实用医学杂志2024，Vol.40Issue(16)：2236-2243,8.DOI:10.3969/j.issn.1006-5725.2024.16.007
房颤合并糖尿病患者影响轻度认知功能障碍发生的多因素分析及预测模型建立
Multivariate analysis and prediction model of mild cognitive impairment in patients with atrial fibrillation and diabetes mellitus
摘要
Abstract
Objective To explore the influencing factors of mild cognitive impairment(MCI)in patients with atrial fibrillation and diabetes mellitus,and to establish the prediction model,so as to provide guidance for the treatment of MCI in patients with atrial fibrillation and diabetes mellitus.Methods 199 patients with atrial fibrillation and diabetes diagnosed in the second ward of Cardiovascular Department of the Fifth Affiliated Hospital of Zhengzhou University from January 2023 to January 2024 were analyzed.The related factors of MCI in patients with atrial fibrillation and diabetes mellitus were analyzed by univariate analysis and multivariate logistic regres-sion.According to the results of multivariate logistic regression analysis,the prediction model of MCI in patients with atrial fibrillation and diabetes mellitus was established.Results Univariate analysis showed that age(P=0.002 3),homocysteine(P＜0.000 1),fasting blood glucose(P=0.022 5),glycated hemoglobin(P=0.006 6),and blood uric acid(P=0.032 2)were the influencing factors of MCI.Multivariate logistic regression analysis:age(OR=1.08,P=0.000 4),homocysteine(OR=1.37,P＜0.000 1),fasting blood glucose(OR=1.22,P=0.023 5),glycated hemoglobin(OR=1.61,P=0.004 2),and blood uric acid(OR=1.29,P=0.009 1)were the independent influencing factors of MCI.The optimal threshold is when the Youden index(YI=sensitivity+speci-ficity)is maximum.At the optimal threshold,the sensitivity was 0.74,the specificity was 0.80,and the area under the curve(AUC)was 0.809,indicating that the model can effectively predict the occurrence of MCI.Conclusion Age,fasting blood glucose,blood homocysteine,blood uric acid and glycosylated hemoglobin are independent risk factors for MCI in patients with atrial fibrillation and diabetes.The clinical prediction model based on multivariate logistic regression has a certain predictive value for the occurrence of MCI in patients with atrial fibrillation and diabetes mellitus.关键词
房颤/糖尿病/轻度认知功能障碍/预测模型/受试者工作特征曲线Key words
atrial fibrillation/diabetes mellitus/mild cognitive impairment/prediction model/ROC分类
医药卫生引用本文复制引用
黄鑫,张普,高瑜,陈凯,李晓峰,谷慧阳,梁雪..房颤合并糖尿病患者影响轻度认知功能障碍发生的多因素分析及预测模型建立[J].实用医学杂志,2024,40(16):2236-2243,8.基金项目
河南省医学科技攻关计划项目(编号:LHGJ20220555) （编号:LHGJ20220555）
