首页|冠心病患者心肌缺血再灌注损伤的危险因素分析及预测模型效能研究

冠心病患者心肌缺血再灌注损伤的危险因素分析及预测模型效能研究

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目的:分析冠心病患者心肌缺血再灌注损伤(MIRI)的危险因素,建立预测模型并评估效能。方法:选择2021年10月至2022年9月东莞市东南部中心医院接受溶栓治疗或经皮冠状动脉介入(PCI)治疗的冠心病患者80例为对象,根据患者治疗后是否发生MIRI分为对照组(未发生MIRI 45例)和观察组(发生MIRI 35例)。查阅所有患者的临床资料,对冠心病患者MIRI可能的影响因素进行统计,建立MIRI列线图预测模型,并评估模型预测效能。结果:80例冠心病患者中,有35例发生MIRI(43。75%)。多因素logistic回归结果显示,发作到手术时间、左室射血分数(LVEF)、中性粒细胞计数与淋巴细胞计数比值(NLR)、血小板计数与淋巴细胞计数比值(PLR)、肌钙蛋白T(TNT)、脑利钠肽(BNP)是冠心病患者MIRI发生的独立危险因素(P<0。05);本研究构建的列线图预测模型校准曲线斜率较高,霍斯莫-莱梅肖(H-L)拟合优度检验的结果为 χ2=1。334,P=0。323,表明模型拟合良好;受试者工作特征(ROC)曲线结果显示,曲线下面积为 0。817,95%CI(0。759,0。871)。结论:发作到手术时间、LVEF、NLR、PLR、TNT及BNP是冠心病患者发生MIRI的独立危险因素,且基于上述因素构建的预测模型具有较高的拟合度,预测效能较高。
Risk Factors Analysis and Predictive Model Efficacy Study of Myocardial Ischemia-reperfusion Injury in Patients with Coronary Heart Disease
Objective To analyze the risk factors of myocardial ischemia-reperfusion injury(MIRI)in patients with coronary heart disease,establish a predictive model and evaluate its effectiveness.Methods A total of 80 patients with coronary heart disease who received thrombolytic therapy or percutaneous coronary intervention(PCI)treatment at The Southeast General Hospital of Dongguan from October 2021 to September 2022 were selected as the subjects.They were divided into a control group(45 cases without MIRI)and an observation group(35 cases occurred MIRI)based on whether the patients occurred MIRI after treatment.The clinical data of all patients were reviewed,the possible influencing factors of MIRI in patients with coronary heart disease were statistically analyzed,the prediction model of MIRI nomogram was established,and the prediction efficiency of the model was evaluated.Results Among 80 patients with coronary heart disease,35 cases(43.75%)occurred MIRI.The results of multiple logistic regression showed that the time from onset to surgery,left ventricular ejection fraction(LVEF),neutrophil to lymphocyte ratio(NLR),platelet count to lymphocyte count ratio(PLR),troponin T(TNT),and brain natriuretic peptide(BNP)were independent risk factors for MIRI in patients with coronary heart disease(P<0.05);The calibration curve slope of the column chart prediction model constructed in this study was relatively high.The results of the Hosmo-Lemeshau(H-L)goodness of fit test showed that the model fits well with a chi square value of 1.334 and a p-value of 0.323;The receiver operating characteristic(ROC)curve results showed that the area under the curve was 0.817,95%CI(0.759,0.871).Conclusion The time from onset to surgery,LVEF,NLR,PLR,TNT,and BNP are the risk factors for MIRI in patients with coronary heart disease.The predictive model constructed based on these factors in this study has a high degree of fit and predictive efficacy.

Coronary heart diseaseMyocardial ischemia-reperfusion injuryNomogram prediction model

陈锐、陈业洋、杨友星

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东莞市东南部中心医院,广东 东莞 523710

冠心病 心肌缺血再灌注损伤 列线图预测模型

东莞市社会发展科技项目

20211800904382

2024

深圳中西医结合杂志
深圳市中西医结合临床研究所

深圳中西医结合杂志

影响因子:0.692
ISSN:1007-0893
年,卷(期):2024.34(12)