基于心电图参数构建的预测模型对急性心肌梗死患者不良心脑血管事件发生的预测价值  

Predictive Value of Prediction Model Based on Electrocardiogram Parameters for Major Cardiovascular Event in Patients with Acute Myocardial Infarction

作　　者：李堂乐 陈伯训 林伙仙 LI Tang-le;CHEN Bo-xun;LIN Huo-xian(Department of Internal Medicine,Fuzhou Changle District Second Hospital,Fuzhou,Fujian,350211,China;Department of Geriatric,Fuzhou Changle District Second Hospital,Fuzhou,Fujian,35021l,China)

机构地区：[1]福州市长乐区第二医院内科,福建福州350211 [2]福州市长乐区第二医院老年科,福建福州350211

出　　处：《现代生物医学进展》2025年第2期333-338,共6页Progress in Modern Biomedicine

基　　金：福州市科技计划项目(2021-S-133)。

摘　　要：目的:探讨基于心电图参数构建的预测模型对急性心肌梗死(AMI)患者发生不良心脑血管事件(MACCE)的预测价值。方法:根据随访1年MACCE发生情况,90例AMI患者分为MACCE组和非MACCE组,所有AMI患者均接受心电图检查。收集AMI患者的临床资料,采用单因素和多因素Logistic回归模型分析AMI患者发生MACCE的影响因素。绘制受试者工作特征(ROC)曲线分析基于心电图参数构建的预测模型对AMI患者发生MACCE的预测价值。结果:90例AMI患者治疗后有26例发生MACCE,发生率为28.89%。MACCE组和非MACCE组的NN间期标准差(SDNN)、NN间期平均值的标准差(SDANN)、三角指数、心率减速力(DC)比较有差异(P<0.05)。SDNN降低、三角指数降低、DC降低是AMI患者发生MACCE的危险因素,SDANN升高则是保护因素(P<0.05)。ROC分析结果显示,当取阈值为0.338时,该预测模型对AMI患者发生MACCE具有最佳的预测效能,其曲线下面积(AUC)(95%CI)为0.959(0.837~0.981),灵敏度为0.923,特异度为0.906时,约登指数为0.829。结论:基于心电图参数(SDNN、SDANN、三角指数、DC)构建的预测模型对AMI患者发生MACCE具有较高的预测价值。Objective:To explore the predictive value of prediction model based on electrocardio gram parameters for major cardiovascular event(MACCE)in patients with acute myocardial infarction(AMI).Methods:According to the occurrence of MACCE during the 1-year follow-up,90 AMI patients were divided into MACCE group and non-MACCE group.The clinical data of AMI patients were collected,and the influencing factors of MACCE in AMI patients were analyzed by univariate and multivariate Logistic regression models.The predictive value of the prediction model based on electrocardiogram parameters for MACCE in AMI patients was analyzed by receiver operating characteristic(ROC)curve.Results:There were 26 cases of MACCE in 90 AMI patients after treatment,and the incidence rate was 28.89%.The standard deviation of the NN interval(SDNN),the standard deviation of the mean NN interval(SDANN),the triangle index,and the heart rate deceleration capacity(DC)were compared between MACCE group and the non-MACCE group were statistically significant(P<0.05).Decreased SDNN,decreased triangle index and decreased DC were risk factors for MACCE in AMI patients,while increased SDANN was a protective factor(P<0.05).ROC analysis showed that when the threshold was0.338,the prediction model had the best predictive efficacy for the occurrence of MACCE in AMI patients.The area under the curve(AUC)(95%CI)was 0.959(0.837-0.981),the sensitivity was0.923,the specificity was 0.906,and the Youden index was 0.829.Conclusion:The prediction model based on electrocardiogram parameters(SDNN,SDANN,triangle index,DC)has a high predictive value for MACCE in AMI patients.

关 键 词：心电图 急性心肌梗死 不良脑血管事件 预测价值 

分 类 号：R3[医药卫生—基础医学] R540.41R542.22