Objective To analyze the influencing factors of prognosis of patients with traumatic brain injury (TBI), and explore the influence of hemoglobin (Hb) level combined with blood pressure variability (BPV) on the quality of prognosis of patients with TBI. Methods The data of 186 TBI patients who received systemic treatment in the Affiliated Zhangjiagang Hospital of Soochow University between January 2020 and December 2021 were retrospectively analyzed. According to the Glasgow Outcome Scale (GOS) 3 months after treatment, they were divided into group A (GOS 4-5, 159 cases) and group B (GOS 1-3, 27 cases). The general clinical data, BPV indexes and Hb levels of the two groups were analyzed by single factor analysis and multiple logistic regression analysis, and the predictive value of the logistic regression model was evaluated by receiver operating characteristic (ROC) curve, sensitivity, specificity and area under the curve (AUC). Results There was no statistical significance in gender, age, body mass index, blood urea nitrogen, prothrombin time, fasting blood glucose level, or smoking history (P>0.05); the patients’ Glasgow Coma Scale at admission in group A was higher than that in group B (P<0.05), and the constituent ratio with a history of hypertension of group A was significantly lower than that of group B (P<0.05). The between-group differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and Hb at admission, and SBP, DBP, and MAP 72 h after treatment were not statistically significant (P>0.05); the SBP-standard deviation (SD), DBP-SD, SPB-coefficient of variation (CV) and DBP-CV of group B 72 h after treatment were significantly higher than those of group A (P<0.05), and the level of Hb was significantly lower than that of group A (P<0.05). Hb [odds ratio (OR)=0.787, 95% confidence interval (CI) (0.633, 0.978), P=0.031], SBP-CV [OR=1.756, 95%CI (1.073, 2.880), P=0.023] and DBP-CV [OR=1.717, 95%CI (1.107, 2.665), P=0.016] were all independent prognostic factors of TBI patients. The ROC showed that the combined index of BPV and Hb was more valuable than that of single prediction, with an AUC of 0.896 [95%CI (0.825, 0.935), P<0.05]. Conclusions Both BPV and Hb are independent factors affecting the prognosis of TBI patients, and their combined application can more effectively predict the prognosis of TBI patients. Therefore, when treating and evaluating the prognosis of TBI patients, closely monitoring the changes in blood pressure and Hb levels can timely and effectively control the development of the disease, and provide scientific reference for subsequent treatment.
The continuous left ventricle blood pressure prediction based on selected heart sound features was realized in this study. The experiments were carried out on three beagle dogs and the variations of cardiac hemodynamics were induced by various dose of epinephrine. The phonocardiogram, electrocardiogram and blood pressures in left ventricle were synchronously acquired. We obtained 28 valid recordings in this study. An artificial neural network was trained with the selected feature to predict left ventricular blood pressure and this trained network made a good performance. The results showed that the absolute average error was 7.3 mm Hg even though the blood pressures had a large range of fluctuation. The average correlation coefficient between the predicted and the measured blood pressure was 0.92. These results showed that the method in this paper was helpful to monitor left ventricular hemodynamics non-invasively and continuously.
Objective To investigate the characteristics of blood pressure and coronary artery impairment in patients with essential hypertension (EH) combining coronary heart disease (CHD). Methods A total of 358 patients with EH combining CHD and other 144 patients with CHD were measured with ambulatory blood pressure monitoring (ABPM), and the parameters of ambulatory blood pressure were analyzed. All the patients underwent coronary angiography. The severity of coronary artery stenosis was evaluated in accordance with the number of impaired arteries. Results Compared to the patients with simplex CHD, those with EH combining CHD had much heavier artery stenosis and more diffuse lesions, with significant differences (χ2=6.03, P=0.019). The 24h systolic blood pressure (SBP), day SBP, night SBP, 24h pulse pressure (PP), day PP and night PP were higher in the patients with EH combining CHD compared to those of the patients with simplex CHD (The t values were 2.580, 2.045, 2.675, 2.037, 2.601, and 1.995, respectively, while the P values were 0.015, 0.037, 0.009, 0.041, 0.017, and 0.047, respectively). Conclusion Compared to the patients with simplex CHD, the patients with EH combining CHD suffer from much severe coronary artery impairment, so a good controlling of blood pressure is advisable to improve the coronary artery impairment for the patients with EH combining CHD.
