南方医科大学学报 ›› 2026, Vol. 46 ›› Issue (8): 1764-1778.doi: 10.12122/j.issn.1673-4254.2026.08.05
向海艳1,2(
), 陈秀娟3, 王来友1,2, 赖伟华1,2(
)
收稿日期:2025-12-24
出版日期:2026-08-20
发布日期:2026-08-01
通讯作者:
赖伟华
E-mail:x3143026490@outlook.com;laiweihuax@163.com
作者简介:向海艳,在读硕士研究生,E-mail: x3143026490@outlook.com
基金资助:
Haiyan XIANG1,2(
), Xiujuan CHEN3, Laiyou WANG1,2, Weihua LAI1,2(
)
Received:2025-12-24
Online:2026-08-20
Published:2026-08-01
Contact:
Weihua LAI
E-mail:x3143026490@outlook.com;laiweihuax@163.com
Supported by:摘要:
目的 探讨非创伤性蛛网膜下腔出血(NSAH)患者入院早期平均动脉压变异性(MBPV)与院内死亡的关联。 方法 基于重症监护医学信息数据库Ⅳ版(MIMIC-Ⅳ)与电子重症监护病房协作研究数据库(eICU-CRD),纳入1345~1820例NSAH患者。提取入院24、48、72 h平均动脉压(MBP)数据,计算标准差(SD)、平均真实变异性(ARV)、极差(Range)、连续变异(SV)作为MBPV指标。采用限制性立方样条(RCS)结合Cox回归分析非线性关系,分段回归确定风险拐点;对违反比例风险假设的指标进行时依Cox回归;并通过排除72 h内手术者、药物信息缺失者两项敏感性分析验证结果稳健性。 结果 各时间窗MBPV均与院内死亡呈显著U型非线性关联(均P<0.05),过低或过高波动均升高死亡风险,其中入院24 h关联最强、稳定性最优。时依分析显示,ARV、SV的风险效应在入院4~7 d后更显著,SD、Range的风险效应则主要集中于入院前14 d。综合稳定性分析显示,24 h和72 h的MBPV为关联最稳健的指标。两项敏感性分析结果与主分析一致。 结论 NSAH患者早期MBPV与院内死亡呈U型关联,中等波动提示更佳预后;24 h的MBPV可作为早期血压监测的首选指标。
向海艳, 陈秀娟, 王来友, 赖伟华. 重症蛛网膜下腔出血患者入院早期平均动脉压变异性与院内死亡风险的U形关系:基于MIMIC-IV和eICU-CRD数据库[J]. 南方医科大学学报, 2026, 46(8): 1764-1778.
Haiyan XIANG, Xiujuan CHEN, Laiyou WANG, Weihua LAI. Early mean arterial pressure variability and in-hospital mortality from severe subarachnoid hemorrhage: a U-shaped association based on MIMIC-IV and eICU-CRD data[J]. Journal of Southern Medical University, 2026, 46(8): 1764-1778.
| Variable | Total (n=1820) | Survival (n=1493) | Death (n=327) | P | |
|---|---|---|---|---|---|
| Age [year, Median (IQR)] | 60.3 (50.0, 71.9) | 59.1 (49.5, 70.4) | 66.0 (54.8, 78.9) | <0.001 | |
| Gender [n (%)] | 0.338 | ||||
| Female | 1045 (57.4) | 865 (57.9) | 180 (55) | ||
| Male | 775 (42.6) | 628 (42.1) | 147 (45) | ||
| Race [n (%)] | <0.001 | ||||
| White | 1173 (64.5) | 994 (66.6) | 179 (54.7) | ||
| Asian | 56 (3.1) | 42 (2.8) | 14 (4.3) | ||
| Black | 149 (8.2) | 130 (8.7) | 19 (5.8) | ||
| Other | 442 (24.3) | 327 (21.9) | 115 (35.2) | ||
| Clinical scores | |||||
| GCS [Median (IQR)] | 14.0 (7.0, 15.0) | 14.0 (9.0, 15.0) | 6.0 (3.0, 10.0) | <0.001 | |
| SAPS Ⅱ [Median (IQR)] | 27.0 (20.0, 38.0) | 26.0 (18.0, 34.0) | 39.0 (32.0, 49.0) | <0.001 | |
| PAASH scale [n (%)] | <0.001 | ||||
| I | 725 (42.0) | 696 (48.8) | 29 (9.6) | ||
| II | 348 (20.1) | 310 (21.8) | 38 (12.5) | ||
| III | 185 (10.7) | 150 (10.5) | 35 (11.6) | ||
| IV | 278 (16.1) | 172 (12.1) | 106 (35) | ||
| V | 192 (11.1) | 97 (6.8) | 95 (31.4) | ||
| Comorbidities and personal history [n (%)] | |||||
| Stroke history | 106 (5.8) | 85 (5.7) | 21 (6.4) | 0.61 | |
| Hypertension | 807 (44.3) | 660 (44.2) | 147 (45) | 0.805 | |
| Diabetes | 180 (9.9) | 136 (9.1) | 44 (13.5) | 0.017 | |
| Pneumonia | 39 (5.9) | 29 (5.2) | 10 (9.4) | 0.092 | |
| Epilepsy | 42 (6.4) | 31 (5.6) | 11 (10.4) | 0.064 | |
| Interventions after admission [n (%)] | |||||
