摘要
目的:探究冠状动脉(冠脉)功能性缺血的相关因素,通过联合危险因素构建预测模型,并分析其对于功能性缺血的诊断价值。方法:连续、回顾性筛选接受冠脉造影,提示血管直径狭窄程度50%～75%,并同时行血流储备分数(FFR)检查的冠心病临界病变患者,经过排除后入选患者277例,其中男176例,女101例。以FFR<0.80视为血管存在功能性缺血的界限,通过单因素与多因素Logistic回归分析筛选与功能性缺血相关的预测因子,利用受试者工作特征(ROC)曲线评价危险因素所构建的多元Logistic方程对于功能性缺血的预测价值。结果:男性、病变血管数及红细胞分布宽度(RDW)与血管功能性缺血存在显著性相关,通过三者构建的多元Logistic方程ROC曲线下面积AUC=0.747,P<0.001,95%置信区间(CI)为0.682～0.813,且该模型优于单独使用RDW用于预测功能性缺血,差异具有统计学意义(P<0.05)。结论:在冠心病临界病变中,男性、病变血管数及红细胞分布宽度为功能性缺血的独立预测因子,所构建的多元Logistic方程对于指导血运重建具有一定价值。
Objective:We explore the factors associated with functional ischemia,constructed a predictive model by combining risk factors,and analyzed its diagnostic value for functional ischemia.Method:Consecutive patients who underwent FFR measurement for intermediate lesions(50~75% stenosis on coronary angiography) were retrospectively screened and 277 patients including 176 males and 101 females were enrolled in this study.A FFR value <0.80 was defined as functional ischemia.Univariate and multivariate logistic regression analysis were used to investigate the association between functional ischemia and clinical variables.The receiver operating characteristic(ROC) curve was applied to evaluate the predictive value of the multivariate logistic equation for functional ischemia.Result:Male gender,number of stenotic vessels and red blood cell distribution(RDW) were significantly correlated with functional ischemia.The area under the ROC curve(AUC) of the multivariate logistic equation was 0.747,P<0.001 and its 95% confidence interval(CI) were 0.682 to 0.813.Conclusion:Our study has shown that male gender,number of stenotic vessels and RDW are independent predictors of functional ischemia in patients with intermediate lesions.The multivariate logistic equation has certain value for guiding revascularization.
作者
左文杰
杨明明
陈怡帆
谢爱明
陈立娟
马根山
ZUO Wenjie;YANG Mingming;CHEN Yifan;XIE Aiming;CHEN Lijuan;MA Genshan(Department of Cardiology,Zhongda Hospital,Medical School of Southeast University,Nanjing 210009,China;The School of Medicine,Southeast University)
出处
《临床心血管病杂志》
CAS
北大核心
2019年第4期344-348,共5页
Journal of Clinical Cardiology
基金
江苏省科技厅社会发展重点病种规范化诊疗项目(No:BE2016785)
江苏省医学重点学科(实验室)(No:ZDXKA2016023)
关键词
冠心病
血流储备分数
临界病变
coronary artery disease
fractional flow reserve
intermediate lesions
