醛固酮瘤患者121例术后血压缓解的影响因素分析及预测模型构建  

Analysis of influencing factors and construction of prediction model for postoperative blood pressure relief in 121 patients with aldosteronoma

作　　者：连梦青 邵明玮[1] 任高飞[1] 宋春花[2] 王芳[1] 王玮杰 陈远思 樊亚亚 卫芳祎 秦贵军[1] LIAN Meng-qing;SHAO Ming-wei;REN Gao-fei;SONG Chun-hua;WANG Fang;WANG Wei-jie;CHEN Yuan-si;FAN Ya-ya;WEI Fang-yi;QIN Gui-jun(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;不详)

机构地区：[1]郑州大学第一附属医院内分泌与代谢病科,河南郑州450052 [2]郑州大学公共卫生学院流行病学教研室,河南郑州450052

出　　处：《中国实用内科杂志》2025年第2期131-135,共5页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金(82170839)。

摘　　要：目的探讨醛固酮瘤患者术后血压缓解的影响因素并建立预测模型。方法收集2014年4月至2021年9月期间郑州大学第一附属医院行手术治疗的醛固酮瘤患者的临床资料。随访术后血压、口服降压药物的剂量与种类、血钾。根据术后随访情况分为血压正常组及血压异常组,采用Logistic回归分析影响因素并构建术后血压缓解的预测模型。结果共121例患者符合纳入标准,病例随访时间为6个月至7年5个月,中位随访时间1年9个月。性别(男、P=0.018、OR=3.213)、体质量指数(BMI)(22.97~25.75、P=0.048、OR=3.257;≥25.75、P=0.003、OR=6.624)、年龄(≥47岁、P<0.001、OR=9.669)、血钙水平(2.25~2.35 mmol/L、P=0.014、OR=3.877;≥2.35 mmol/L、P=0.034、OR=3.990)为醛固酮瘤术后血压缓解的主要影响因素,构建了由这四项指标组成的醛固酮瘤术后血压缓解的预测模型,模型曲线下面积(AUC)为0.838(95%置信区间0.766~0.910)。结论男性、高BMI、高龄、术前高血清钙的患者,术后血压异常的概率将增加。根据危险因素建立的模型对预后有较好的区分度。Objective To explore the influencing factors of postoperative blood pressure relief in patients with aldosteronoma and establish a prediction model.Methods Clinical data of patients with aldosteronoma who underwent surgical treatment in the First Affiliated Hospital of Zhengzhou University from April 2014 to September 2021 were collected.Postoperative blood pressure,dosage and type of oral antihypertensive drugs and blood potassium were followed up.According to the data,the patients were divided into normal blood pressure group and abnormal blood pressure group.Logistic regression was used to analyze the influencing factors and the prediction model of postoperative blood pressure relief was built.ResultsA total of 121 patients were included,and the follow-up time was from 6 months to 7 years and 5 months,with a median follow-up time of 1 year and 9 months.Gender(male,P=0.018,OR=3.213),body mass index(BMI)(22.97-25.75,P=0.048,0R=3.257;≥25.75,P=0.003,0R=6.624),age(≥47 years,P<0.001,0R=9.669),and blood calcium level(2.25-2.35 mmol/L,P=0.014,OR=3.877;≥2.35 mmol/L,P=0.034,0R=3.990)were the main influencing factors of blood pressure relief after aldosteronoma surgery.A prediction model of blood pressure relief after aldosteronoma surgery was constructed,and the area under the curve(AUC)of the model was 0.838(95%confidence interval 0.766-0.910).Conclusion For elderly male patients with high BMI,and high serum calcium before surgery,the probability of abnormal blood pressure after surgery will increase.The model established according to the risk factors has a good differentiation of prognosis.

关 键 词：醛固酮瘤 手术治疗 预后 预测模型 

分 类 号：R586.9[医药卫生—内分泌]