基于潜类别增长模型的冠心病患者介入治疗术后心血管健康评分发展轨迹刻画及影响因素  

Trajectory of cardiovascular health score in patients with CHD after PCI based on LCGM and analysis on its influencing factors

作　　者：高立豪 邱久纯[2] 李龙炎 Gao Lihao;Qiu Jiuchun;Li Longyan(Department of Gastroenterology,Beijing Renhe Hospital,Beijing 102699,China)

机构地区：[1]北京市仁和医院消化科,102699 [2]天津医科大学第二医院心内科

出　　处：《中华老年心脑血管病杂志》2025年第4期468-472,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的基于潜类别增长模型(latent class growth modeling,LCGM)分析冠心病患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后心血管健康评分发展轨迹刻画及影响因素。方法前瞻性选取2021年6月至2023年6月北京市仁和医院收治的行PCI术后的冠心病患者186例,进行心血管健康评分,对术后心血管健康评分发展进行LCGM分析,并使用多因素logistic回归分析影响冠心病患者PCI术后心血管健康评分发展轨迹的影响因素。结果冠心病患者PCI术后当天、术后1个月、术后6个月、术后12个月的心血管健康评分分别为(6.34±1.38)分、(6.76±1.44)分、(7.49±1.85)分、(8.06±2.07)分,不同时间点的心血管健康评分比较,差异有统计学意义(F=37.167,P<0.01)。二次估计方法构建的LCGM模型分析显示,冠心病患者PCI术后心血管健康评分发展轨迹可分为3个亚群,第一类心血管健康评分增长型98例(52.69%),第二类心血管健康评分稳定型67例(36.02%),第三类心血管健康评分波动型21例(11.29%)。不同文化程度、家庭人均月收入、冠心病病程、合并慢性病种数的冠心病患者PCI术后心血管健康评分比较,差异有统计学意义(P<0.05,P<0.01)。文化程度、家庭人均月收入、冠心病病程、合并慢性病种数均为冠心病患者PCI术后心血管健康评分发展轨迹的影响因素(P<0.01)。结论冠心病患者PCI术后的心血管健康评分可分为3种发展轨迹,文化程度、家庭人均月收入、冠心病病程及合并慢性病种数是影响冠心病患者PCI术后心血管健康评分的独立影响因素。Objective To analyze the trajectory of cardiovascular health score and its influencing factors in patients with CHD after PCI based on LCGM.Methods A total of 186 CHD patients undergoing PCI in our hospital from June 2021 to June 2023 were enrolled,and all of them received an assessment for cardiovascular health scores.LCGM analysis was performed on the change in their postoperative cardiovascular health scores.Multivariate logistic regression analysis was applied to identify the factors affecting the trajectory of the change in the scores of the patients.Results The cardiovascular health score was 6.34±1.38,6.76±1.44,7.49±1.85,and 8.06±2.07,respectively on the day of,and at 1,6 and 12 months after surgery.There were significant differences in the score among different time points(F=37.167,P<0.01).LCGM model constructed by quadratic estimation showed that the trajectory of the cardiovascular health score in CHD patients after PCI could be divided into three types:growth type(98 cases,52.69%),stable type(67 cases,36.02%)and volatile type(21 cases,11.29%).Statistical difference was observed in the score among the post-PCI CHD patients with different education level,per capita monthly family income,duration of coronary artery disease,and number of comorbid chronic diseases(P<0.05,P<0.01).The education level,per capita monthly family income,duration of coronary heart disease,and number of comorbid chronic diseases were all influencing factors for the trajectory of cardiovascular health score in the CHD patients after PCI(P<0.01).Conclusion There are three types of trajectory in cardiovascular health score of CHD patients after PCI.Education level,family per capita monthly income,duration of coronary heart disease and number of chronic diseases are independent factors affecting the score of the patients.

关 键 词：冠心病 经皮冠状动脉介入治疗 危险因素 

分 类 号：R54[医药卫生—心血管疾病]