ST段抬高型心肌梗死合并糖尿病患者高血栓负荷的预测模型  

Nomogram prediction model of high thrombus burden in ST segment elevation myocardial infarction with diabetes mellitus patients

作　　者：连政 苏京[1] 张国勇 马铮 罗斌 刘佩林 郭彩霞 LIAN Zheng;SU Jing;ZHANG Guoyong;MA Zheng;LUO Bin;LIU Peilin;GUO Caixia(Department of Cardiovascular Center,Beijing Tongren Hospital,Capital Medical University,Beijing100176,China)

机构地区：[1]首都医科大学附属北京同仁医院心血管中心,100176

出　　处：《心肺血管病杂志》2025年第2期117-122,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京同仁医院青年后备人才(2021-YJJ-ZZL-051)。

摘　　要：目的:探讨构建急性ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)合并2型糖尿病(type 2 diabetes mellitus,T2DM)患者,梗死相关动脉(infarction related artery,IRA)高血栓负荷的临床预测模型,用以早期识别高危患者,以便指导临床治疗。方法:共纳入134例患者,通过冠状动脉造影对IRA血栓负荷进行TIMI血栓分级进行分组,将血栓积分≥3级的定义为高血栓负荷组,<3级的定义为低血栓负荷组,搜集患者的临床资料,对数据进行统计并构建临床预测模型。结果:高MPV、高血小板体积分布宽度(platelet volume distribution width,PDW)和高红细胞压积(hematocrit,HCT)是高血栓负荷的危险因素。基于以上危险因素构建STEMI合并T2DM患者IRA高血栓负荷的列线图模型,预测发生率与实际发生率基本一致,曲线下面积(area under carve,AUC)为0.80且具有良好的临床适用度。结论:根据STEMI合并T2DM患者IRA高血栓负荷的危险因素构建的列线图模型对其发生具有较好的预测效能。Objective:This study was to investigate the risk factors of high thrombus burden in ST segment elevation myocardial infarction(STEMI)with type2 diabetes mellitus(T2DM)patients and establish a clinical prediction model for early identifying high-risk patients and guiding clinical treatment.Methods:A total of 134 patients were included in this study.Infarcted related artery thrombus burden was divided by TIMI thrombus grade through coronary angiography.The grade≥3 defined as the high thrombus burden group,and the thrombus grade<3 was defined as the low thrombus burden group.The clinical data of patients were collected.Results:High MPV,high PDW and high hematocrit(HCT)were independent risk factors for high thrombus burden.Based on the above risk factors,a nomogram model of high thrombus burden in STEMI complicated with T2DM patients was established.The predicted incidence was consistent with the actual incidence,and the area under the curve(AUC)of the model was 0.80,which had a good clinical applicability.Conclusions:Based on the risk factors of patients with STEMI complicated with T2DM,the nomogram model can predict the high thrombus burden.

关 键 词：冠心病 ST段抬高型心肌梗死 糖尿病 血栓负荷 临床预测模型 列线图 

分 类 号：R54[医药卫生—心血管疾病]