| Clipping within 24 h | 68 (3.7) | 59 (4) | 9 (2.8) | 0.3 | |
| Clipping within 48 h | 76 (4.2) | 67 (4.5) | 9 (2.8) | 0.155 | |
| Clipping within 72 h | 79 (4.3) | 70 (4.7) | 9 (2.8) | 0.12 | |
| Endovascular intervention within 24 h | 420 (23.1) | 373 (25) | 47 (14.4) | <0.001 | |
| Endovascular intervention within 48 h | 448 (24.6) | 398 (26.7) | 50 (15.3) | <0.001 | |
| Endovascular intervention within 72 h | 458 (25.2) | 408 (27.3) | 50 (15.3) | <0.001 | |
| Mechanical ventilation within 24 h | 764 (39.4) | 475 (30.4) | 289 (77.5) | <0.001 | |
| Mechanical ventilation within 48 h | 786 (40.6) | 493 (31.5) | 293 (78.6) | <0.001 | |
| Mechanical ventilation within 72 h | 801 (41.4) | 503 (32.2) | 298 (79.9) | <0.001 | |
| Antihypertensive within 24 h | 687 (35.5) | 558 (35.7) | 129 (34.6) | 0.692 | |
| Antihypertensive within 48 h | 774 (40.0) | 623 (39.8) | 151 (40.5) | 0.818 | |
| Antihypertensive within 72 h | 831 (42.9) | 669 (42.8) | 162 (43.4) | 0.818 | |
| Nimodipine within 24 h | 360 (24.3) | 328 (27.2) | 32 (11.8) | <0.001 | |
| Nimodipine within 48 h | 401 (27.1) | 365 (30.2) | 36 (13.2) | <0.001 | |
| Nimodipine within 72 h | 426 (28.8) | 388 (32.1) | 38 (14) | <0.001 | |
| Sedatives within 24 h | 538 (36.4) | 406 (33.6) | 132 (48.5) | <0.001 | |
| Sedatives within 48 h | 614 (41.5) | 464 (38.4) | 150 (55.1) | <0.001 | |
| Sedatives within 72 h | 661 (44.7) | 500 (41.4) | 161 (59.2) | <0.001 | |
| Vasopressors within 24 h | 150 (10.1) | 92 (7.6) | 58 (21.3) | <0.001 | |
| Vasopressors within 48 h | 185 (12.5) | 118 (9.8) | 67 (24.6) | <0.001 | |
| Vasopressors within 72 h | 209 (14.1) | 131 (10.8) | 78 (28.7) | <0.001 | |
表2 患者基线特征
Tab.2 Characteristics of the included patients
| Variable | Total (n=1820) | Survival (n=1493) | Death (n=327) | P | |
|---|---|---|---|---|---|
| Age [year, Median (IQR)] | 60.3 (50.0, 71.9) | 59.1 (49.5, 70.4) | 66.0 (54.8, 78.9) | <0.001 | |
| Gender [n (%)] | 0.338 | ||||
| Female | 1045 (57.4) | 865 (57.9) | 180 (55) | ||
| Male | 775 (42.6) | 628 (42.1) | 147 (45) | ||
| Race [n (%)] | <0.001 | ||||
| White | 1173 (64.5) | 994 (66.6) | 179 (54.7) | ||
| Asian | 56 (3.1) | 42 (2.8) | 14 (4.3) | ||
| Black | 149 (8.2) | 130 (8.7) | 19 (5.8) | ||
| Other | 442 (24.3) | 327 (21.9) | 115 (35.2) | ||
| Clinical scores | |||||
| GCS [Median (IQR)] | 14.0 (7.0, 15.0) | 14.0 (9.0, 15.0) | 6.0 (3.0, 10.0) | <0.001 | |
| SAPS Ⅱ [Median (IQR)] | 27.0 (20.0, 38.0) | 26.0 (18.0, 34.0) | 39.0 (32.0, 49.0) | <0.001 | |
| PAASH scale [n (%)] | <0.001 | ||||
| I | 725 (42.0) | 696 (48.8) | 29 (9.6) | ||
| II | 348 (20.1) | 310 (21.8) | 38 (12.5) | ||
| III | 185 (10.7) | 150 (10.5) | 35 (11.6) | ||
| IV | 278 (16.1) | 172 (12.1) | 106 (35) | ||
| V | 192 (11.1) | 97 (6.8) | 95 (31.4) | ||
| Comorbidities and personal history [n (%)] | |||||
| Stroke history | 106 (5.8) | 85 (5.7) | 21 (6.4) | 0.61 | |
