冠心病稳定期再发心血管事件预警模型的建立与效能评估  

Establishment and Evaluation of Recurrent Event Early Alarming Model for Stable Coronary Heart Disease

作　　者：曲丹[1] 刘洋[2] 孟一[2] 尚青华[2] 徐浩[3] 

机构地区：[1]首都医科大学潞河教学医院 [2]中国中医科学院西苑医院 [3]中国中医科学院西苑医院心血管病中心

出　　处：《中西医结合心脑血管病杂志》2014年第7期777-779,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：北京市中医药科技发展基金项目(No.JJ2010-49);国家重点基础研究发展规划(973)项目(No.2006CB504803);北京市科技计划项目(No.D08050703020801);首发基金重点支持项目(No.SF-2007-II-13)

摘　　要：目的探索性构建稳定期冠心病患者1年内发生急性心血管事件的预警模型,应用ROC曲线评价效能。方法选择中日友好医院稳定期冠心病患者,且完成了1年随访者共397例,结合随访1年后发生急性心血管事件情况,对患者的临床资料进行多因素分析。结果建立预警方程:Logit(p)=-2.319-0.779(ApoA1分层)-0.978运动+0.908脑卒中病史+0.877(hs-CRP分层)+0.797胸闷。应用ROC曲线评价效能,评价指标结果:曲线下面积(AUC)为0.744,敏感度为81.4%,特异度为62.2%,Youden指数为0.436,阳性似然比为2.153,阴性似然比为0.299,阳性预报值为0.218,阴性预报值为0.964。结论建立的预警方程主要应用于预测1年内稳定期冠心病患者发生心血管事件的危险。Objective To establish a recurrent event early alarming model for stable coronary heart disease （CHD）.Methods Three hundreds and ninety seven patients with stable CHD followed up for one year were enrolled.All patients were treated with acute cardiovascular event（ACE）.The clinical data were collected and analyzed.Results Early alarming model：Logit（p）=-2.319 0.779 ApoA1-0.978 physical exercises ＋0.908 stroke history＋0.877 hs CRP ＋0.797 suffocating.Then the effectiveness of the model was verified by ROC curve,and the results showed that AUC=0.744,sensitivity was 81.40%,specificity was 62.20%,Youden index=0.436,positive likelihood=2.153,negative likelihood=0.29,positive predictive=0.218,negative predictive=0.964.Conclusion A recurrent event early alarming model for stable CHD was established to predict the risk of stable CHD patient with ACE within one year.

关 键 词：稳定期冠心病 急性心血管事件 预警模型 ROC曲线 

分 类 号：R541.4[医药卫生—心血管疾病] R256.2[医药卫生—内科学]