摘要
目的构建非瓣膜性心房颤动患者冷冻球囊消融术后复发的预测模型,并对其效能进行验证。方法将2015年1月至2018年6月于陕西省勉县医院及贵州省黔东南苗族侗族自治州人民医院行冷冻球囊消融术的120例非瓣膜性心房颤动患者纳入研究,根据术后12个月内是否复发,将其分为复发组(38例)及对照组(82例),比较两组患者的年龄、性别等一般资料,以及患者左心房内径、左心室射血分数等相关因素,应用Logistic回归模型分析影响心房颤动复发的独立危险因素,使用R软件建立心房颤动复发的列线图预测模型,并从纳入病例中随机抽取20%进行外部验证。结果复发组患者的年龄、病程、左心房内径、左心室舒张末内径及术前超敏C-反应蛋白(hs-CRP)水平明显高于未复发组(t=4.086、4.021、4.647、4.325、3.357,均P<0.05),孤立性心房颤动人数明显少于未复发组(χ^2=5.207,P<0.01);两组患者心房颤动分类、左心室射血分数等无统计学意义(χ^2/t=0.340、1.597,均P>0.05)。多因素Logistic分析示年龄、病程、左心房内径及术前高hs-CRP均是心房颤动复发的独立危险因素(OR=1.139、1.097、1.699、1.485,均P<0.05),而孤立性心房颤动则是心房颤动复发的保护因素(OR=0.015,P<0.05);术后列线图预测心房颤动复发发生的一致性指数(C-index)为0.874(95%CI=0.759~0.931)。结论高龄、久病、左心房内径过大等危险因素构件的列线图可对非瓣膜性心房颤动冷冻球囊消融术后的再复发进行有效预测,并具有较好的应用价值。
Objective To construct a predictive model for recurrence in patients with nonvalvular atrial fibrillation after cryoballoon ablation,and verify its efficacy.Methods A total of 150 patients with non-valvular atrial fibrillation who underwent cryoplasty ablation at Mianxian hospital of Shaanxi province and Qiandongnan Miao and Dong autonomous prefecture people's hospital of Guizhou province from January 2015 to June 2018 were included in the study.According to whether it recured within 12 months after surgery,patients were divided into relapse group(n=38)and control group(n=82).The general information such as age and sex of the two groups of patients were compared,and related factors such as left atrial inner diameter,left ventricular ejection fraction were also compared,the independent risk factors affecting the recurrence of atrial fibrillation were analyzed using logistic regression model,and a nomogram prediction model of atrial fibrillation recurrence was established using R software,and 20%of the included cases were randomly selected for external verification.Results The age,duration,left atrial inner diameter,left ventricular end diastolic diameter,and preoperative high-sensitivity C-reactive protein(hs-CRP)levels in the relapse group were significantly higher than those in the non-relapse group(t=4.086,4.021,4.647,4.325,3.357;both P<0.05),the number of solitary atrial fibrillation was significantly less than that in the non-relapsed group(χ^2=5.207,P<0.01);the atrial fibrillation classification and left ventricular ejection fraction of the two groups were not statistically significant different(χ^2/t=0.340,1.597,both P>0.05).Multivariate Logistic analysis showed that advanced age,long course of disease,large left atrial diameter,and high preoperative hs-CRP were independent risk factors for atrial fibrillation recurrence(OR=1.139,1.097,1.699,1.485;all P<0.05),but isolated atrial fibrillation was a protective factor for the recurrence of atrial fibrillation(OR=0.015,P<0.05);the consistency index(C-index)of
作者
张立立
周雪娥
王芳
Zhang Lili;Zhou Xue'e;Wang Fang(Department of Cardiology,Mianxian Hospital,Hanzhong 724200,China;Department of Cardiology,Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital,Kaili 556000,China)
出处
《心脑血管病防治》
2020年第6期592-595,共4页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