| Hypertension | 807 (44.3) | 660 (44.2) | 147 (45) | 0.805 | |
| Diabetes | 180 (9.9) | 136 (9.1) | 44 (13.5) | 0.017 | |
| Pneumonia | 39 (5.9) | 29 (5.2) | 10 (9.4) | 0.092 | |
| Epilepsy | 42 (6.4) | 31 (5.6) | 11 (10.4) | 0.064 | |
| Interventions after admission [n (%)] | |||||
| Clipping within 24 h | 68 (3.7) | 59 (4) | 9 (2.8) | 0.3 | |
| Clipping within 48 h | 76 (4.2) | 67 (4.5) | 9 (2.8) | 0.155 | |
| Clipping within 72 h | 79 (4.3) | 70 (4.7) | 9 (2.8) | 0.12 | |
| Endovascular intervention within 24 h | 420 (23.1) | 373 (25) | 47 (14.4) | <0.001 | |
| Endovascular intervention within 48 h | 448 (24.6) | 398 (26.7) | 50 (15.3) | <0.001 | |
| Endovascular intervention within 72 h | 458 (25.2) | 408 (27.3) | 50 (15.3) | <0.001 | |
| Mechanical ventilation within 24 h | 764 (39.4) | 475 (30.4) | 289 (77.5) | <0.001 | |
| Mechanical ventilation within 48 h | 786 (40.6) | 493 (31.5) | 293 (78.6) | <0.001 | |
| Mechanical ventilation within 72 h | 801 (41.4) | 503 (32.2) | 298 (79.9) | <0.001 | |
| Antihypertensive within 24 h | 687 (35.5) | 558 (35.7) | 129 (34.6) | 0.692 | |
| Antihypertensive within 48 h | 774 (40.0) | 623 (39.8) | 151 (40.5) | 0.818 | |
| Antihypertensive within 72 h | 831 (42.9) | 669 (42.8) | 162 (43.4) | 0.818 | |
| Nimodipine within 24 h | 360 (24.3) | 328 (27.2) | 32 (11.8) | <0.001 | |
| Nimodipine within 48 h | 401 (27.1) | 365 (30.2) | 36 (13.2) | <0.001 | |
| Nimodipine within 72 h | 426 (28.8) | 388 (32.1) | 38 (14) | <0.001 | |
| Sedatives within 24 h | 538 (36.4) | 406 (33.6) | 132 (48.5) | <0.001 | |
| Sedatives within 48 h | 614 (41.5) | 464 (38.4) | 150 (55.1) | <0.001 | |
| Sedatives within 72 h | 661 (44.7) | 500 (41.4) | 161 (59.2) | <0.001 | |
| Vasopressors within 24 h | 150 (10.1) | 92 (7.6) | 58 (21.3) | <0.001 | |
| Vasopressors within 48 h | 185 (12.5) | 118 (9.8) | 67 (24.6) | <0.001 | |
| Vasopressors within 72 h | 209 (14.1) | 131 (10.8) | 78 (28.7) | <0.001 | |
图2 基于Cox回归调整协变量的MBPV与院内死亡的限制性立方样条曲线
Fig.2 Restricted cubic spline curves of the association between MBPV and in-hospital mortality based on covariate-adjusted Cox regression. A1: MBP SD within 24 h. B1: MBP ARV within 24 h. C1: MBP Range within 24 h. D1: MBP SV within 24 h. A2: MBP SD within 48 h. B2: MBP ARV within 48 h. C2: MBP Range within 48 h. D2: MBP SV within 48 h. A3: MBP SD within 72 h. B3: MBP ARV within 72 h. C3: MBP Range within 72 h. D3: MBP SV within 72 h.
| Variable | Breakpoint | Model 1 | Model 2 | ||||
|---|---|---|---|---|---|---|---|
| HR (95% CI) | P | LRT (P value) | HR (95% CI) | P | LRT (P value) | ||
| MBP SD within 24 h | <8.9 | 0.88 (0.79, 0.97) | 0.013 | <0.001 | 0.86 (0.78, 0.95) | 0.004 | <0.001 |
| ≥8.9 | 1.11 (1.06, 1.16) | <0.001 | 1.10 (1.06, 1.15) | <0.001 | |||
| MBP ARV within 24 h | <6.5 | 0.85 (0.74, 0.98) | 0.03 | 0.014 | 0.85 (0.73, 0.98) | 0.022 | 0.008 |
| ≥6.5 | 1.07 (1.01, 1.13) | 0.016 | 1.08 (1.02, 1.14) | 0.005 | |||
