检验医学与临床2024，Vol.21Issue(14)：2057-2061,5.DOI:10.3969/j.issn.1672-9455.2024.14.015
基于检验指标构建急性心肌梗死患者预后不良的列线图预测模型
Nomogram prediction model construction based on test indexes for poor prognosis in patients with acute myocardial infarction
摘要
Abstract
Objective To analyze the risk factors related to poor prognosis in the patients with acute myocardial infarction(AMI)based on the test indexes,and to construct a nomogram predictive model.Methods The clinical data of 300 patients with AMI receiving percutaneous coronary intervention(PCI)in Qinhuangdao Hospital of Peking University Third Hospital from September 2020 to August 2022 were retrospectively analyzed.The patients were divided into the observation group(occurrence,61 cases)and control group(non-occurrence,239 cases)according to whether the adverse cardiovascular events occurred or not during 1-year follow-up.The clinical data of the two groups were statistically analyzed.The independent risk factors of poor prognosis in the patients with AMI were analyzed by the multivariate Logistic regression.The R software was used to construct a nomogram model for predicting the prognosis of AMI.The correction curve was adopted to con-duct the internal verification for the predictive model.The decision curve was used to evaluate the clinical net benefit of the predictive model.Results The Gensini score,cystatin C(CysC)level,brain natriuretic peptide(BNP)level,high sensitive C-reactive protein(hs-CRP)level,high mobility group protein 1(HMGB1)level,proportion of the patients with white blood cell count＞10.0×109/L in observation group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The increases of white blood cell count,CysC,BNP,hs-CRP and HMGB1 levels were the independent risk factors for poor prognosis in the patients with AMI.The C-index of the nomogram predictive model based on this was 0.791(95％CI:0.486-0.984),and the calibration curve was close to the ideal curve.The decision curve showed that this pre-dictive model could provide the additional clinical net benefit in the aspect of predicting the risk of poor prog-nosis in the patients with AMI when the risk threshold value was＞0.17.Conclusion This study constructs a nomogram predictive model for the risk factors of poor prognosis in the patients with AMI,which is helpful for the medical staff to understand the related factors of poor prognosis in AMI and formulate the personalized countermeasures to improve the prognosis as early as possible.关键词
急性心肌梗死/不良心血管事件/预后/危险因素/列线图/预测模型Key words
acute myocardial infarction/adverse cardiovascular events/prognosis/risk factors/no-mogram/predictive model分类
医药卫生引用本文复制引用
杨茹,李保林,梁微微,王文慧,魏世杰..基于检验指标构建急性心肌梗死患者预后不良的列线图预测模型[J].检验医学与临床,2024,21(14):2057-2061,5.基金项目
河北省秦皇岛市科学技术局课题(202301A206). （202301A206）
