冠心病患者PCI术后发生支架内再狭窄风险预测模型的构建及价值评价  

Construction and value evaluation of risk prediction model for in-stent restenosis after PCI in patients with coronary heart disease

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作  者:秦昌芸 韩晶[1] 高利传 荀洪霞 刘晓艳 QIN Changyun;HAN Jing;GAO Lichuan;XUN Hongxia;LIU Xiaoyan(Qingdao University,Qingdao 266071;Zibo First Hospital,Zibo 255200,China)

机构地区:[1]青岛大学,山东青岛266071 [2]淄博市第一医院,山东淄博255200

出  处:《临床医学研究与实践》2025年第12期26-29,共4页Clinical Research and Practice

摘  要:目的构建冠心病患者经皮冠状动脉介入治疗(PCI)术后发生支架内再狭窄(ISR)风险预测模型,并对其价值进行评价。方法回顾性收集2021年9月至2022年9月淄博市第一医院成功进行PCI手术的196例患者的一般资料,根据随访结果将其分为发生ISR组和未发生ISR组。采用单因素、多因素Logistic回归分析构建冠心病患者PCI术后发生ISR的风险预测模型,并通过受试者工作特征(ROC)曲线评价预测价值。结果96例患者中发生ISR 46例,未发生ISR 150例。两组的冠心病年限、支架植入直径、低密度脂蛋白胆固醇、甘油三酯、肌酸激酶同工酶、病变血管、Killip心功能分级、吸烟史、高血压病史及糖尿病病史情况比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,支架植入直径、低密度脂蛋白胆固醇、病变血管、吸烟史及高血压病史是冠心病患者PCI术后发生ISR的影响因素(P<0.05)。多因素Logistic回归模型的曲线下面积(AUC)为0.731(95%CI 0.640~0.818,P<0.001),灵敏度为77.76%,特异度为68.94%,说明本研究模型对冠心病患者PCI术后发生ISR的预测价值中等。结论支架植入直径、低密度脂蛋白胆固醇、病变血管、吸烟史及高血压病史是冠心病患者PCI术后发生ISR的影响因素,临床医护人员可针对上述因素对患者进行风险管理。Objective To construct a risk prediction model for in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with coronary heart disease,and to evaluate its value.Methods The general data of 196 patients who successfully underwent PCI in Zibo First Hospital from September 2021 to September 2022 were retrospectively collected.According to the follow-up results,the patients were divided into ISR group and non-ISR group.Univariate and multivariate Logistic regression analysis were used to construct a risk prediction model for ISR after PCI in patients with coronary heart disease,and the prediction value was evaluated by receiver operating characteristic(ROC)curve.Results Of the 96 patients,46 cases had ISR and 150 cases had no ISR.There were statistically significant differences in coronary heart disease duration,stent implantation diameter,low-density lipoprotein cholesterol,triglyceride,creatine kinase isoenzyme,diseased blood vessels,Killip cardiac function classification,smoking history,hypertension history and diabetes history between the two groups(P<0.05).Multivariate Logistic regression analysis showed that stent implantation diameter,low-density lipoprotein cholesterol,diseased blood vessels,smoking history and hypertension history were the influencing factors of ISR after PCI in patients with coronary heart disease(P<0.05).The areas under curve(AUC)of the multivariate Logistic regression model was 0.731(95%CI 0.640-0.818,P<0.001),the sensitivity was 77.76%,and the specificity was 68.94%,indicating that the predictive value of this model for ISR after PCI in patients with coronary heart disease was moderate.Conclusion The stent implantation diameter,low-density lipoprotein cholesterol,diseased blood vessels,smoking history and hypertension history are the influencing factors of ISR after PCI in patients with coronary heart disease.Clinical medical staff can manage the risk of patients according to the above factors.

关 键 词:冠心病 经皮冠状动脉介入治疗 支架内再狭窄 

分 类 号:R541.4[医药卫生—心血管疾病]

 

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