| MBP Range within 24 h | <39.9 | 0.98 (0.96, 0.99) | 0.009 | <0.001 | 0.98 (0.96, 0.99) | 0.008 | <0.001 |
| ≥39.9 | 1.02 (1.01, 1.03) | <0.001 | 1.02 (1.01, 1.03) | <0.001 | |||
| MBP SV within 24 h | <9.2 | 0.89 (0.81, 0.98) | 0.016 | 0.002 | 0.89 (0.81, 0.98) | 0.020 | 0.003 |
| ≥9.2 | 1.08(1.03, 1.12) | <0.001 | 1.08 (1.03, 1.12) | <0.001 | |||
| MBP SD within 48 h | <11 | 0.91 (0.84, 1.00) | 0.038 | 0.011 | 0.93 (0.85, 1.01) | 0.103 | 0.026 |
| ≥11 | 1.10 (1.02, 1.20) | 0.017 | 1.10 (1.02, 1.20) | 0.018 | |||
| MBP ARV within 48 h | <7.3 | 0.82 (0.72, 0.93) | 0.003 | 0.011 | 0.84 (0.73, 0.96) | 0.009 | 0.007 |
| ≥7.3 | 1.04 (0.96, 1.13) | 0.289 | 1.09 (1.00, 1.18) | 0.041 | |||
| MBP Range within 48 h | <51 | 0.98 (0.96, 0.99) | 0.011 | 0.007 | 0.99 (0.97, 1.00) | 0.100 | 0.032 |
| ≥51 | 1.02 (1.00, 1.03) | 0.025 | 1.02 (1.00, 1.03) | 0.025 | |||
| MBP SV within 48 h | <10.4 | 0.89 (0.82, 0.98) | 0.015 | 0.018 | 0.93 (0.85, 1.01) | 0.096 | 0.059 |
| ≥10.4 | 1.05 (0.99, 1.11) | 0.119 | 1.05 (0.99, 1.12) | 0.095 | |||
| MBP SD within 72 h | <12 | 0.90 (0.82, 0.98) | 0.014 | 0.005 | 0.93 (0.85, 1.01) | 0.087 | 0.012 |
| ≥12 | 1.17 (1.04, 1.33) | 0.011 | 1.18 (1.04, 1.33) | 0.009 | |||
| MBP ARV within 72 h | <8.3 | 0.81 (0.72, 0.91) | <0.001 | 0.005 | 0.86 (0.76, 0.97) | 0.016 | 0.008 |
| ≥8.3 | 1.10 (0.97, 1.24) | 0.13 | 1.15 (1.02, 1.30) | 0.023 | |||
| MBP Range within 72 h | <59.7 | 0.98 (0.96, 0.99) | 0.003 | 0.001 | 0.98 (0.97, 1.00) | 0.061 | 0.014 |
| ≥59.7 | 1.03 (1.01, 1.05) | 0.005 | 1.02 (1.00, 1.04) | 0.013 | |||
| MBP SV within 72 h | <10.8 | 0.86 (0.78, 0.95) | 0.004 | 0.019 | 0.90 (0.81, 0.99) | 0.036 | 0.027 |
| ≥10.8 | 1.05 (0.96, 1.14) | 0.267 | 1.08 (0.99, 1.17) | 0.078 | |||
表3 拐点分析
Tab.3 Threshold effect analysis
| Variable | Breakpoint | Model 1 | Model 2 | ||||
|---|---|---|---|---|---|---|---|
| HR (95% CI) | P | LRT (P value) | HR (95% CI) | P | LRT (P value) | ||
| MBP SD within 24 h | <8.9 | 0.88 (0.79, 0.97) | 0.013 | <0.001 | 0.86 (0.78, 0.95) | 0.004 | <0.001 |
| ≥8.9 | 1.11 (1.06, 1.16) | <0.001 | 1.10 (1.06, 1.15) | <0.001 | |||
| MBP ARV within 24 h | <6.5 | 0.85 (0.74, 0.98) | 0.03 | 0.014 | 0.85 (0.73, 0.98) | 0.022 | 0.008 |
| ≥6.5 | 1.07 (1.01, 1.13) | 0.016 | 1.08 (1.02, 1.14) | 0.005 | |||
| MBP Range within 24 h | <39.9 | 0.98 (0.96, 0.99) | 0.009 | <0.001 | 0.98 (0.96, 0.99) | 0.008 | <0.001 |
| ≥39.9 | 1.02 (1.01, 1.03) | <0.001 | 1.02 (1.01, 1.03) | <0.001 | |||
| MBP SV within 24 h | <9.2 | 0.89 (0.81, 0.98) | 0.016 | 0.002 | 0.89 (0.81, 0.98) | 0.020 | 0.003 |
| ≥9.2 | 1.08(1.03, 1.12) | <0.001 | 1.08 (1.03, 1.12) | <0.001 | |||
| MBP SD within 48 h | <11 | 0.91 (0.84, 1.00) | 0.038 | 0.011 | 0.93 (0.85, 1.01) | 0.103 | 0.026 |
| ≥11 | 1.10 (1.02, 1.20) | 0.017 | 1.10 (1.02, 1.20) | 0.018 | |||
| MBP ARV within 48 h | <7.3 | 0.82 (0.72, 0.93) | 0.003 | 0.011 | 0.84 (0.73, 0.96) | 0.009 | 0.007 |
