摘要
目的构建急性心肌梗死患者重组人尿激酶原(rhPro-UK)溶栓后恶性心律失常预测风险模型并评估该模型预测价值。方法回顾性纳入2015年10月至2019年2月于山东省东营市广饶县人民医院就诊的118例急性心肌梗死患者为研究对象,所有患者均接受经皮冠状动脉介入治疗(PCI)及rhPro-UK溶栓治疗;采用多因素Logistic回归分析影响急性心肌梗死患者rhPro-UK溶栓后恶性心律失常发生的预测因子,构建预测模型,使用Medcale软件对模型进行受试者特征性工作曲线分析,检验模型效能。结果118例患者,共15例因不同原因失访,共纳入103例患者,其中39例患者发生恶性心律失常,分为发生组和未发生组64例;多因素Logistic回归分析显示,QRS失真畸变、片段性QRS波、大面积心肌梗死是急性心肌梗死患者rhPro-UK溶栓后恶性心律失常发生的预测因子[OR(95%CI)=0.090(2.821~55.635)、1.561(0.012~0.822)、0.069(0.008~0.616),P<0.05];通过Medcale软件逻辑回归建立预测模型,进行ROC曲线分析显示,预测模型的曲线下面积为0.679(95%CI=0.599~0.784),敏感度为81.25%,特异度为61.28%。结论QRS失真畸变、片段性QRS波、大面积心肌梗死是心肌梗死rhPro-UK溶栓患者恶性心律失常的预测因子,通过建立预测模型能够做到早期预警,指导临床治疗方案的制定。
Objective To construct a model for predicting the risk of malignant arrhythmia after thrombolysis with recombinant human prourokinase(rhPro-UK)in acute myocardial infarction(AMI)patients and to evaluate its predictive value.Methods 118 acute myocardial infarction patients who treated in Guangrao County People's Hospital from October 2015 to February 2019 were included as the research objects.All patients received percutaneous coronary intervention(PCI)and rhPro-UK thrombolytic therapy;multivariate logistic regression analysis was used to analyze the predictors effecting the occurrence of malignant arrhythmia after rhPro-UK thrombolysis in patients with AMI.A predictive model were constructed and its effectiveness were tested by receiver characteristic operating curve(ROC)with Medcale software.Results Of the 118 patients,15 patients were lost to follow-up due to different reasons.Among enrolled 103 patients,39 patients developed malignant arrhythmia were included into the occurring group and the others were included into the non-occurring group(64 cases);multivariate logistic regression analysis showed that QRS distortion,fragment QRS complex,and large area myocardial infarction were the predictors of malignant arrhythmia after rhPro-UK thrombolysis in patients with AMI[OR(95%CI)=0.090(2.821-55.635),1.561(0.012-0.822),0.069(0.008-0.616);P<0.05];the predictive model was established by Medcale software logistic regression,and ROC analysis showed that the area under the curve of the predictive model was 0.679(95%CI=0.599-0.784),the sensitivity was 81.25%,and the specificity was 61.28%.Conclusion QRS distortion,fragmented QRS complexes and large-area myocardial infarction are predictors of malignant arrhythmia after rhPro-UK thrombolysis in patients with AMI.The establishment of a predictive model can achieve early warning and guide the formulation of clinical treatment plans.
作者
丁小青
刘红伟
刘海峰
顾磊
Ding Xiaoqing;Liu Hongwei;Liu Haifeng;Gu Lei(Department of Cardiology,Guangrao County People's Hospital,Dongying 257300,China;Department of Cardiology,Dongying City People's Hospital,Dongying 257300,China)
出处
《心脑血管病防治》
2021年第5期458-461,共4页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
关键词
急性心肌梗死
重组人尿激酶原溶栓
恶性心律失常
预测风险模型
Acute myocardial infarction
Recombinant human prourokinase thrombolysis
Malignant arrhythmia
Predictive risk model
