微创医学2025，Vol.20Issue(4)：400-406,7.DOI:10.11864/j.issn.1673.2025.04.05
急性心肌梗死患者经皮冠状动脉介入治疗后发生慢血流/无复流的危险因素及列线图模型的构建
Risk factors for slow flow/no-reflow and construction of a nomogram model in patients with acute myocardial infarction after percutaneous coronary intervention
摘要
Abstract
Objective To investigate the influencing factors for the occurrence of slow flow/no-reflow in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI),and to construct a nomogram predictive model.Methods A total of 226 AMI patients who underwent PCI were selected as the research subjects.These patients were divided into a training set(n=158)and a validation set(n=68)at a ratio of 7∶3.A multivariate Logistic regression model was used to analyze the risk factors for the occurrence of slow flow/no-reflow in AMI patients after PCI,while R 4.4.1 software was employed to construct a nomogram predictive model and evaluate the model's predictive performance.Results According to whether slow flow/no-reflow occurred in AMI patients after PCI,the 158 patients in the training set were divided into the slow flow/no-reflow group(27 cases)and the normal flow group(131 cases).The systolic blood pressure in the slow flow/no-reflow group was lower than that in the normal flow group,while the levels of γ glutamyl transferase,D-dimer,and cystatin C in the slow flow/no-reflow group were higher than those in the normal flow group(P<0.05).Results of multivariate Logistic regression analysis showed that systolic blood pressure,γ glutamyl transferase,D-dimer,and cystatin C levels were influencing factors for the occurrence of slow flow/no-reflow in AMI patients after PCI(P<0.05).The nomogram predictive model constructed based on the aforementioned influencing factors showed the following performance:in the training set,the area under the receiver operating characteristic curve(AUC)was 0.910(95%CI:0.838,0.981),with a specificity of 0.977 and a sensitivity of 0.778;while in the validation set,the AUC was 0.917(95%CI:0.806,1.000),with a specificity of 1.000 and a sensitivity of 0.812.Results of the calibration curve indicated that the predictive curves of both the training set and the validation set were close to the ideal curve.Conclusion Systolic blood pressure,γ glutamyl transferase,D-dimer,and cystatin C levels are influencing factors for the occurrence of slow flow/no-reflow in AMI patients after PCI,and the nomogram model constructed based on the aforementioned indicators has good predictive value.关键词
急性心肌梗死/经皮冠状动脉介入治疗/慢血流/无复流/影响因素/列线图模型Key words
Acute myocardial infarction/Percutaneous coronary intervention/slow flow/no-reflow/Inflnencing factors/Nomogram model引用本文复制引用
卢家路,袁杰林,何乾,陈严..急性心肌梗死患者经皮冠状动脉介入治疗后发生慢血流/无复流的危险因素及列线图模型的构建[J].微创医学,2025,20(4):400-406,7.基金项目
广西高校中青年教师科研基础能力提升项目(编号:2023KY0113) （编号:2023KY0113）
