医疗大数据背景下构建老年“心衰-高血压”共病风险评估模型的可行性分析  

Feasibility analysis of constructing a model of"heart failure-hypertension"comorbidity risk assessment in elderly people based on medical big data

作　　者：于建辉[1] 马静[1] 毛丽[1] 杨虹[1] Yu Jianhui;Ma Jing;Mao Li;Yang Hong(Cardiovascular Department of The Second Medical Center&National Clinical Research Center for Geriatric Diseases,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心国家老年疾病临床研究中心,北京100853

出　　处：《国际医药卫生导报》2022年第4期446-449,共4页International Medicine and Health Guidance News

基　　金：国家老年疾病临床研究中心开放课题孵化项目(ZXFH2005)。

摘　　要：目的在医疗大数据背景下构建老年“心衰-高血压”共病风险评估模型,并对其可行性进行分析。方法选取2020年1月1日至2021年6月1日解放军总医院第二医学中心收治的高血压患者500例作为研究对象,按照是否合并心衰分为合并心衰组(124例)和未合并心衰组(376例)。合并心衰组男88例、女36例,年龄(74.25±4.38)岁;未合并心衰组男234例、女142例,年龄(73.66±5.25)岁。对临床资料进行回顾性分析。采用单因素和logistic多因素回归分析对“心衰-高血压”共病风险进行分析和模型建立,采用受试者工作特征曲线(ROC)检验模型效果。计数资料采用χ^(2)检验,计量资料采用独立样本t检验。结果血压水平、体质量指数(BMI)、合并感染、合并高脂血症、合并高尿酸血症、合并左心室肥厚、吸烟是心衰-高血压共病的影响因素(OR=1.071、0.852、1.835、1.978、2.002、2.552、1.988;均P<0.05)。曲线下面积(AUC)为0.852,灵敏度为0.685,特异度为0.835,约登指数为0.521,AUC>0.7,预测效能中等。结论高血压患者心衰的患病率较高,血压水平、BMI、合并感染、合并高脂血症、合并高尿酸血症、合并左心室肥厚、吸烟是心衰-高血压共病的影响因素,风险评估模型预测效能较好。Objective To construct a model of"heart failure-hypertension"comorbidity risk assessment in elderly people based on medical big data and analyze its feasibility.Methods A total of 500 hypertensive patients treated in The Second Medical Center,Chinese PLA General Hospital from January 1,2020 to June 1,2021 were selected as subjects and were divided into a heart failure group(124 cases)and a non-heart failure group(376 cases)according to whether combined with heart failure.In the heart failure group,there were 88 males and 36 females,with an age of(74.25±4.38)years old;in the non-heart failure group,there were 234 males and 142 females,with an age of(73.66±5.25)years old.The clinical data of the two groups were analyzed retrospectively.Univariate and multivariate logistic regression analysis were used to analyze the comorbidity risk of"heart failure-hypertension"and model it,and the receiver operating characteristic curve(ROC)was used to test the model effect.χ^(2) test was used for the count data and independent sample t test was used for the measurement data.Results Blood pressure level,body mass index(BMI),concomitant infection,concomitant hyperlipidemia,concomitant hyperuricemia,concomitant left ventricular hypertrophy,and smoking were influence factors for heart failure-hypertension comorbidity(OR=1.071,0.852,1.835,1.978,2.002,2.552,and 1.988;all P<0.05).The area under the curve(AUC)was 0.852,the sensitivity was 0.685,the specificity was 0.835,and the Youden index was 0.521.The AUC was over 0.7,which indicated a moderate predictive efficiency.Conclusions The prevalence of heart failure in elderly hypertensive patients is high,blood pressure level,BMI,concomitant infection,concomitant hyperlipidemia,concomitant hyperuricemia,concomitant left ventricular hypertrophy,and smoking are influence factors for heart failure-hypertension comorbidity,and the risk assessment model has a good predictive efficiency.

关 键 词：高血压 心衰 共病 风险预测 

分 类 号：R544.1[医药卫生—心血管疾病] R541.6[医药卫生—内科学]