| ≥7.3 | 1.04 (0.96, 1.13) | 0.289 | 1.09 (1.00, 1.18) | 0.041 | |||
| MBP Range within 48 h | <51 | 0.98 (0.96, 0.99) | 0.011 | 0.007 | 0.99 (0.97, 1.00) | 0.100 | 0.032 |
| ≥51 | 1.02 (1.00, 1.03) | 0.025 | 1.02 (1.00, 1.03) | 0.025 | |||
| MBP SV within 48 h | <10.4 | 0.89 (0.82, 0.98) | 0.015 | 0.018 | 0.93 (0.85, 1.01) | 0.096 | 0.059 |
| ≥10.4 | 1.05 (0.99, 1.11) | 0.119 | 1.05 (0.99, 1.12) | 0.095 | |||
| MBP SD within 72 h | <12 | 0.90 (0.82, 0.98) | 0.014 | 0.005 | 0.93 (0.85, 1.01) | 0.087 | 0.012 |
| ≥12 | 1.17 (1.04, 1.33) | 0.011 | 1.18 (1.04, 1.33) | 0.009 | |||
| MBP ARV within 72 h | <8.3 | 0.81 (0.72, 0.91) | <0.001 | 0.005 | 0.86 (0.76, 0.97) | 0.016 | 0.008 |
| ≥8.3 | 1.10 (0.97, 1.24) | 0.13 | 1.15 (1.02, 1.30) | 0.023 | |||
| MBP Range within 72 h | <59.7 | 0.98 (0.96, 0.99) | 0.003 | 0.001 | 0.98 (0.97, 1.00) | 0.061 | 0.014 |
| ≥59.7 | 1.03 (1.01, 1.05) | 0.005 | 1.02 (1.00, 1.04) | 0.013 | |||
| MBP SV within 72 h | <10.8 | 0.86 (0.78, 0.95) | 0.004 | 0.019 | 0.90 (0.81, 0.99) | 0.036 | 0.027 |
| ≥10.8 | 1.05 (0.96, 1.14) | 0.267 | 1.08 (0.99, 1.17) | 0.078 | |||
图4 排除入院72 h内手术患者后基于Cox回归调整协变量的MBPV与院内死亡的限制性立方样条曲线
Fig.4 Restricted cubic spline curves of the association between MBPV and in-hospital mortality based on covariate-adjusted Cox regression, after excluding patients who underwent surgery within 72 hours of admission.A1: MBP SD within 24 h. B1: MBP ARV within 24 h. C1: MBP Range within 24 h. D1: MBP SV within 24 h. A2: MBP SD within 48 h. B2: MBP ARV within 48 h. C2: MBP Range within 48 h. D2: MBP SV within 48 h. A3: MBP SD within 72 h. B3: MBP ARV within 72 h. C3: MBP Range within 72 h. D3: MBP SV within 72 h.
图5 入院24 h Kaplan-Meier生存曲线
Fig.5 Kaplan-Meier survival analysis within the first 24 h after admission. A: MBP SD within 24 h. B: MBP ARV within 24 h. C: MBP Range within 24 h. D: MBP SV within 24 h.
图6 入院48 h Kaplan-Meier生存曲线
Fig.6 Kaplan-Meier survival analysis within the first 48 hours after admission. A: MBP SD within 48 h. B: MBP ARV within 48 h. C: MBP Range within 48 h. D: MBP SV within 48 h.
图7 入院72 h Kaplan-Meier生存曲线
Fig7 Kaplan-Meier survival analysis within the first 72 hours after admission. A: MBP SD within 72 h.B: MBP ARV within 72 h. C: MBP Range within 72 h. D: MBP SV within 72 h.
| Variable | Breakpoint | Model 1 | Model 2 | ||||
|---|---|---|---|---|---|---|---|
| HR (95% CI) | P | LRT (P value) | HR (95%CI) | P | LRT (P value) | ||
| MBP SD within 24 h | <8.9 | 0.85(0.77, 0.95) | 0.004 | <0.001 | 0.83 (0.74, 0.92) | <0.001 | <0.001 |
| ≥8.9 | 1.13 (1.07, 1.19) | <0.001 | 1.11 (1.06, 1.16) | <0.001 | |||
| MBP ARV within 24 h | <6.5 | 0.86(0.74, 1.00) | 0.055 | 0.023 | 0.83 (0.70, 0.97) | 0.018 | 0.006 |
| ≥6.5 | 1.08 (1.02, 1.14) | 0.013 | 1.09 (1.03, 1.15) | 0.005 | |||
| MBP Range within 24 h | <39.9 | 0.97 (0.95, 0.99) | 0.001 | <0.001 | 0.97 (0.95, 0.99) | <0.001 | <0.001 |
