摘要
目的建立个体化预测冠心病合并肺动脉高压的风险Nomgram模型。方法选取南京医科大学医院诊治的352例冠心病合并肺动脉高压患者作为研究对象,另选取352例未合并肺动脉高压冠心病患者作为对照组,分析两组患者的临床基线资料,采用logistic多因素分析,探究冠心病合并肺动脉高压的危险因素,建立Nomgram模型预测风险,通过受试者曲线(ROC)检验模型的预测价值。结果Logistic多因素分析结果显示,患者酗酒、吸烟、脑卒中史,高血压病程、冠心病病程、PASP、HCT、PaCO_(2)、D-二聚体、NIHSS评分,低PaO_(2)均是造成其冠心病合并肺动脉高压的独立危险因素;冠心病患者Nomgram模型预测结果显示,酗酒、抽烟、脑卒中史、高血压病程(5.66年)、冠心病病程(2.12年)、NIHSS(12.33分)、PASP(75.22mmHg)、HCT(33.22%)、PaCO_(2)(56.11mmHg)、D-二聚体(255.12μg/L),PaO_(2)(56.22mmHg)是冠心病合并肺动脉高压的危险因素;ROC曲线发现Nomgram模型对冠心病合并肺动脉高压的预测曲线下面积为0.675。结论Nomgram模型可以一定程度预测冠心病患者合并肺动脉高压情况进行预测。
Objective To establish an individual Nomgram model for predicting the risk of coronary heart disease complicated with pulmonary hypertension.Methods From January 2017 to December 2021,352 patients with coronary heart disease(CHD)complicated with pulmonary hypertension in our hospital were selected,and 352 patients with coronary heart disease but without pulmonary hypertension were selected as the control group.The clinical baseline data of the two groups were analyzed first,and then logistic multivariate analysis was performed.To explore the risk factors of coronary heart disease complicated with pulmonary hypertension,the Nomgram model was established to predict the risk,and the predictive value of the model was tested by receiver characteristic curve(ROC).Results Logistic multivariate analysis showed that alcoholism,smoking,stroke history,hypertension course,CHD course,PASP,HCT,PaCO_(2),D-dimer,NIHSS score and low PaO_(2)were all independent risk factors for CHD complicated with pulmonary hypertension.Nomgram model prediction results for patients with coronary heart disease showed that Alcohol abuse,smoking,stroke history,duration of hypertension(5.66 years),duration of coronary heart disease(2.12 years),NIHSS(12.33 points),PASP(75.22 mmHg),HCT(33.22%),PaCO_(2)(56.11 mmHg),D-dimer(255.12μg/L),PaO_(2)(56.22 mmHg)is a risk factor for coronary heart disease complicated with pulmonary hypertension.ROC curve showed that the area under the prediction curve of Nomgram model for coronary heart disease complicated with pulmonary hypertension was 0.675.Conclusion Nomgram model can predict pulmonary hypertension in patients with coronary heart disease to a certain extent.
作者
李红梅
王迪斌
翁晓芹
LI Hongmei;WANG Dibin;WENG Xiaoqin(Emergency Department of the Second Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210003,China;Department of Cardiology,the Second Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210003,China;Department of Respiration,the Second Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210003,China)
出处
《公共卫生与预防医学》
2024年第1期89-92,共4页
Journal of Public Health and Preventive Medicine
关键词
冠心病
肺动脉高压
Nomgram
预测价值
Coronary heart disease(CHD)
Pulmonary hypertension
Nomgram
Predictive value
