摘要
目的 探讨急性心肌梗死患者行经皮冠状动脉介入治疗(PCI)术后心力衰竭(心衰)的影响因素及风险预测模型研究.方法 选择2020年6月至2022年12月于东部战区总医院心内科收治的180例急性心肌梗死患者进行研究,根据随访情况分为发生心力衰竭组(n=56)和未发生心力衰竭组(n=124).采用多因素Logistic回归模型分析急性心肌梗死术后发生心衰的危险因素,ROC曲线分析风险预测模型.结果 单因素分析结果显示,两组患者性别、体质指数(BMI)、吸烟史、饮酒史、高血压、糖尿病、心肌梗死史、脑卒中史、PCI史、肌钙蛋白I(cTnI)、病变支数差异均无统计学意义(P＞0.05);两组年龄、收缩压、舒张压、心率、脑钠肽(BNP)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)差异均有统计学意义(P＜0.05);将以上单因素有统计学意义的的变量作为自变量,急性心肌梗死术后发生心衰为因变量,进行多因素非条件Logistic回归.结果 显示,年龄、收缩压、舒张压、心率、BNP、TG、LDL-C及HDL-C均是急性心肌梗死术后发生心衰的独立危险因素(P＜0.05);ROC结果提示,年龄、收缩压、舒张压、心率、BNP、TG、LDL-C及HDL-C,AUC分别为0.784、0.609、0.686、0.933、0.644、0.814、0.802、0.751,最佳截断值分别为57.56岁、121.24 mmHg、74.16 mmHg、92.15 次/min、352.58 ng/L、1.92 mmol/L、2.20 mmol/L、1.18 mmol/L.结论 急性心肌梗死行PCI术后发生心衰的危险因素较多,利用年龄、收缩压、舒张压、心率、BNP、TG、LDL-C及HDL-C构建的预测模型具有较高的预测效能.
Abstract
Objective To investigate the influence factors of heart failure(HF)in patients with acute myocardial infarction(AMI)after PCI and risk predictive model.Methods AMI patients(n=180)were chosen from Department of Cardiology,Eastern Theater Command General Hospital from June 2020 to Dec.2022.The patients were divided,according to follow-up results,into HF group(n=56)and non-HF group(n=124).The risk factors of HF after PCI for AMI were analyzed by using multi-factor Logistic regression model,and risk predictive model was analyzed by using ROC curve.Results The results of single-factor analysis showed that the differences in gender,body mass index(BMI),smoking history,drinking history,hypertension,diabetes,myocardial infarction history,stroke history,PCI history,cardiac troponin I(cTnI)and diseases vessels had no statistical significance between 2 groups(P>0.05).The differences in age,systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),brain natriuretic peptide(BNP),triglyceride(TG),low-density lipoprotein-cholesterol(LDL-C)and high-density lipoprotein-cholesterol(HDL-C)had statistical significance between 2 groups(P<0.05).The results of multi-factor Logistic regression analysis showed that age,SBP,DBP,HR,BNP,TG,LDL-C and HDL-C were independent risk factors of HF after PCI for AMI(P<0.05).The results of ROC curve analysis showed that AUC of age,SBP,DBP,HR,BNP,TG,LDL-C and HDL-C were,respectively,0.784,0.609,0.686,0.933,0.644,0.814,0.802 and 0.751 and the optimal cutoff values were,respectively,57.56 years old,121.24 mmHg,74.16 mmHg,92.15 time/min,352.58 ng/L,1.92 mmol/L,2.20 mmol/L and 1.18 mmol/L.Conclusion There are many risk factor of HF after PCI for AMI,and the predictive model established by using age,SBP,DBP,HR,BNP,TG,LDL-C and HDL-C has a higher predictive efficacy.
NETL
NSTL
维普
万方数据