AMI病人PCI术后2年内发生主要心血管不良事件的列线图模型构建及验证  

Construction and validation of a nomogram model for major cardiovascular adverse events in acute myocardial infarction patients within 2 years after percutaneous coronary intervention

作　　者：罗钢 高丽 丁宏[1] 李胜辉 翟康宁 陈震[1] LUO Gang;GAO Li;DING Hong;LI Shenghui;ZHAI Kangning;CHEN Zhen(Department of Cardiology,Taixing People′s Hospital Affiliated to Bengbu Medical University,Taixing Jiangsu 225400,China)

机构地区：[1]蚌埠医科大学附属泰兴市人民医院心内科,江苏泰兴225400

出　　处：《蚌埠医学院学报》2024年第5期597-600,共4页Journal of Bengbu Medical College

基　　金：江苏省泰州市科技支撑计划社会发展(指导性)项目(2021-16);蚌埠医学院科研创新计划项目(Byycx20081);江苏大学临床医学科技发展项目(JLY2021191);江苏省泰兴市人民医院院级科研项目(try2129)。

摘　　要：目的:研究影响急性心肌梗死(AMI)病人经皮冠状动脉介入治疗(PCI)术后2年内发生主要心血管不良事件(MACE)的危险因素,构建列线图模型并验证。方法:回顾性分析AMI行PCI术病人491例临床资料,将病人以7∶3比例随机分为建模组345例和验证组146例。采用单因素和多因素logistic回归分析,对建模组病人2年内发生MACE的影响因素进行分析,构建列线图模型并进行验证。结果:单因素及多因素logistic回归分析显示,年龄、fQRS波、Gensini评分、中性粒细胞/淋巴细胞均为AMI病人PCI术后2年内发生MACE的独立影响因素(P<0.05~P<0.01)。经绘制列线图,建模组AUC为0.743,表明该模型区分度良好,H-L曲线拟合良好(χ^(2)=3.827,P=0.922),验证组AUC为0.720,提示模型准确度良好。结论:年龄、fQRS波、Gensini评分、中性粒细胞/淋巴细胞是AMI病人PCI术后2年内发生MACE的独立危险因素,构建的列线图模型具有良好预测作用。Objective:To study the risk factors of major adverse cardiovascular events in acute myocardial infarction(AMI)patients within 2 years after percutaneous coronary intervention(PCI),construct a nomogram model and verify it.Methods:The clinical data of 491 patients with AMI undergoing PCI were analyzed retrospectively.The patients were randomly divided into a modeling group of 345 cases and a validation group of 146 cases in a 7:3 ratio.The influencing factors of major adverse cardiovascular events in the modeling group within 2 years were analyzed by univariate and multivariate logistic regression analysis,and a nomogram model was constructed and verified.Results:Univariate and multivariate logistic regression analysis showed that age,fQRS wave,Gensini score and neutrophils/lymphocytes ratio(NLR)were independent influencing factors of major adverse cardiovascular events in AMI patients within 2 years after PCI(P<0.05 to P<0.01).The nomogram was drawn,and the AUC of the modeling group was 0.743,showing that the model had good discrimination,the H-L curve was well fitted(χ^(2)=3.827,P=0.922),and the AUC of the validation group was 0.720,indicating that the model was accurate.Conclusions:The age,fQRS wave,Gensini score and NLR are independent risk factors for major adverse cardiovascular events in AMI patients within 2 years after PCI,and the nomogram model has a good predictive function.

关 键 词：急性心肌梗死 主要心血管不良事件 经皮冠状动脉介入 列线图 

分 类 号：R542.22[医药卫生—心血管疾病]