontrolled diabetes mellitus with proteinuria irrespective of age and sex were studied for urinary ACR in all the three types of samples over a period of 2 years. The statistical analysis showed that first morning ACR (r = 0.999, p > 0.001) of the subjects was more significantly correlated with their 24 hour urine sample ACR than spot urine (r = 0.995,
文摘To estimate the rate of excretion of urinary calcium, a 24-hour sample of urine is required and this is not always easy to collect accurately in infant and children. So, random urine calcium to creatinine ratio (Ca/Cr ratio) has been developed. But as the ratio varies worldwide, reference values of the parameter in paediatric population are not developed. To determine reference value, the present study was conducted in healthy paediatric population in Burdwan district, West Bengal. This study was performed on 693 healthy paediatric subjects, aged between 3 months to 18 years and divided into five groups. Early morning non-fasting urine samples from all study groups were analyzed for Ca/Cr ratio. A negative correlation was observed between age and urinary Ca/Cr ratio, but there was no significant difference of urinary Ca/Cr ratio between two sexes. Considering 97.5th percentile of the underlying distribution of values as the upper limit of reference range, upper reference values of urinary Ca/Cr ratio for age groups
文摘Fifteen cases of fresh fractures have been studied, including 14 cases of tubu-lar bone fractures with age from 28 to 60 years and one case of vertebral fracture ofdorsolumbar region, 16 years of age. There were 13 male and 2 female patients. Theyhad no endocrine disturbances or other bone diseases. The ratio ofhydroxyproline/creatinine (HP/Cr) in these cases increased gradually within 20-30 daysafter fracture and then reached the peak value which was about 3-4 times of normal, thepeak value maintained for a long time. If the trauma was mild or the patient was young,the peak began to decline on the 60th day after fracture. While in those severe cases withprolonged confinement to bed, the peak only began to come down about 110th dayafter fracture. The ratio of HP/Cr decreased rapidly from the peak at first, then pursueda slow course. Generally, the ratio of HP/Cr returned to normal on the 240th to 310thday. Bone union began at a time when peak value started to decline, and with completionof the remodelling process, the HP/Cr value returned to normal.
文摘目的探讨晨尿白蛋白/肌酐比值(albumin-to-creatinine ratio,ACR)与24 h尿总蛋白(24-hour urine total protein,24 h UTP)之间的定量关系并探讨其在慢性肾脏病(chronic kidney disease,CKD)患者的临床应用价值。方法选取2023年10月至2024年9月住院CKD患者169例,按照CKD诊断标准将患者分为6期,检测晨尿ACR和24 h UTP并进行相关性分析;分析估算肾小球滤过率(estimated glomerular filtration rate,eGFR)、性别、年龄对二者相关性的影响;采用ROC曲线分析晨尿ACR预测24 h UTP最佳临界点。结果CKD患者未予分期时,晨尿ACR与24 h UTP呈显著正相关(r=0.854,P<0.000)。按照CKD诊断标准分为6期后两者也呈正相关,但相关性存在组间差异(CKD 2、3期患者两者高度相关、CKD 1、4、5期患者两者中度相关),性别、年龄对二者的相关性没有影响。应用受试者工作特征(ROC)曲线确定CKD患者晨尿ACR相对应于24 h UTP≥150 mg、≥1000 mg、≥3500 mg的诊断界值分别为80.14 mg/g、274.15 mg/g、1007.67 mg/g,其敏感度和特异度最佳。结论晨尿白蛋白/肌酐比值用于监测慢性肾脏病患者的尿蛋白排泄情况优于24 h尿蛋白监测,具有较好的应用前景。
文摘目的:探讨血清白蛋白/肌酐比值(serum albumin to creatinine ratio,ACR)对ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者PCI术后短期临床结局的预测价值。方法:回顾性队列研究纳入2020年1月至2024年6月间在安徽医科大学第二附属医院接受PCI治疗的892例STEMI患者,按ACR四分位数分为4组。主要终点为30d全因死亡率,次要终点包括对比剂肾病、支架血栓形成、充血性心力衰竭及复发性心肌梗死。采用Logistic回归分析评估ACR与临床结局的关联,并绘制受试者工作特征(ROC)曲线评估ACR的预测价值。进行多种因素的亚组分析以验证结果稳健性。结果:多因素分析结果显示,ACR与STEMI患者30d全因死亡率呈显著负相关(OR=0.60,95%CI:0.45~0.81,P<0.001),表现为明显的剂量-反应关系(P趋势<0.001)。较高ACR还与对比剂肾病(OR=0.71,95%CI:0.60~0.85,P<0.001)和充血性心力衰竭(OR=0.72,95%CI:0.60~0.86,P<0.001)风险降低相关。ROC曲线分析表明,ACR(AUC=0.744)在预测30d全因死亡率方面优于单独的血清肌酐(AUC=0.643)或白蛋白(AUC=0.615)。亚组分析显示,合并高血压患者中ACR与死亡率关联更为显著(交互P=0.007)。结论:较高的ACR与STEMI患者PCI后30d全因死亡率、对比剂肾病及充血性心力衰竭风险降低显著相关,可作为评估STEMI患者短期预后的有效预测工具。
文摘目的:探究妊娠期高血压(Hypertensive Disorders of Pregnancy,HDP)合并糖尿病患者的心率变异性、血压水平与尿蛋白/肌酐比值的相关性。方法:选取2022年6月至2024年6月本院收治的妊娠期高血压合并糖尿病患者106例为研究组,另选取同期本院妊娠期高血压患者106例为HDP组;及同期本院106例正常孕妇为对照组;比较三组患者的血压水平、心率变异性与尿蛋白/肌酐比值的差异,皮尔逊分析其相关性;ROC分析诊断的价值。结果:研究组患者的24h舒张压(Diastolic Blood Pressure,DBP)、24h收缩压(Systolic Blood Pressure,SBP)、日间DBP与SBP、夜间DBP与SBP均高于HDP组、对照组,差异有统计学意义(P<0.05)。研究组患者的NN间期均值标准差(Standard Deviation of the Average of All Normal NN Intervals,SDANN)、NN间期差值个数百分比(Proportion of NN50 divided by total number of NNs,PNN50)、相邻NN间期差值均方根值(Root Mean Square of the Standard Deviation of All NN Intervals,RMSSD)、NN间期标准差(Standard Deviation of NN Intervals,SDNN)均低于HDP组与对照组,ACR高于HDP组与对照组;差异有统计学意义(P<0.05)。皮尔逊相关性显示ACR与24hDBP、24hSBP互呈正相关(r=0.755、0.724,P<0.05);24hDBP与PNN50互呈负相关(r=-0.259,P<0.05);24hSBP与SDANN、PNN50、RMSSD、SDNN互呈负相关(r=-0.213、-0.355、-0.194、-0.256,P<0.05)。ROC曲线分析显示,尿蛋白/肌酐比值、血压水平、心率变异性诊断妊娠期高血压合并糖尿病的AUC分别为0.885、0.991、0.931;敏感度分别为89.6%、99.1%、90.6%;特异性分别为70.8%、90.6%、88.7%。结论:妊娠期高血压合并糖尿病患者的心率变异性降低与血压升高负相关,同时ACR与血压升高正相关;强调心率变异性、血压水平与ACR在评估病情及预测并发症中的重要性,为临床提供参考。
