基于Logistic回归方程分析155例老年ACS患者PCI后MACE的相关影响因素  

Logistic regression equation-based analysis of influencing factors associated with major adverse cardiovascular events after PCI in 155 elderly ACS patients

作　　者：夏珂珺 胡佩佩 张晓丹 XIA Kejun;HU Peipei;ZHANG Xiaodan(Department of Cardiology,Xuchang Hospital,Xuchang,Henan 461000,China)

机构地区：[1]河南省许昌医院心血管内科,河南许昌461000

出　　处：《检验医学与临床》2023年第21期3197-3200,3204,共5页Laboratory Medicine and Clinic

摘　　要：目的基于Logistic回归方程分析老年急性冠状动脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后主要不良心血管事件(MACE)的相关影响因素并构建预测评分系统。方法选取2019年3月至2022年4月于该院行PCI治疗的155例老年ACS患者为研究对象,根据PCI后6个月内是否发生MACE分为发生组和未发生组。收集并比较两组临床资料;采用多因素Logistic回归分析MACE发生的影响因素;构建预测评分模型,并采用受试者工作特征(ROC)曲线分析该评分模型对MACE的预测价值。结果PCI后6个月,58例患者发生MACE(发生组)的发生率为37.42%(58/155),剩余97例为未发生组;发生组全球急性冠状动脉事件注册风险(GRACE)评分、小而密低密度脂蛋白胆固醇(sdLDL-C)、脂蛋白相关磷脂酶A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)水平及饮酒史、糖尿病史、未血运重建患者比例高于未发生组,而淋巴细胞计数低于对照组,差异均有统计学意义(P<0.05);Logistic回归结果显示,淋巴细胞计数、未血运重建、sdLDL-C、hs-CRP、Lp-PLA2是老年ASC患者PCI后MACE发生的影响因素(P<0.05);预测评分系统预测老年ASC患者PCI后MACE发生的AUC为0.811。结论淋巴细胞计数、未血运重建、sdLDL-C、hs-CRP、Lp-PLA2是老年ACS患者PCI后MACE发生的影响因素,基于Logistic回归方程分析构建的预测评分系统具有良好预测效能。Objective To analyze the influencing factors associated with major adverse cardiovascular events(MACE)in elderly patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI)based on Logistic regression equation and construct a predictive scoring system.Methods A total of 155 elderly ACS patients who underwent PCI in the hospital from March 2019 to April 2022 were selected as the research objects.According to whether MACE occurred within 6 months after PCI or not,they were divided into the occurrence group and the non-occurrence group.The clinical data of the two groups were collected and compared,the influencing factors of MACE were analyzed by Logistic regression equation,and the predictive model was constructed.The predictive value of the model for MACE was analyzed by receiver operating characteristic(ROC)curve.Results After 6 months,MACE occurred in 58 patients(occurrence group),with incidence of MACE of 37.42%,The remaining 97 patients were in the non-occurrence group.Compared with the non-occurrence group,the Global Registry of Acute Coronary Events(GRACE)score,levels of sdLDL-C,hs-CRP,Lp-PLA2,and proportions of patients with history of alcohol consumption,history of diabetes mellitus,no revascularization in the occurrence group increased(P<0.05),lymphocyte count decreased(P<0.05).Logistic regression analysis results showed that lymphocyte count,no revascularization,sdLDL-C,hs-CRP and Lp-PLA2 were the influencing factors of MACE after PCI in elderly ACS patients(P<0.05).The AUC of the prediction model for MACE after PCI in elderly ACS patients was 0.811.Conclusion Lymphocyte cou nt,no revascularization,sdLDL-C,hs-CRP and Lp-PLA2 are the influencing factors of MACE in elderly ACS patients after PCI.The predictive model based on Logistic regression equation analysis has good predictive efficacy.

关 键 词：急性冠状动脉综合征 主要不良心血管事件 Logistic回归方程 影响因素 预测效能 

分 类 号：R541.4[医药卫生—心血管疾病]