疑难病杂志2025，Vol.24Issue(9)：1025-1030,6.DOI:10.3969/j.issn.1671-6450.2025.09.001
老年冠心病多支血管病变患者不完全血运重建预后危险因素分析与相关预测模型构建
Analyze the risk factors of incomplete revascularization in elderly patients with coronary heart disease and multivessel disease and to construct a prediction model
摘要
Abstract
Objective To investigate the independent risk factors of major adverse cardiovascular events(MACE)af-ter incomplete revascularization in elderly patients with coronary heart disease combined with multi-vessel disease,establish a predictive model based on clinical indicators and verify its efficacy.Methods A total of 143 elderly patients with coronary heart disease and multi-vessel disease were selected from November 2022 to November 2023.The data set was divided into a training set(100 cases)and a verification set(43 cases)using the train_test_split function in the sklearn toolkit.The training set was divided into MACE group(n=28)and non-MACE group(n=72)according to whether MACE was present in the training set.By comparing the baseline data of the two groups,multivariate Logistic regression was used to analyze the ad-verse prognostic factors,and a neagram model and model efficacy were established.Results There was no statistical signifi-cance between the training set and the verification set(P＞0.05).Compared with the non-MACE group,the age,diabetes and abnormal glucose tolerance ratio,Cr and UA levels in the MACE group were higher than those in the non-MACE group(P＜0.05),the male ratio,UB level and TIMI blood flow grade in the MACE group were lower than those in the non-MACE group(P＜0.05),and there were no statistically significant differences among other indicators(P＞0.05).Multivariate Logistic regres-sion analysis showed abnormal glucose tolerance[OR=1.656,95％CI:1.049-1.818],SCr[OR=1.071,95％CI:1.013-1.598],UA[OR=1.079,95％CI:1.012-1.663]and TIMI blood flow grade[OR=1.083,95％CI:1.027-1.196]were risk factors for poor prognosis(P＜0.05).The nomogram model shows that the consistency index of training set and verification set are 0.812 and 0.809,respectively.The AUC was 0.836(95％CI:0.709-0.875)and 0.901(95％CI:0.722-0.983),respectively.Conclusion Abnormal glucose tolerance,increased Cr and UA,and decreased TIMI blood flow grade are independent risk factors for MACE after incomplete re-vasculopathy in elderly patients with multi-vessel coronary heart disease.The constructed histogram model has good predictive efficacy.Clinical attention should be paid to glucose metabolism,renal func-tion and hemodynamic management to improve prognosis.关键词
冠心病/多支血管病变/血运重建/预后/老年人Key words
Coronary heart disease/Multi-vessel disease/Revascularization/Prognosis/Elderly分类
医药卫生引用本文复制引用
庾辉,王勇军,李蓉,范群华,罗彩东..老年冠心病多支血管病变患者不完全血运重建预后危险因素分析与相关预测模型构建[J].疑难病杂志,2025,24(9):1025-1030,6.基金项目
国家卫生健康委医院管理研究所"医疗质量循证管理持续改进研究项目"(YLZLXZ22K012) National Health Commission Hospital Management Research Institute"Evidence based Management Continu-ous Improvement Research Project for Medical Quality"(YLZLXZ22K012) （YLZLXZ22K012）
