AMI后早期Q-T间期延长的危险因素研究及风险预测模型建立  

Risk factor research and risk prediction model establishment for early Q-T interval prolongation after acute myocardial infarction

作　　者：李思凡 肖莹 王冬波[1] 刘思宁[1] 汤亚东 田学峰[1] Li Sifan;Xiao Ying;Wang Dongbo;Liu Sining;Tang Yadong;Tian Xuefeng(Department of Cardiology,Heilongjiang Provincial Hospital,Harbin 150036,Heilongjiang Province,China;Department of Health Medicine,PLA Joint Logistics Support Force No.903 Hospital,Hangzhou 310007,Zhejiang Province,China)

机构地区：[1]黑龙江省医院心内科,哈尔滨150036 [2]联勤保障部队第九〇三医院健康医学科,杭州310007

出　　处：《中国基层医药》2024年第2期175-179,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的构建急性心肌梗死(AMI)后早期Q-T间期延长危险因素的预测模型,帮助预防急性恶性事件发生。方法采用病例对照研究方法,选取2018年1月至2022年12月就诊于黑龙江省医院的AMI后发生Q-T间期延长患者100例,再选取与其同一周入院的AMI后未发生Q-T间期延长患者100例,将其一半作为建模组(Q-T间期延长组50例、非Q-T间期延长组50例),一半作为验证组(Q-T间期延长组50例,非Q-T间期延长组数50例)。通过logistic回归分析构建预测模型并绘制受试者工作特征曲线(ROC曲线)下面积(AUC)对模型进行评价,并在验证组中检验该模型的价值。结果多因素logistic回归显示,女性(OR=2.307,95%CI:0.09~0.91,P=0.041)和心力衰竭(OR=3.087,95%CI:1.15~8.27,P=0.025)是影响AMI后发生Q-T间期延长的独立危险因素;构建的预测模型的AUC为0.770,灵敏度84.0%,特异度66.0%,约登指数为0.44,所对应最佳临界值为0.43,模型拟合程度较好。结论女性和心力衰竭是AMI后Q-T间期延长的独立危险因素,基于上述危险因素构建的模型拟合度好,预测价值高,有助于减少AMI后早期Q-T间期延长事件发生。Objective To establish a prediction model of risk factors for early Q-T interval prolongation after acute myocardial infarction(AMI),which helps prevent and reduce the occurrence of acute malignant events.Methods This is a case-control study.A total of 100 patients with Q-T interval prolongation after AMI who received treatment at Heilongjiang Provincial Hospital from January 2018 to December 2022 were included in this study.An additional 100 patients without Q-T interval prolongation after AMI who concurrently received treatment in the same hospital were also included in this study.Two model groups,including model group 1(with Q-T interval prolongation,n=50)and model group 2(without Q-T interval prolongation,n=50),and two test groups,including test group 1(with Q-T interval prolongation,n=50)and test group 2(without Q-T interval prolongation,n=50),were designated.Logistic regression analysis was performed to construct a prediction model of risk factors for Q-T interval prolongation.The area under the receiver operating characteristic curve was determined to evaluate the prediction model.The value of the prediction model was validated in the test groups.Results Multivariate logistic regression showed that female gender(OR=2.307,95%CI:0.09-0.91,P=0.041)and heart failure(OR=3.087,95%CI:1.15-8.27,P=0.025)were independent risk factors for early Q-T interval prolongation after AMI.The area under the receiver operating characteristic curve of the prediction model was 0.770,with a sensitivity of 84.0%,a specificity of 66.0%,the Jordan index of 0.44,and the corresponding optimal critical value of 0.43.This indicates good fit of the model.Conclusion Female gender and heart failure are independent risk factors for early Q-T interval prolongation after AMI.The model constructed based on the above-mentioned risk factors fits well and has a high predictive value,which helps reduce the occurrence of early Q-T interval prolongation after AMI.

关 键 词：心肌梗死 心电描记术 危险因素 预测 LOGISTIC模型 女性 心力衰竭 ROC曲线 

分 类 号：R542.22[医药卫生—心血管疾病]