| ≥39.9 | 1.03(1.01, 1.04) | <0.001 | 1.03 (1.01, 1.04) | <0.001 | |||
| MBP SV within 24 h | <9.2 | 0.88(0.80, 0.98) | 0.016 | 0.002 | 0.87 (0.78, 0.96) | 0.007 | <0.001 |
| ≥9.2 | 1.09 (1.04, 1.13) | <0.001 | 1.09 (1.04, 1.14) | <0.001 | |||
| MBP SD within 48 h | <11 | 0.89 (0.81, 0.98) | 0.015 | 0.002 | 0.90 (0.81, 0.99) | 0.039 | 0.008 |
| ≥11 | 1.15 (1.05, 1.25) | 0.002 | 1.13 (1.04, 1.24) | 0.006 | |||
| MBP ARV within 48 h | <7.3 | 0.81 (0.71, 0.93) | 0.003 | 0.008 | 0.83 (0.71, 0.96) | 0.011 | 0.005 |
| ≥7.3 | 1.07 (0.98, 1.16) | 0.148 | 1.11 (1.02, 1.22) | 0.019 | |||
| MBP Range within 48 h | <51 | 0.97 (0.95, 0.99) | 0.002 | <0.001 | 0.98 (0.96, 1.00) | 0.030 | 0.007 |
| ≥51 | 1.03 (1.01, 1.04) | 0.002 | 1.02 (1.01, 1.04) | 0.006 | |||
| MBP SV within 48 h | <10.4 | 0.90 (0.81, 0.99) | 0.03 | 0.021 | 0.93 (0.84, 1.02) | 0.133 | 0.062 |
| ≥10.4 | 1.06 (1.00, 1.13) | 0.068 | 1.06 (1.00, 1.14) | 0.061 | |||
| MBP SD within 72 h | <12 | 0.84 (0.76, 0.93) | <0.001 | <0.001 | 0.86 (0.78, 0.95) | 0.004 | <0.001 |
| ≥12 | 1.30 (1.13, 1.49) | <0.001 | 1.27 (1.11, 1.45) | <0.001 | |||
| MBP ARV within 72 h | <8.3 | 0.78 (0.68, 0.89) | <0.001 | 0.001 | 0.82 (0.71, 0.94) | 0.005 | 0.001 |
| ≥8.3 | 1.16 (1.01, 1.33) | 0.033 | 1.22 (1.06, 1.40) | 0.004 | |||
| MBP Range within 72 h | <59.7 | 0.96 (0.95, 0.98) | <0.001 | <0.001 | 0.97 (0.95, 0.99) | 0.004 | 0.002 |
| ≥59.7 | 1.04 (1.02, 1.06) | <0.001 | 1.03 (1.01, 1.05) | 0.006 | |||
| MBP SV within 72 h | <10.8 | 0.84 (0.75, 0.94) | 0.002 | 0.007 | 0.87 (0.77, 0.97) | 0.014 | 0.009 |
| ≥10.8 | 1.08 (0.98, 1.18) | 0.103 | 1.11 (1.01, 1.22) | 0.031 | |||
表4 排除入院72h内手术患者后各MBPV指标的COX分析结果
Tab. 4 Results of Cox analysis for each MBPV index after excluding patients undergoing surgery within 72 hours of admission
| Variable | Breakpoint | Model 1 | Model 2 | ||||
|---|---|---|---|---|---|---|---|
| HR (95% CI) | P | LRT (P value) | HR (95%CI) | P | LRT (P value) | ||
| MBP SD within 24 h | <8.9 | 0.85(0.77, 0.95) | 0.004 | <0.001 | 0.83 (0.74, 0.92) | <0.001 | <0.001 |
| ≥8.9 | 1.13 (1.07, 1.19) | <0.001 | 1.11 (1.06, 1.16) | <0.001 | |||
| MBP ARV within 24 h | <6.5 | 0.86(0.74, 1.00) | 0.055 | 0.023 | 0.83 (0.70, 0.97) | 0.018 | 0.006 |
| ≥6.5 | 1.08 (1.02, 1.14) | 0.013 | 1.09 (1.03, 1.15) | 0.005 | |||
| MBP Range within 24 h | <39.9 | 0.97 (0.95, 0.99) | 0.001 | <0.001 | 0.97 (0.95, 0.99) | <0.001 | <0.001 |
| ≥39.9 | 1.03(1.01, 1.04) | <0.001 | 1.03 (1.01, 1.04) | <0.001 | |||
| MBP SV within 24 h | <9.2 | 0.88(0.80, 0.98) | 0.016 | 0.002 | 0.87 (0.78, 0.96) | 0.007 | <0.001 |
| ≥9.2 | 1.09 (1.04, 1.13) | <0.001 | 1.09 (1.04, 1.14) | <0.001 | |||
| MBP SD within 48 h | <11 | 0.89 (0.81, 0.98) | 0.015 | 0.002 | 0.90 (0.81, 0.99) | 0.039 | 0.008 |
| ≥11 | 1.15 (1.05, 1.25) | 0.002 | 1.13 (1.04, 1.24) | 0.006 | |||
| MBP ARV within 48 h | <7.3 | 0.81 (0.71, 0.93) | 0.003 | 0.008 | 0.83 (0.71, 0.96) | 0.011 | 0.005 |
