摘要
目的:探究Stanford A型主动脉夹层(ATAAD)术后发生低氧血症的危险因素,并构建发生风险的列线图预测模型.方法:120例ATAAD患者依据术后是否发生低氧血症分为发生组(n=68)和未发生组(n=52).分析影响患者术后发生低氧血症的危险因素,并根据危险因素构建预测模型.受试者工作特征(ROC)曲线分析预测效能.结果:ATAAD患者术后发生低氧血症的独立危险因素包括高体质量指数(BMI)、高白细胞、高谷丙转氨酶(ALT)、高白细胞介素-6(IL-6)、高高敏C反应蛋白(hs-CRP)(P＜0.05).BMI、白细胞、ALT、IL-6、hs-CRP及列线图预测模型的曲线下面积(AUC)分别为0.800、0.867、0.661、0.639、0.829、0.974.根据决策曲线分析,该模型的阈值概率范围在0.01至0.97之间,其净收益高于两条无效线.结论:高BMI、白细胞、ALT、IL-6、hs-CRP水平与ATAAD术后低氧血症风险相关,基于危险因素构建的列线图预测模型可用于评估患者术后低氧血症发生风险.
Abstract
Objective:To explore the risk factors of hypoxemia after Stanford type A aortic dissection(ATAAD)operation,and to construct nomogram prediction model for the occurrence of risks.Methods:120 ATAAD patients were divided into occurrence group(n=68)and non-occurrence group(n=52)according to whether hypoxemia occurred after operation.The risk factors affecting postopera-tive hypoxemia in patients were analyzed,and constructed the prediction model based on these risk factors.The predictive efficacy was analyzed by receiver operating characteristic(ROC)curve.Results:The independent risk factors for postoperative hypoxemia in ATAAD patients included High body mass index(BMD,high white blood cells,high alanine aminotransferase(ALT),high interleukin-6(IL-6),high sensitive C-reactive protein(hs-CRP)(P＜0.05).The area under the curve(AUC)of BMI,leukocyte,ALT,IL-6,hs-CRP and nomo-gram prediction models were 0.800,0.867,0.661,0.639,0.829 and 0.974 respectively.According to the decision curve analysis,the threshold probability range of the model was between 0.01 and 0.97,and its net benefit was higher than the two invalid lines.Conclusion:High BMI,leukocyte,ALT,IL-6 and hs-CRP levels are associate with the risk of hypoxemia after ATAAD,the nomogram prediction model based on risk factors can be used to assess the risk of postoperative hypoxemia in patients.
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