高血压前期人群发生心血管疾病的风险预测列线图模型构建  

Construction of the Nomogram Model for Predicting the Risk of Cardiovascular Disease in Prehypertensive Populations

作　　者：冶成芳 任映丽 王梦卉[1] 孙乐[1] 刘园园[1] 李南方[1] YE Chengfang;REN Yingli;WANG Menghui;SUN Le;LIU Yuanyuan;LI Nanfang(Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region/Xinjiang Hypertension Institute/National Health Committee Key Laboratory of Hypertension Clinical Research/Key Laboratory of Xinjiang Uygur Autonomous Region"Hypertension Research Laboratory"/Xinjiang Clinical Medical Research Center for Hypertension(Cardio-Cerebrovascular)Diseases,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院高血压中心、新疆高血压研究所、国家卫生健康委高血压诊疗研究重点实验室、新疆维吾尔自治区重点实验室、“新疆高血压病研究实验室”新疆高血压(心脑血管)疾病临床医学研究中心,新疆维吾尔自治区乌鲁木齐市830001

出　　处：《实用心脑肺血管病杂志》2023年第12期54-59,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：新疆维吾尔自治区重大科技专项项目(2022A03012-2);新疆维吾尔自治区人民医院院内项目(20210133)。

摘　　要：目的构建高血压前期人群发生心血管疾病的风险预测列线图模型。方法从新疆维吾尔自治区人民医院高血压中心2019年1月建立的塔城地区额敏县自然人群队列中选取高血压前期人群3690例为研究对象。收集研究对象一般资料、体格检查结果、实验室检查结果。从研究对象入组开始对其进行面对面随访或电话随访,每6个月随访1次,随访时间截至2022年12月。根据随访结果,将研究对象分为对照组和心血管疾病组。采用多因素Logistic回归分析探讨高血压前期人群发生心血管疾病的影响因素;基于多因素Logistic回归分析结果,采用R 3.6.3中的rms程序包构建高血压前期人群发生心血管疾病的风险预测列线图模型;采用Hosmer-Lemeshow拟合优度检验评估该列线图模型的拟合情况,采用ROC曲线评估该列线图模型的区分度,采用校准曲线评估该列线图模型的校准度。结果随访结束后共231例研究对象发生了心血管疾病,心血管疾病发生率为6.3%(231/3690)。多因素Logistic回归分析结果显示,年龄、心血管疾病家族史、吸烟、饮酒、锻炼情况、BMI、TC、血红蛋白是高血压前期人群发生心血管疾病的独立影响因素(P<0.05)。基于多因素Logistic回归分析结果,构建高血压前期人群发生心血管疾病的风险预测列线图模型。Hosmer-Lemeshow拟合优度检验结果显示,该列线图模型的拟合情况较好(χ^(2)=6.625,P=0.578)。ROC曲线分析结果显示,该列线图模型预测高血压前期人群发生心血管疾病的曲线下面积为0.829〔95%CI(0.803,0.854)〕。校准曲线分析结果显示,该列线图模型预测高血压前期人群的心血管疾病发生率与实际发生率基本一致。结论年龄、心血管疾病家族史、吸烟、饮酒、锻炼情况、BMI、TC、血红蛋白是高血压前期人群发生心血管疾病的独立影响因素,而基于上述影响因素构建的高血压前期人群发生心血�Objective To construct the nomogram model for predicting the risk of cardiovascular disease in prehypertensive populations.Methods A total of 3690 persons with prehypertension were selected from the natural population cohort of Emin County,Tacheng District,established by Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region in January 2019.General information,physical examination results and laboratory examination results were collected.The subjects were followed up face-to-face or by telephone evert 6 months from enrollment,and the follow-up period was up to December 2022.According to the follow-up results,the subjects were divided into control group and cardiovascular disease group.Multivariate Logistic regression analysis was used to explore the influencing factors of cardiovascular disease in prehypertensive population.Based on the results of multivariate Logistic regression analysis,the rms package in R 3.6.3 was used to construct the nomogram model for predicting the risk of cardiovascular disease in prehypertensive population.Hosmer-Lemeshow goodness of fit test was used to evaluate the fit of the nomogram model,ROC curve was used to evaluate the differentiation of the nomogram model,calibration curve was used to evaluate the calibration degree of the nomogram model.Results At the end of followup,231 subjects developed cardiovascular disease,the incidence of cardiovascular disease was 6.3%(231/3690).Multivariate Logistic regression analysis showed that age,family history of cardiovascular disease,smoking,drinking,exercise,BMI,TC and hemoglobin were independent influencing factors of cardiovascular disease in prehypertensive population(P<0.05).Based on the results of multivariate Logistic regression analysis,the nomogram model for predicting the risk of cardiovascular disease in prehypertensive population was constructed.The Hosmer-Lemeshow goodness of fit test showed that the nomogram model was well fitted(χ^(2)=6.625,P=0.578).The ROC curve analysis results showed that the area unde

关 键 词：高血压前期 心血管疾病 预测 列线图 

分 类 号：R543[医药卫生—心血管疾病] R54[医药卫生—内科学]