老年男性急性心肌梗死患者冠状动脉病变程度列线图模型的建立和验证  

Establishment and validation of a contour map model of coronary artery lesion in elderly male patients with acute myocardial infarction

作　　者：杨艳梅[1] 杨栋梁[1] 赵文涛[1] 何雪娟[1] 王佳旺[2] 刘凡[3] YANG Yanmei;YANG Dongliang;ZHAO Wentao;HE Xuejuan;WANG Jiawang;LIU Fan(Cangzhou Medical College,Cangzhou,Hebei,061001,China;Department of Cardiology,Cangzhou Central Hospital;Department of Cardiology,Hebei Medical University Second Hospital)

机构地区：[1]沧州医学高等专科学校,河北沧州061001 [2]沧州市中心医院心内一科 [3]河北医科大学第二医院心内二科

出　　处：《临床心血管病杂志》2020年第5期463-467,共5页Journal of Clinical Cardiology

基　　金：河北省沧州市科学技术研究与发展指导计划项目(No:131302063)。

摘　　要：目的:构建加重老年男性急性心肌梗死(AMI)患者冠状动脉(冠脉)病变程度的列线图模型,为加重老年男性冠脉病变程度危险因素的初步筛查提供更直观的新方法。方法:回顾性分析行冠脉造影术的1 358例老年男性AMI患者的临床资料,计算并合并Gensini积分等级得出轻度病变组和重度病变组。比较2组间的各项危险因素,采用Logistic多因素回归分析加重老年男性患者冠脉病变程度的危险因素,然后应用Nomogram法建立列线图模型进行验证。结果:①轻度病变组和重度病变组吸烟、年龄和空腹血糖的差异均有统计学意义(均P<0.05);②多因素Logistic回归分析结果显示,年龄(OR=2.883,95%CI:1.746~4.759)和空腹血糖(OR=3.649,95%CI:2.259~5.896)是加重老年男性AMI患者冠脉病变程度的独立危险因素(均P<0.001);③Nomogram模型分析显示,总分越高的老年男性AMI患者加重冠脉病变程度的风险越大;④Nomogram模型的ROC曲线预测风险能力指数为0.751,具有良好的一致性。结论:年龄和空腹血糖是加重老年男性冠脉病变的独立危险因素,构建加重老年男性AMI患者冠脉病变程度的列线图模型,可以更直观、快捷地定量评价加重老年男性患者冠脉病变程度的危险因素,为老年男性预防AMI的发生和加重提供理论依据。Objective:To construct a contour map model for the severity of coronary artery lesions in elderly male patients with acute myocardial infarction(AMI),and to provide a more intuitive and new method for the preliminary screening of risk factors for the severity of coronary artery lesions in elderly male patients.Method:The clinical data of 1 358 elderly male patients with AMI who underwent coronary angiography were retrospectively analyzed.Gensini scores were calculated and combined to obtain mild and severe lesions.The risk factors were compared between the two groups.Logistic multivariate regression analysis was used to analyze the risk factors that aggravate the severity of coronary artery disease in elderly male patients.Nomogram method was used to establish a contour map model to verify the results.Result:①There were significant differences in smoking,age and fasting blood glucose(Glu) between mild and severe coronary artery lesions in elderly male patients with AMI(all P<0.05);②Multivariate Logistic regression analysis showed that age(OR=2.883,95%CI:1.746-4.759) and Glu (OR=3.649,95%CI:2.259-5.896)were independent risk factors for the severity of coronary artery disease in elderly male patients with AMI(both P<0.001);(3)Nomogram model analysis showed that the higher the total score,the greater the risk of the severity of coronary artery disease in elderly male patients with AMI;(4)ROC curve predictive ability index of Nomogram model was 0.751,with right consistency.Conclusion:Age and Glu are independent risk factors for aggravating coronary artery disease in elderly male patients.Establishing a contour map model of the degree of coronary artery disease in elderly male patients with AMI can more intuitively and quickly quantitatively evaluate the risk factors of aggravating coronary artery disease and provide theoretical basisfor the preventionofthe occurrenceand aggravation of AMI.

关 键 词：急性心肌梗死 老年 男性 冠状动脉病变 列线图 

分 类 号：R541.4[医药卫生—心血管疾病]