摘要:目的：研究成都地区中老年人群体重指数(BMI)与高血压患病率及血压水平的关系。方法:按照随机抽样的方法抽取样本,对711人(平均年龄为63.28±6.25岁;男性占57.8%)进行了相关调查,调查内容中包括身高、体重、血压及脉搏等。结果:成都地区中老年人群的超重及肥胖所占比重较大(约45%),按BMI分组(lt;18.5 kg/m2,18.5~23.9 kg/m2,24~27.9 kg/m2,≥28.0 kg/m2)的高血压患病率分别是31.6%,54.8%,64.4%,82.8%,差异有统计学意义。采用logistic回归分析发现在调整年龄、性别、腰围及尿酸等后,BMI对高血压的患病率有独立影响。在整个人群及女性病人中,血压随着BMI的升高而有升高的趋势,差异有统计学意义。结论:成都地区中老年人群超重及肥胖所占比重较大。BMI可以影响高血压的患病率及影响女性病人的血压水平,是高血压的独立危险因素。Abstract: Objective: To investigate the effects of body mass index on prevalence of hypertension and blood pressure in the elderly. MethodsA survey, including height, weight, blood pressure and pulse, was carried out in a general population of Chengdu. A total of 711 subjects (average age: 63.28±6.25 years; male: 57.8%) were recruited by random sampling method. Results：The proportion of overweight and obesity was about 45%. The hypertension prevalence rate was significantly positively correlated with BMI (Plt;0.01), and that was also seen in the level of SBP and DBP for the female (Plt;0.05). In logistic regression analysis adjusting for age, gender, waist, uric acid, the standardized OR for higher BMI (≥28.0 kg/m2) as a risk factor of hypertension was 5.140. Conclusion：The proportion of overweight and obesity was great in Chengdu area. BMI can affect the prevalence rate of hypertension and the level of blood pressure.
摘要:目的:研究老年患者动脉弹性功能与围术期血压变化的关系。方法:随机选择68例ASA分级Ⅰ－Ⅱ级行全麻手术的老年患者,根据检查所得动脉弹性的结果分为四组,分别是A组(C1、C2均正常),B组(C1异常,C2正常),C组(C1正常,C2异常),D组(C1、C2均异常)。测量其术前血压及全麻诱导8分钟后的血压水平。结果:〓动脉弹性功能不良的患者其术前MAP较高,且全麻诱导以后血压波动的比例较大。结论:高血压病的老年患者动脉弹性功能普遍降低;动脉弹性下降的老年病人全麻诱导后血压波动较大。Abstract: Objective:To investigate the relationship between the function of arterial elasticity and BP changes during perioperation in senile patients.Methods: 68 senile patients ASA class Ⅰor Ⅱ undergoing elective surgery under general anesthestia, were divided into four groups by evaluation of arterial elasticity (C1 was for large arterial elastic index and C2 for small. C1 and C2 were normal in group A, only C2 normal in group B, only C1 normal in group C, neither was normal in group D). Arterial blood pressure (BP) before operation and 8 min after induction were monitored and recorded. Results: Patients with dysfunction of arterial elasticity presented higher MAP during preoperation and significant BP changes after induction. Conclusion: Hypertension plays a key role in arterial elasticity.Arterial Blood Pressure of the senile patients with decreased arterial elasticity changes significantly after general anesthesia induction.
摘要:目的: 观察腰硬联合麻醉在前列腺电切术患者中的临床应用效果。 方法 : 76例经尿道前列腺电切术患者(78±7岁)随机均分为腰硬联合麻醉组(C组)及硬膜外组(E组)。C组以腰硬联合穿刺针于L34穿刺至蛛网膜下腔后,注入05%布比卡因2 mL,通过硬膜外穿刺针置入硬膜外导管;E组行L34间隙硬膜外穿刺置管。记录麻醉起效时间、麻醉效果、麻醉前及麻醉后5、15、30分钟时血压、心率。 结果 : 所有患者均穿刺顺利,麻醉起效时间C组为36±13 min, E组68±15 min;C组麻醉效果完善率为100%,E组为95%;麻醉后两组血压均下降(〖WTBX〗P lt;005),但降幅均未超过基础值的20%;两组麻醉前及麻醉后血压、心率均无显著性差异。 结论 :腰硬联合麻醉用于前列腺电切术具有起效快、麻醉效果佳的优点。Abstract: Objective: To investigate and compare the clinical efficacy and safety of combined spinalepidural(CSEA) and epidural(EA) anesthesia on elderly patients undergoing transurethral resection of the prostate(TURP). Methods : 76 patients(78±7 years) suffering TURP were divided into two group: group CSEA(38cases) and groupEA(38 cases). The dose of bupivacaine in spinal anesthesia is 10 mg. Blood pressure(BP), heart rate(HR) and anesthesia efficacy were observed before anesthesia, 5, 15 and 30min after anesthesia. Results : BP decreased after anesthesia in two groups than before anesthesia(〖WTBX〗P lt;005). The decreases of BP were less than 20% of basises. There were no significant differents of BP and HR between two groups before and after anesthesia. Conclusion :CSEA with bupivacaine 10 mg is safe and efficient in elderly undergoing TURP.
