通讯作者: 孟馥芬, 349428940@qq.com

DOI：10.12201/bmr.202608.00011

Research Progress on Intraoperative Blood Pressure Variability in Elderly Hypertensive Patients with Postoperative Acute Kidney Injury

• 摘要：术后急性肾损伤（postoperative acute kidney injury, PO-AKI）是围术期最常见的严重并发症之一，在高龄、合并高血压的患者中尤为突出。近年来，学术界开始重视血压波动模式——血压变异性（blood pressure variability, BPV）——与靶器官损伤的关联。慢性高血压人群的流行病学证据表明，BPV是独立于平均血压的心血管事件与死亡风险的强预测因子。这一发现是否适用于血流动力学波动更为剧烈的围术期场景，已成为麻醉学研究的前沿课题。本文系统回顾BPV的生理学基础与量化方法，梳理术中BPV与PO-AKI的现有证据，探索理论争议与方法学挑战。现有证据提示，术中收缩压变异性，可能与老年高血压患者PO-AKI风险独立相关，但研究异质性大，尚需标准化定义及前瞻性干预试验加以验证。

  关键词： 血压变异性；术后急性肾损伤；老年高血压；术中管理；围术期血流动力学

   

  Abstract: Postoperative acute kidney injury (PO?AKI) is one of the most common serious perioperative complications, particularly prominent in elderly patients with concomitant hypertension. In recent years, academic circles have attached growing importance to the association between blood pressure fluctuation patterns, namely blood pressure variability (BPV), and target?organ damage. Epidemiological evidence from populations with chronic hypertension indicates that BPV serves as a strong predictor of cardiovascular events and mortality, independent of mean blood pressure. Whether this finding applies to the perioperative setting, where hemodynamic fluctuations are more pronounced, has become a cutting?edge research topic in anesthesiology. This article systematically reviews the physiological basis and quantification methods of BPV, summarizes current evidence linking intraoperative BPV to PO?AKI, and explores theoretical controversies and methodological challenges. Available evidence suggests that intraoperative systolic blood pressure variability may be independently associated with the risk of PO?AKI in elderly hypertensive patients. Nevertheless, substantial heterogeneity exists among existing studies, and standardized definitions as well as prospective interventional trials are warranted for further validation.

  Key words: blood pressure variability ；postoperative acute kidney injury；elderly hypertension；intraoperative management；perioperative hemodynamics

  提交时间：2026-08-05

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• 序号	提交日期	编号	操作
  1	2026-07-06	10.12201/bmr.202608.00011V1	下载

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