原发性高血压患者静息心率加快的影响因素及预测模型的建立  

Influencing factors and establishment of a prediction model for resting heart rate acceleration in patients with primary hypertension

作　　者：刘婷[1] 黄旭 刘曼[1] Liu Ting;Huang Xu;Liu Man(Department of Cardiology,West China hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院心内科,成都610041

出　　处：《广西医科大学学报》2023年第11期1902-1907,共6页Journal of Guangxi Medical University

摘　　要：目的:探讨原发性高血压患者静息心率加快的影响因素,并建立风险预测模型。方法:选择2022年2月至2023年1月四川大学华西医院收治的原发性高血压患者306例,分为心率加快组(静息心率>80次/min,n=187)和心率正常组(静息心率≤80次/min,n=119)。比较两组患者一般资料、疾病相关因素等,采用多因素logistic回归分析患者静息心率加快的危险因素,建立列线图模型并进行验证。结果:Lasso回归基础上多因素分析显示,吸烟史、糖尿病史、家庭月收入、高血压病程、肌酐清除率、血钾、C反应蛋白及臂踝脉搏波传导速度均为高血压患者静息心率加快的独立影响因素(P<0.05)。列线图模型预测原发性高血压患者静息心率加快风险的一致性指数(C-index)为0.968。列线图模型校准曲线显示预测值与实际观测值基本一致。列线图模型的受试者工作特征(ROC)曲线下面积(AUC)为0.968(95%CI:0.946~0.990),灵敏度和特异度分别为83.33%、92.05%。结论:吸烟史、糖尿病史、家庭月收入等为原发性高血压患者静息心率加快的影响因素,建立的列线图模型预测原发性高血压患者静息心率加快具有较高的准确度和区分度。Objective:To investigate the influencing factors of resting heart rate acceleration(RHR)in patients with primary hypertension and establish a risk prediction model.Methods:A study was conducted on 306 patients with primary hypertension admitted to West China Hospital of Sichuan University from February 2022 to January 2023.Patients were divided into resting heart rate acceleration group(RHR>80 beats/min,n=187)and the normal group(RHR≤80 beats/min,n=119).The general information,disease-related factors of the two groups of patients were compared.Multivariate logistic regression was used to analyze the risk factors of resting heart rate acceleration,and a column chart model was established and verified.Results:The results of multifactor analysis based on LASSO regression showed that smoking history,diabetes history,family monthly income,hypertension course,creatinine clearance rate,blood potassium,C-reactive protein and brachial-ankle pulse wave velocity were independent influencing factors for the acceleration of resting heart rate in hypertensive patients(P<0.05).The concordance index(C-index)of the column chart model predicting the risk of resting heart rate acceleration in patients with primary hypertension was 0.968.The calibration curve of the column chart model showed that the predicted values were basically consistent with the actual observed values.The area under the receiver operating characteristic(ROC)curve(AUC)of the column chart model was 0.968(95%CI:0.946-0.990),with sensitivity and specificity of 83.33%and 92.05%,respectively.Conclusion:Smoking history,diabetes history and family monthly income are the influencing factors of resting heart rate acceleration in patients with primary hypertension.The column chart model established in this study has high accuracy and discrimination in predicting resting heart rate acceleration in patients with primary hypertension.

关 键 词：高血压 静息心率加快 多因素分析 列线图模型 

分 类 号：R544.11[医药卫生—心血管疾病]