Objective To systematically review the benefits and risks of more intensive versus less intensive blood pressure control in Asian elderly patients over 60 years old. Methods The PubMed, EMbase, Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) of intensive versus less blood pressure control from inception to August 2022. Two reviewers independently screened the literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 6 RCTs involving 20 701 patients were included. The results of meta-analysis showed that intensive blood pressure control could reduce the incidence of cardiovascular death, stroke, and heart failure. However, it could not reduce the incidence of all-cause death and myocardial infarction. Subgroup analysis showed that systolic blood pressure greater than 140 mmHg could not reduce the incidence of cardiovascular death. The safety evaluation found no increase in adverse events or renal injury in intensive blood pressure control group. Conclusion The current evidence shows that intensive blood pressure control can reduce the incidence of cardiovascular death, stroke and heart failure events in elderly Asian patients over 60 years old, but it has no effect on all-cause mortality and myocardial infarction events. It has good safety. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
【Abstract】 Objective To study the effects of obstructive sleep apnea hypopnea syndrome ( OSAHS) on blood pressure variations, and explore the possible mechanism. Methods 84 adult patients ( mean age 50. 1 ±14. 8 years, male /female 67 /17) were recruited for polysomnography ( PSG) and ambulatory blood pressure monitoring. Four groups were identified based on apnea hyponea index ( AHI) ,ie. non-OSAHS group ( n=9) ,mild group ( n=19) , moderate group ( n=23) , and severe group ( n =33) .The blood pressure levels were compared among the four groups. Correlations between PSG indexes,variations of systolic blood pressure ( SBP) and diastolic blood pressure ( DBP) were analyzed. Results Inter-group blood pressure comparison showed significant differences in SBP and DBP( P lt;0. 05) , except forthe mild and the moderate OSAHS patients. As compared with the non-OSAHS patients, SBP for those with severe OSAHS was about 15 mm Hg higher, and DBP 10 mm Hg higher. Observation on SBP non-dipping rate indicated that, except for the mild and the moderate OSAHS patients where no significant differences were found, SBP non-dipping rate increased with the severity of OSAHS( the rates were 78. 3%, 57. 1% ,54. 5%, and 32. 6% , respectively for the four groups) , whereas DBP non-dipping rate significantly increased in the severe OSAHS patients( 54. 3% ) ( P lt;0. 05) . For the mild OSAHS patients, blood pressure was found to be correlated positively with the body mass index ( correlation coefficient for day time SBP was 0. 26, and for DBP was 0. 22) , the arousal index ( correlation coefficient for day time SBP was 0. 25, and for DBP was 0. 17) , and heart rate variation ( correlation coefficient for night time SBP was 0. 18, and for DBP was 0. 17) . For the moderate OSAHS patients, a positive correlation was also found between blood pressure and AHI ( correlation coefficient for day time SBP was 0. 31, and for DBP was 0. 22, correlation coefficient fornight time SBP was 0. 26) , and between blood pressure and the longest hypopnea time during sleep ( LH) ( correlation coefficient for night time DBP was 0. 2) . For the severe OSAHS patients, blood pressure was correlated positively with apnea index ( AI) ( correlation coefficient for day time SBP was 0. 61, and for DBP was 0. 5, correlation coefficient for night time SBP was 0. 57 and for night time DBP was 0. 48) . Conclusions OSAHS has ber impact on SBP than on DBP. DBP hypertension and SBP non-dipping are usually found in early OSAHS-affected patients. Factors affecting blood pressure differ with the severity of the OSAHS.
Hypertension is the primary disease that endangers human health. A convenient and accurate blood pressure measurement method can help to prevent the hypertension. This paper proposed a continuous blood pressure measurement method based on facial video signal. Firstly, color distortion filtering and independent component analysis were used to extract the video pulse wave of the region of interest in the facial video signal, and the multi-dimensional feature extraction of the pulse wave was preformed based on the time-frequency domain and physiological principles; Secondly, an integrated feature selection method was designed to extract the universal optimal feature subset; After that, we compared the single person blood pressure measurement models established by Elman neural network based on particle swarm optimization, support vector machine (SVM) and deep belief network; Finally, we used SVM algorithm to build a general blood pressure prediction model, which was compared and evaluated with the real blood pressure value. The experimental results showed that the blood pressure measurement results based on facial video were in good agreement with the standard blood pressure values. Comparing the estimated blood pressure from the video with standard blood pressure value, the mean absolute error (MAE) of systolic blood pressure was 4.9 mm Hg with a standard deviation (STD) of 5.9 mm Hg, and the MAE of diastolic blood pressure was 4.6 mm Hg with a STD of 5.0 mm Hg, which met the AAMI standards. The non-contact blood pressure measurement method based on video stream proposed in this paper can be used for blood pressure measurement.
ObjectiveTo systematically review the relationship between frailty and risk of orthostatic hypotension.MethodsPubMed, EMbase, Web of Science, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect studies on the association between frailty and orthostatic hypotension from inception to July 7th, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software.ResultsFive cross-sectional studies involving 8 671 patients were included. The results of meta-analysis showed that prefrailty (OR=1.04, 95%CI 0.99 to 1.09, P=0.11) and frailty (OR=1.02, 95%CI=0.92 to 1.13, P=0.70) were not associated with orthostatic hypotension. The results of subgroup analysis showed that differences of sample size (<500 or ≥500), using different frailty assessment tools (Fried scale, clinical frailty scale, and frailty index), different regions (Europe, Asia, and America) and different sources of studied subjects (hospitals and communities), the risk of orthostatic hypotension were not increased with frailty.ConclusionsCurrent evidence shows that frailty does not increase the risk of orthostatic hypotension. Due to limited quality and quantity of included studies, the above conclusions are needed to be validated by more high-quality studies.