| 构建危险因素模型预测前降支近段临界病变患者发生主要心脏不良事件的价值 |
| 投稿时间：2017-02-27 修订日期：2017-02-27 点此下载全文 |
| 引用本文：宋洁,夏勇.构建危险因素模型预测前降支近段临界病变患者发生主要心脏不良事件的价值[J].医学研究杂志,2017,46(11):93-96 |
| DOI：
10.11969/j.issn.1673-548X.2017.11.023 |
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| 中文摘要:目的 分析前降支近段临界病变（ICS-PLAD）患者发生主要不良心脏事件（MACE）的相关危险因素，建立危险因素模型预测ICS-PLAD患者发生MACE的价值，为治疗策略的选择提供指导。方法 分析行冠状动脉造影提示ICS-PLAD （最重处直径狭窄 ≥ 50%且<70%）的患者221例。采用二分类Logistic回归分析影响ICS-PLAD患者发生MACE的危险因素，建立危险因素模型。运用ROC曲线评价危险因素模型对ICS-PLAD患者发生MACE的预测价值。结果 （1）与未发生MACE组比较，发生MACE组中糖尿病、高血压和冠脉病变数 ≥ 2更常见，体重指数（BMI）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯（TG）更高（P均<0.05）。（2）采用二分类Logistic回归分析显示，TG （OR=2.447，P=0.000，95% CI：1.608~3.725）、LDL-C （OR=1.971，P=0.006，95% CI：1.219~3.187）及冠脉病变数 ≥ 2（OR=6.596，P=0.000，95% CI：2.995~14.526）是ICS-PLAD患者发生MACE的独立危险因素，建立危险因素模型。（3）危险因素模型预测ICS-PLAD患者发生MACE的ROC曲线下面积为0.794（P=0.000）。结论 在有糖尿病、高血压、肥胖、高LDL-C血症、高TG血症或多支冠脉病变的ICS-PLAD患者中MACE发生率高，TG、LDL-C及冠脉病变数 ≥ 2是ICS-PLAD患者发生MACE的独立危险因素，由此建立的危险因素模型对ICS-PLAD患者发生MACE具有一定的预测价值。 |
| 中文关键词:临界病变 左前降支 危险因素 主要不良心脏事件 |
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| Predictive Value of Risk Factors Model for Major Adverse Cardiac Events in Patients with Intermediate Coronary Stenosis in Proximal Left Anterior Descending Artery |
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| Abstract:Objective To investigate the risk factors of major adverse cardiac events (MACE) in patients with intermediate coronary stenosis in proximal left anterior descending artery (ICS-PLAD) and to assess the predictive value of risk factors model for MACE in patients with ICS-PLAD.Methods Totally 221 patients with ICS-PLAD (≥ 50% and <70% diameter stenosis by angiography) were retrospectively studied. The risk factors of MACE in patients with ICS-PLAD were explored by binary logistic regression analysis. The predictive value of risk factors model for MACE in patients with ICS-PLAD was evaluated by receiver operator curves (ROC).Results Compared with No MACE group,the MACE group had more patients with diabetes(DM),hypertension and number of stenotic vessels ≥ 2,had higher body mass index (BMI), low density lipoprotein cholesterol(LDL-C)and triglycerides(TG)(P all<0.05). Binary logistic regression analysis showed that the independent risk facts were TG (OR=2.447, P=0.000, 95%CI:1.608-3.725), LDL-C (OR=1.971, P=0.006, 95%CI:1.219-3.187) and number of stenotic vessels ≥ 2 (OR=6.596, P=0.000, 95%CI:2.995-14.526). The area under the ROC (AUC) of risk factor model for the prediction of MACE in patients with ICS-PLAD were 0.794(P=0.000).Conclusion Patients with ICS-PLAD, with DM, hypertension, number of stenotic vessels ≥ 2, obesity, high LDL-C or high TG, had higher MACE rate. TG, LDL-C and number of stenotic vessels ≥ 2 were the independent risk factors of MACE in patients with ICS-PLAD. The risk factors model has some clinical value for the prediction of MACE in patients with ICS-PLAD. |
| keywords:Intermediate coronary stenosis Left anterior descending artery Risk factors Major adverse cardiac events |
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