基于病案首页的心血管病种间共病关系分析  

Study on the Relationship between Comorbidities of Cardiovascular Diseases Based on Social Network Analysis

作　　者：云科[1] 石锋[2] 穆润清[1] 康辉[1] Yun Ke;Shi Feng;Mu Runqing;Kang Hui(The First affiliated Hospital of China Medical University,Shenyang 110001,Liaoning Province,China)

机构地区：[1]中国医科大学附属第一医院,辽宁省沈阳市110001 [2]中国医科大学附属盛京医院,辽宁省沈阳市110022

出　　处：《中国病案》2019年第10期66-69,共4页Chinese Medical Record

摘　　要：目的了解心血管疾病病种间共病的网络关系和结构,为临床综合诊治和诊断相关群组设计提供数据支撑。方法共收集58100例心血管病房病案首页数据,根据帕累托图的原理筛选心血管病房A类高频病种,构建病种关系矩阵,运用UCINET生成高频病种网络,并对其进行社会网络分析。结果共筛选出30个高频A类病种,其共现网络密度的平均值为14.7±44.8;在核心病种网络中,心律失常处于核心位置与周围其它病种联系十分密切;其余有较高连接度的病种包括:不稳定性心绞痛、心房颤动、高血压3级等。凝聚簇分析发现凝聚子群的密度值为0.5241±0.4994,病种可以分为代表不同疾病亚群的8个簇。中心性分析具有较高的点度中心度的病种有高血压3级(D=2274)、冠状动脉粥样硬化性心脏病(D=2009)、不稳定性心绞痛(D=1089);具有较高的接近中心度节点有心律失常(C=90.625)、心功能Ⅳ级(C=85.294)、心功能Ⅲ级(C=85.294);具有较高的中间中心度节点有心律失常(B=48.367)、心功能Ⅳ级(B=28.858)、心功能Ⅲ级(B=28.858)。结论心血管不同亚病种共病网络关系复杂,病种间存在聚集现象,且不同病种在网络中发挥的作用不同。心律失常占据心血管疾病共病网络的核心位置,与其它病种共患的概率大,并且处于其它病种共患通路的重要"中介"位置。Objective To understand the network relationship and structure of comorbidities among cardiovascular diseases,and provide data support for clinical diagnosis and treatment and DRGS design.Methods Screening 58100 high-frequency diseases of Class A in cardiovascular wards,constructing the relationship matrix of disease types,using UCINET to generate high-frequency keyword social networks,and conducting central analysis,cohesion subgroups and factional analysis.Results A total of 30 high frequency class A diseases were screened.The average social network density is 14.7±44.8.In the core disease network,arrhythmia is at a core location and is closely linked to other surrounding diseases.Coagulation block analysis found that the disease can be divided into 8 blocks,representing different disease subgroups.The density of condensed subgroup is 0.5241±0.4994.The patients with high degree of centrality in central analysis were hypertension grade 3(D=2274),coronary atherosclerotic heart disease(D=2009) and unstable angina pectoris(D=1089).With a higher degree of proximity to the center of the node are Arrhythmia(C=90.625),cardiac function level IV(C=85.294),cardiac function level3(C=85.294);The nodes with higher intermediate center degree are Cardiac function IV grade(B=28.858),cardiac function grade 3(B=28.858),cardiac function grade 3(B=28.858),cardiac function grade 3(B=28.858).Conclusion There is a complex relationship between the diseases of the different diseases of the cardiovascular and other diseases,and there is a clustering phenomenon among the diseases,and the different disease species play a different role in the network.Arrhythmia occupies the core position of cardiovascular disease co-disease network,has a high probability of co-occurrence with other diseases,and is in an important "intermediary" position of other disease co-disease pathways.

关 键 词：网络分析 心血管疾病 共病 凝聚子群 中心性 

分 类 号：R54[医药卫生—心血管疾病]