2型糖尿病内科住院患者急性肺栓塞远期预后预测模型的建立  

Establishment of prediction model for long?term prognosis of acute pulmonary embolism in internal medicine inpatients with type 2 diabetes mellitus

作　　者：顿晓熠 薛琴 马怿民 吴勤奋[3] 陈尧 马义梅 DUN Xiaoyi;XUE Qin;MA Yimin(Department of Hematology,The Fifth Affiliated of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第五附属医院血液科,乌鲁木齐830011 [2]新疆四七四医院医学影像科 [3]新疆医科大学神经脑科临床诊疗中心 [4]新疆四七四医院内分泌科 [5]新疆四七四医院呼吸与危重症医学科

出　　处：《中国糖尿病杂志》2024年第12期923-927,共5页Chinese Journal of Diabetes

基　　金：新疆维吾尔自治区自然科学基金(2018D01A47);新疆维吾尔自治区创新环境(人才、基地)建设专项基金资助项目(PT2108)。

摘　　要：目的探讨T2DM内科住院患者急性肺栓塞(APE)远期预后影响因素并建立远期预后预测模型。方法选取2019年7月至2022年6月于新疆四七四医院和新疆医科大学第五附属医院内科住院治疗的T2DM合并APE住院患者156例(T2DM+APE组),同期选取内科住院的单纯APE患者156例(APE组),均随访1年,分析两组预后情况。根据预后情况将T2DM+APE组分为预后良好亚组(n=108)及预后不良亚组(n=48),分析预后不良的危险因素,建立预测模型及其对预后不良的预测效能。结果T2DM+APE组预后不良事件发生率高于APE组(P<0.05)。Logistic回归分析显示,N末端脑利尿钠肽前体、心肌肌钙蛋白T、心型脂肪酸结合蛋白及简化肺栓塞严重指数评分是T2DM合并APE患者远期预后不良的危险因素。受试者工作特征曲线分析显示,T2DM合并APE患者预后预测模型的曲线下面积为0.938,敏感度、特异度为83.3%、96.3%,高于单一指标检测(P<0.05)。结论T2DM合并APE患者远期预后较单纯APE患者更差,基于此建立的预测模型有助于临床评估远期预后。Objective To investigate the long-term prognostic factors of acute pulmonary embolism(APE)among internal medicine inpatients with type 2 diabetes mellitus(T2DM),and establish a prediction model of long-term prognosis.Methods This study included 156 internal medicine inpatients with T2DM and APE(T2DM+APE group)admitted to internal medicine of Xinjiang 474 Hospital and The Fifth Affiliated Hospital of Xinjiang Medical University from July 2019 to June 2022.At the same time,156 inpatients with APE from the department of hematology were selected as APE group.All patients were fo llowed up for 1 year to evaluate the prognosis.Patients in T2DM+APE group were divided into good prognosis subgroup(n=108)and poor prognosis subgroup(n=48).The risk factors for poor prognosis were analyzed and a prediction model was established.Results The incidence of adverse events in T2DM+APE group was higher than that in APE group(P<0.05).Logistic regression analysis found that N-terminal precursor of B-type natriuretic peptide(NT-proBNP),cardiac troponin T(c-TnT),heart-type fatty acid binding protein(H-FABP)and simplified Pulmonary Embolism Severity Index(s PESI)score were risk factors for poor long-term prognosis of T2DM complicated with APE.The area under the curve(AUC),sensitivity and specificity of this model for predicting poor prognosis of T2DM complicated with APE were 0.938,83.3%and 96.3%,which were higher than those of prediction with single indicator.Conclusions Patients with T2DM and APE have worse long-term prognosis than those with simple APE.The establishment of a prediction model is helpful for clinical evaluation of long-term prognosis.

关 键 词：糖尿病 2型 急性肺栓塞 远期预后 危险因素 预测模型 

分 类 号：R563.5[医药卫生—呼吸系统] R587.1[医药卫生—内科学]