| ≥7.3 | 1.07 (0.98, 1.16) | 0.148 | 1.11 (1.02, 1.22) | 0.019 | |||
| MBP Range within 48 h | <51 | 0.97 (0.95, 0.99) | 0.002 | <0.001 | 0.98 (0.96, 1.00) | 0.030 | 0.007 |
| ≥51 | 1.03 (1.01, 1.04) | 0.002 | 1.02 (1.01, 1.04) | 0.006 | |||
| MBP SV within 48 h | <10.4 | 0.90 (0.81, 0.99) | 0.03 | 0.021 | 0.93 (0.84, 1.02) | 0.133 | 0.062 |
| ≥10.4 | 1.06 (1.00, 1.13) | 0.068 | 1.06 (1.00, 1.14) | 0.061 | |||
| MBP SD within 72 h | <12 | 0.84 (0.76, 0.93) | <0.001 | <0.001 | 0.86 (0.78, 0.95) | 0.004 | <0.001 |
| ≥12 | 1.30 (1.13, 1.49) | <0.001 | 1.27 (1.11, 1.45) | <0.001 | |||
| MBP ARV within 72 h | <8.3 | 0.78 (0.68, 0.89) | <0.001 | 0.001 | 0.82 (0.71, 0.94) | 0.005 | 0.001 |
| ≥8.3 | 1.16 (1.01, 1.33) | 0.033 | 1.22 (1.06, 1.40) | 0.004 | |||
| MBP Range within 72 h | <59.7 | 0.96 (0.95, 0.98) | <0.001 | <0.001 | 0.97 (0.95, 0.99) | 0.004 | 0.002 |
| ≥59.7 | 1.04 (1.02, 1.06) | <0.001 | 1.03 (1.01, 1.05) | 0.006 | |||
| MBP SV within 72 h | <10.8 | 0.84 (0.75, 0.94) | 0.002 | 0.007 | 0.87 (0.77, 0.97) | 0.014 | 0.009 |
| ≥10.8 | 1.08 (0.98, 1.18) | 0.103 | 1.11 (1.01, 1.22) | 0.031 | |||
| Variable | Breakpoint | Model 1 | Model 2 | ||||
|---|---|---|---|---|---|---|---|
| HR (95% CI) | P | LRT (P value) | HR (95% CI) | P | LRT (P value) | ||
| MBP SD within 24 h | <8.9 | 0.84 (0.75, 0.94) | 0.003 | <0.001 | 0.84 (0.75, 0.94) | 0.003 | <0.001 |
| ≥8.9 | 1.11 (1.05, 1.17) | <0.001 | 1.11 (1.06, 1.17) | <0.001 | |||
| MBP ARV within 24 h | <6.5 | 0.87 (0.73, 1.02) | 0.09 | 0.057 | 0.88 (0.75, 1.05) | 0.156 | 0.045 |
| ≥6.5 | 1.06 (1.00, 1.13) | 0.067 | 1.10 (1.03, 1.17) | 0.004 | |||
| MBP Range within 24 h | <39.9 | 0.97 (0.95, 0.99) | 0.004 | <0.001 | 0.97 (0.95, 0.99) | 0.011 | 0.002 |
| ≥39.9 | 1.02 (1.01, 1.04) | <0.001 | 1.02 (1.01, 1.04) | 0.001 | |||
| MBP SV within 24 h | <9.2 | 0.90 (0.80, 1.00) | 0.057 | 0.019 | 0.91 (0.82, 1.02) | 0.121 | 0.026 |
| ≥9.2 | 1.07 (1.02, 1.12) | 0.008 | 1.08 (1.03, 1.13) | 0.002 | |||
| MBP SD within 48 h | <11 | 0.91 (0.83, 1.01) | 0.064 | 0.023 | 0.90 (0.81, 0.99) | 0.037 | 0.008 |
| ≥11 | 1.10 (1.01, 1.21) | 0.033 | 1.13 (1.03, 1.24) | 0.008 | |||
| MBP ARV within 48 h | <7.3 | 0.83 (0.72, 0.96) | 0.015 | 0.032 | 0.85 (0.73, 0.99) | 0.038 | 0.026 |
| ≥7.3 | 1.05 (0.96, 1.16) | 0.288 | 1.09 (0.99, 1.21) | 0.072 | |||
| MBP Range within 48 h | <51 | 0.97 (0.96, 0.99) | 0.01 | 0.006 | 0.98 (0.96, 1.00) | 0.04 | 0.023 |
| ≥51 | 1.02 (1.00, 1.04) | 0.023 | 1.02 (1.00, 1.04) | 0.046 | |||
| MBP SV within 48 h | <10.4 | 0.90 (0.81, 1.00) | 0.047 | 0.073 | 0.93 (0.84, 1.03) | 0.175 | 0.127 |
| ≥10.4 | 1.04 (0.97, 1.11) | 0.325 | 1.05 (0.98, 1.13) | 0.196 | |||
| MBP SD within 72 h | <12 | 0.89 (0.80, 0.98) | 0.016 | 0.006 | 0.89 (0.80, 0.98) | 0.019 | 0.005 |
| ≥12 | 1.19 (1.04, 1.37) | 0.014 | 1.21 (1.05, 1.39) | 0.009 | |||
