急性冠脉综合征患者行经皮冠状动脉介入术后发生抑郁症的危险因素分析及风险列线图模型的建立  

Analysis of risk factors of depression in patients with acute coronary syndrome after percutaneous coronary intervention and establishment of risk nomogram model

作　　者：王波[1] 方小丽[1] 欧阳艳红[1] WANG Bo;FANG Xiao-li;OUYANG Yan-hong(Hainan Affliated Hospital of Hainan Medical University,Haikou 570311,China)

机构地区：[1]海南省人民医院,海南医学院附属海南医院,海口570311

出　　处：《临床精神医学杂志》2021年第4期292-295,共4页Journal of Clinical Psychiatry

摘　　要：目的:分析急性冠脉综合征患者(ACS)行经皮冠状动脉介入(PCI)术后发生抑郁症的危险因素,并建立相关风险列线图模型。方法:回顾性分析121例ACS行PCI术患者的临床病历资料,单因素和多因素Logistic分析筛选PCI术后发生抑郁症的危险因素,并建立风险预测列线图模型。结果:受教育程度(OR=6.966,95%CI:2.162~22.446)、ACS严重程度(OR=7.933,95%CI:2.349~26.794)、高血压(OR=3.846,95%CI:1.208~12.248)、血糖水平(OR=2.680,95%CI:1.092~6.578)、PCI术前未心理健康教育(OR=5.109,95%CI:1.906~13.693)是ACS患者行PCI术后发生抑郁症的独立危险因素,基于以上5项独立危险因素,建立风险列线图预测模型,并内部验证该列线图模型,预测值与实际值基本相近,C-index指数为0.821(95%CI:0.803~0.847),表明该列线图模型具有较高的精准度和区分度。结论:受教育程度、ACS严重程度、高血压、血糖水平、PCI术前未进行心理健康教育是ACS患者行PCI术后发生抑郁症的独立危险因素,本研究构建的列线图预测模型风险预测精准度较好,临床应用指导价值高。Objective:To analyze the risk factors of depression after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS)and to establish a risk nomogram model.Method:The clinical data of 121 patients with acute coronary syndrome undergoing PCI were retrospectively analyzed.The risk factors of depression after PCI were screened by univariate and multivariate Logistic analysis,and the risk predictive nomogram model was established.Results:Education level(OR=6.966,95%CI:2.162-22.446),severity of acute coronary syndrome(OR=7.933,95%CI:2.349-26.794),hypertension(OR=3.846,95%CI:1.208-12.248),diabetes mellitus(OR=2.680,95%CI:1.092-6.578)and lack of mental health education(OR=5.109,95%CI:1.906-13.693)before PCI were independent risk factors for depression in patients with ACS after PCI.Based on the above five independent risk factors,a risk nomogram prediction model was established and verified internally.The predicted value was basically similar to the actual value 0.821(95%CI:0.803-0.847),indicating that the nomogram model had high accuracy and discrimination.Conclusion:Education level,severity of ACS,hypertension,diabetes mellitus and lack of mental health education before PCI are independent risk factors for depression in ACS patients after PCI.The nomogram prediction model established in this study has good accuracy in risk prediction and high value in clinical application guidance.

关 键 词：急性冠脉综合征 经皮冠状动脉介入 抑郁症 危险因素 列线图 

分 类 号：R749.4[医药卫生—神经病学与精神病学]