冠心病合并2型糖尿病患者冠状动脉正性重构的影响因素及临床预测模型构建
Influential factors and clinical prediction model construction of coronary artery positive remodeling in patients with coronary heart disease and type 2 diabetes
连政 1于海荣 1刘佩林 1郭彩霞1
作者信息
- 1. 100176 首都医科大学附属北京同仁医院心血管中心
- 折叠
摘要
目的 探讨冠心病合并2 型糖尿病患者发生冠状动脉正性重构的影响因素并构建相关的临床预测模型用以早期识别高危患者,指导临床治疗.方法 选择2016 年1 月—2023 年6 月于首都医科大学附属北京同仁医院心血管中心诊断的冠心病合并2 型糖尿病患者104 例,通过冠状动脉内超声(IVUS)对靶病变进行测量,并计算重构指数(RI),根据RI将患者分为正性重构组和非正性重构组,搜集患者的临床资料,对 2 组数据进行统计并构建临床预测模型.结果 Logistic回归分析结果发现,低血钙[OR(95%CI)=1.544(1.263～1.927),P<0.001]、并发急性冠状动脉综合征(ACS)[OR(95%CI)=1.198(1.024～1.401),P =0.024]、高糖化血红蛋白(HbA1c)[OR(95%CI)= 1.498(1.104～2.032),P =0.010]和高低密度脂蛋白胆固醇(LDL-C)[OR(95%CI)=1.275(1.139～1.428,P<0.001]是冠心病合并2 型糖尿病患者冠状动脉正性重构的独立危险因素.基于以上危险因素构建冠心病合并2 型糖尿病患者冠状动脉正性重构的列线图模型,预测发生率与实际发生率基本一致,模型内部验证曲线下面积(AUC)为0.937,且具有良好的临床适用度.结论 根据冠心病合并2 型糖尿病患者的危险因素构建的列线图模型对其发生冠状动脉正性重构具有较好的预测效能.
Abstract
Objective To explore the influencing factors of coronary artery positive remodeling in patients with coronary heart disease(CHD)and type 2 diabetes,and to construct related clinical prediction models to identify high-risk patients early and guide clinical treatment.Methods One hundred and four patients with coronary heart disease and type 2 diabetes diagnosed in the Cardiovascular Center of Beijing Tongren Hospital affiliated to Capital Medical University from January 2016 to June 2023 were selected.The target lesions were measured by intracoronary ultrasound(IVUS),and the re-construction index(RI)was calculated.According to RI,patients were divided into positive reconstruction group and non positive reconstruction group.Clinical data of patients were collected,and the data of the two groups were statistically ana-lyzed and a clinical prediction model was constructed.Results Low blood calcium[OR(95%CI)=1.544(1.263-1.927),P<0.001],concurrent acute coronary syndrome(ACS)[OR(95%CI)=1.198(1.024-1.401),P=0.024],high glycated hemoglo-bin(HbA1c)[OR(95%CI)=1.498(1.104-2.032),P=0.010]and high and low density lipoprotein cholesterol(LDL-C)[OR(95%CI)=1.275(1.139-1.428),P<0.001]are independent risk factors for positive remodeling of coronary artery in this population.Based on the above risk factors,a nomograph model of positive remodeling of coronary artery in patients with coronary heart disease and type 2 diabetes was constructed.The predicted incidence rate was basically consistent with the actual incidence rate.The area under the internal validation curve(AUC)of the model was 0.937,And it has good clinical applicability.Conclusion The nomogram model based on the risk factors of patients with coronary heart disease and type 2 diabetes has a good predictive effect on the occurrence of positive coronary remodeling.
关键词
冠心病/糖尿病,2型/冠状动脉正性重构/临床预测模型Key words
Coronary heart disease/Diabetes mellitus,type 2/Coronary artery positive remodeling/Clinical prediction model引用本文复制引用
基金项目
北京同仁医院青年后备人才项目(2021-YJJ-ZZL-051)
出版年
2024
国家科技期刊平台
NSTL
万方数据