| MBP ARV within 72 h | <8.3 | 0.79 (0.69, 0.91) | <0.001 | 0.003 | 0.83 (0.72, 0.95) | 0.009 | 0.005 |
| ≥8.3 | 1.13 (0.99, 1.30) | 0.068 | 1.18 (1.03, 1.35) | 0.018 | |||
| MBP Range within 72 h | <59.7 | 0.97 (0.95, 0.99) | 0.003 | 0.005 | 0.97 (0.96, 0.99) | 0.009 | 0.009 |
| ≥59.7 | 1.02 (1.00, 1.05) | 0.041 | 1.02 (1.00, 1.05) | 0.039 | |||
| MBP SV within 72 h | <10.8 | 0.84 (0.75, 0.94) | 0.003 | 0.017 | 0.86 (0.77, 0.97) | 0.013 | 0.016 |
| ≥10.8 | 1.05 (0.95, 1.15) | 0.314 | 1.08 (0.99, 1.19) | 0.097 | |||
表 5 排除入院药物缺失患者后各 MBPV 指标的 COX 分析结果
Tab.5 Results of Cox analysis for each MBPV index after excluding patients missing medication
| Variable | Breakpoint | Model 1 | Model 2 | ||||
|---|---|---|---|---|---|---|---|
| HR (95% CI) | P | LRT (P value) | HR (95% CI) | P | LRT (P value) | ||
| MBP SD within 24 h | <8.9 | 0.84 (0.75, 0.94) | 0.003 | <0.001 | 0.84 (0.75, 0.94) | 0.003 | <0.001 |
| ≥8.9 | 1.11 (1.05, 1.17) | <0.001 | 1.11 (1.06, 1.17) | <0.001 | |||
| MBP ARV within 24 h | <6.5 | 0.87 (0.73, 1.02) | 0.09 | 0.057 | 0.88 (0.75, 1.05) | 0.156 | 0.045 |
| ≥6.5 | 1.06 (1.00, 1.13) | 0.067 | 1.10 (1.03, 1.17) | 0.004 | |||
| MBP Range within 24 h | <39.9 | 0.97 (0.95, 0.99) | 0.004 | <0.001 | 0.97 (0.95, 0.99) | 0.011 | 0.002 |
| ≥39.9 | 1.02 (1.01, 1.04) | <0.001 | 1.02 (1.01, 1.04) | 0.001 | |||
| MBP SV within 24 h | <9.2 | 0.90 (0.80, 1.00) | 0.057 | 0.019 | 0.91 (0.82, 1.02) | 0.121 | 0.026 |
| ≥9.2 | 1.07 (1.02, 1.12) | 0.008 | 1.08 (1.03, 1.13) | 0.002 | |||
| MBP SD within 48 h | <11 | 0.91 (0.83, 1.01) | 0.064 | 0.023 | 0.90 (0.81, 0.99) | 0.037 | 0.008 |
| ≥11 | 1.10 (1.01, 1.21) | 0.033 | 1.13 (1.03, 1.24) | 0.008 | |||
| MBP ARV within 48 h | <7.3 | 0.83 (0.72, 0.96) | 0.015 | 0.032 | 0.85 (0.73, 0.99) | 0.038 | 0.026 |
| ≥7.3 | 1.05 (0.96, 1.16) | 0.288 | 1.09 (0.99, 1.21) | 0.072 | |||
| MBP Range within 48 h | <51 | 0.97 (0.96, 0.99) | 0.01 | 0.006 | 0.98 (0.96, 1.00) | 0.04 | 0.023 |
| ≥51 | 1.02 (1.00, 1.04) | 0.023 | 1.02 (1.00, 1.04) | 0.046 | |||
| MBP SV within 48 h | <10.4 | 0.90 (0.81, 1.00) | 0.047 | 0.073 | 0.93 (0.84, 1.03) | 0.175 | 0.127 |
| ≥10.4 | 1.04 (0.97, 1.11) | 0.325 | 1.05 (0.98, 1.13) | 0.196 | |||
| MBP SD within 72 h | <12 | 0.89 (0.80, 0.98) | 0.016 | 0.006 | 0.89 (0.80, 0.98) | 0.019 | 0.005 |
| ≥12 | 1.19 (1.04, 1.37) | 0.014 | 1.21 (1.05, 1.39) | 0.009 | |||
| MBP ARV within 72 h | <8.3 | 0.79 (0.69, 0.91) | <0.001 | 0.003 | 0.83 (0.72, 0.95) | 0.009 | 0.005 |
| ≥8.3 | 1.13 (0.99, 1.30) | 0.068 | 1.18 (1.03, 1.35) | 0.018 | |||
| MBP Range within 72 h | <59.7 | 0.97 (0.95, 0.99) | 0.003 | 0.005 | 0.97 (0.96, 0.99) | 0.009 | 0.009 |
| ≥59.7 | 1.02 (1.00, 1.05) | 0.041 | 1.02 (1.00, 1.05) | 0.039 | |||
| MBP SV within 72 h | <10.8 | 0.84 (0.75, 0.94) | 0.003 | 0.017 | 0.86 (0.77, 0.97) | 0.013 | 0.016 |
| ≥10.8 | 1.05 (0.95, 1.15) | 0.314 | 1.08 (0.99, 1.19) | 0.097 | |||
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