基于logistic回归模型的冠状动脉旁路移植术后桥血管再狭窄的预测  

Prediction of Restenosis of Bridging Vessels After Coronary Artery Bypass Grafting Based on Logistic Regression Model

作　　者：于鑫溢 张竞超[1] YU Xin-yi;ZHANG Jing-chao(Cardiovascular Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院心血管外科,河南郑州450052

出　　处：《河南医学研究》2020年第19期3462-3465,共4页Henan Medical Research

摘　　要：目的建立冠状动脉旁路移植术(coronary artery bypass grafting,CABG)后桥血管再狭窄的logistic回归模型,以预测术后桥血管再狭窄的概率。方法回顾性分析2015年1月至2019年10月在郑州大学第一附属医院接受CABG手术的285例患者的病历资料,根据术后桥血管是否出现再狭窄分为桥血管通畅组(203例)和桥血管再狭窄组(82例)。比较两组患者一般资料,采用多因素logistic回归分析CABG术后再狭窄的独立危险因素,根据回归系数建立logistic回归模型。结果两组体质量、高血压病史、脑梗死病史、吸烟史、冠脉狭窄程度和D-二聚体、国际标准化比值和射血分数(EF)比较,差异有统计学意义(均P<0.05)。logistic回归分析显示,高血压病史、吸烟史、EF、D-二聚体水平是冠状动脉旁路移植术后再狭窄的独立危险因素(均P<0.05)。logistic回归模型ROC曲线下面积为0.827(95%CI:0.775~0.877)。结论临床工作中应关注高血压病史、吸烟史、EF和D-二聚体水平对CABG术后桥血管再狭窄的影响。CABG术后再狭窄的logistic回归模型可用于早期识别具有桥血管再狭窄风险的患者。Objective Logistic regression model of restenosis of bridging vessels after coronary artery bypass grafting(CABG)was established to predict the probability of restenosis of bridging vessels after CABG.Methods The data of 285 patients with CABG who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2015 to October 2019 were retrospectively analyzed.According to whether bridging vessels after CABG were restenosis or not,the patients were divided into bridge vessel patency group(203 cases)and bridge vessel restenosis group(82 cases).The general data of the two groups were compared.Multivariate logistic regression analysis was used to analyze the independent risk factors for restenosis after CABG.Logistic regression model was established according to regression coefficient.Results There were statistical differences on body mass,hypertension history,cerebral infarction history,smoking history,degree of coronary stenosis and D-dimer,international standardized ratio and ejection fraction(EF)between the two groups(all P<0.05).Logistic regression analysis showed that history of hypertension,history of smoking,EF and D-Dimer level were the independent risk factors for restenosis after CABG(all P<0.05).The area under ROC curve of logistic regression model was 0.827(95%CI:0.775~0.877).Conclusion Clinical attention should be paid to the effect of history of hypertension,history of smoking,EF and D-Dimer level on bridge vessel restenosis after CABG.Logistic regression model of restenosis after CABG can be used for early identification of patients at risk of bridging restenosis.

关 键 词：冠状动脉旁路移植术 再狭窄 LOGISTIC回归模型 

分 类 号：R654.3[医药卫生—外科学]