长期服用阿司匹林冠心病患者胃黏膜损伤风险预测模型的构建和验证  

Construction and validation of a risk prediction model for gastric mucosal injury in patients with long-term aspirin use and coronary heart disease

作　　者：刘苑 付宽 张洋洋 Liu Yuan;Fu Kuan;Zhang Yangyang(Jinghai District Hospital,Tianjin 301600,China)

机构地区：[1]天津市静海区医院,天津301600

出　　处：《首都食品与医药》2025年第9期64-67,共4页Capital Food Medicine

摘　　要：目的 分析长期服用阿司匹林冠心病患者发生胃黏膜损伤风险的影响因素,构建列线图预测模型并评价其性能。方法 选取2022年8月-2023年8月天津市静海区医院心内科收治的100例冠心病患者作为研究对象,根据随访1年后是否发生胃黏膜损伤分为损伤组(n=27)和非损伤组(n=73)。采用多元Logistic回归分析影响长期服用阿司匹林冠心病患者发生胃黏膜损伤的独立危险因素;R软件构建预测冠心病患者术后预后不良的列线图模型;校正曲线对预测模型进行内部验证;ROC曲线评估预测模型的预测效能。结果 多因素Logistic回归分析结果显示,年龄、使用胃黏膜保护药物、服用阿司匹林时间、HGB和HDL-C是长期服用阿司匹林冠心病患者胃黏膜损伤的影响因素(P均<0.05)。内部验证结果显示,临床预测模型的Brier评分为0.081(<0.25),预测发生率与实际发生率基本一致;ROC曲线下面积为0.948,提示该列线图模型具有较好的预测效能。结论 本研究构建了长期服用阿司匹林冠心病患者发生胃黏膜损伤风险的列线图预测模型,有助于帮助临床进行个性化管理,减少阿司匹林相关的胃肠道不良反应,改善患者的预后。Objective To analyze the influencing factors of the risk of gastric mucosal injury in patients with coronary heart disease who take aspirin for a long time,construct a column chart prediction model,and evaluate its performance.Methods 100 patients with coronary heart disease admitted to the cardiology department of Jinghai District Hospital in Tianjin from August 2022 to August 2023 were selected as the study subjects.They were divided into an injury group(n=27)and a non injury group(n=73)based on whether gastric mucosal injury occurred after a one-year follow-up.Using multiple logistic regression analysis to identify independent risk factors for gastric mucosal injury in patients with long-term aspirin use and coronary heart disease;constructing a column chart model for predicting poor postoperative prognosis in patients with coronary heart disease using R software;internal validation of the prediction model using calibration curves;ROC curve evaluates the predictive performance of prediction models.Results Multivariate logistic regression analysis showed that age,use of gastric mucosal protective drugs,duration of aspirin use,HGB,and HDL-C were the influencing factors of gastric mucosal injury in long-term aspirin taking coronary heart disease patients(all P<0.05).The internal validation results showed that the Brier score of the clinical prediction model was 0.081(<0.25),and the predicted incidence rate was basically consistent with the actual incidence rate;the area under the ROC curve is 0.948,indicating that the column chart model has good predictive performance.Conclusion This study constructed a column chart prediction model for the risk of gastric mucosal injury in long-term aspirin taking coronary heart disease patients,which can help personalized management in clinical practice,reduce aspirin related gastrointestinal adverse reactions,and improve patient prognosis.

关 键 词：阿司匹林 冠心病 胃黏膜损伤 风险预测模型 消化道出血 

分 类 号：R573[医药卫生—消化系统]