摘要
目的探讨个体化预测下肢动脉硬化闭塞症(lower extremity atherosclerotic occlusive disease,LEAOD)患者介入治疗后复发风险的列线图模型构建。方法回顾性分析暨南大学附属第一医院介入血管科2018年1月至2020年6月收治的487例LEAOD患者的临床资料,根据介入治疗后是否复发分为发生组与未发生组。调取所有患者一般资料,并做Logistic回归分析,筛选出影响LEAOD患者血管介入治疗后复发的独立危险因素,利用R软件建立相应的列线图风险预测模型。结果Logistic回归分析结果显示,年龄(OR=4.870,95%CI:2.273~10.436)、糖尿病(OR=2.417,95%CI:1.179~4.954)、原发性高血压(高血压)(OR=2.688,95%CI:1.364~5.297)、吸烟史(OR=2.894,95%CI:1.421~5.894)和抗血小板药物使用(OR=3.229,95%CI:1.683~6.197)是LEAOD患者血管介入治疗后复发的独立危险因素(P<0.05),与LEAOD患者血管介入治疗后复发高度相关。建模集和验证集的C-index指数分别为0.819(95%CI:0.712~0.938)和0.816(95%CI:0.746~0.928),两组的校正曲线均与标准曲线拟合较好,两组受试者工作特征曲线(receiver operating characteristic curve,ROC)的曲线下面积(AUC)分别为0.825和0.822,证明本次模型具有良好的预测精准度。结论对LEAOD行血管介入治疗前,应充分考虑年龄、糖尿病、高血压、吸烟史和抗血小板药物使用等因素,综合评估LEAOD患者血管介入治疗后的复发率,能提高介入治疗后复发的诊断效能,具有较高的临床价值。
Objectives To study the individual lower extremity atherosclerotic occlusive diseases(LEAOD)risk of recurrence after interventional treatment in patients with nomogram model building.Methods Totally 487 patients from January 2018 to June 2020 in The First Affiliated Hospital of Jinan University were divided into occurrence group and non-occurrence group,according to whether they had recurrence after interventional therapy.General data of all the patients were collected and Logistic regression analysis was performed to screen out independent risk factors affecting LEAOD patients′recurrence after vascular intervention,and R software was used to establish the corresponding risk prediction model of the column chart.Results Logistic regression analysis showed age(OR=4.870,95%CI:2.273-10.436),diabetes(OR=2.417,95%CI:1.179-4.954),hypertension(OR=2.688,95%CI:1.364-5.297),smoking history(OR=2.894,95%CI:1.421-5.894)and CHA2DS2-VASc score(OR=3.229,95%CI:1.683-6.197)were independent risk factors for recurrence after vascular intervention in LEAOD patients(P<0.05),and was highly correlated with recurrence after vascular intervention in LEAOD patients.The C-index indexes of the modeling set and the validation set were 0.819(95%CI:0.712-0.938)and 0.816(95%CI:0.746-0.928),respectively.The correction curves of the two groups were well fitted to the standard curve,and the areas under receiver operating characteristic curve of the two groups were 0.825 and 0.822,respectively,proving that the model had good prediction accuracy.Conclusions Before vascular intervention for LEAOD,factors such as age,diabetes,hypertension,smoking history and CHA2DS2-VASC score should be fully considered to comprehensively evaluate the recurrence rate of LEAOD in patients after vascular intervention,which can improve the diagnostic efficiency of postoperative recurrence and has high clinical value.
作者
韩雯雯
陈婷
曹灵转
黄碧清
刘星怡
HAN Wen-wen;CHEN Ting;CAO Ling-zhuan;HUANG Bi-qing;LIU Xing-yi(Department of Interventional Plastic Surgery,The First Affiliated Hospital of Jinan University,Guangzhou 510630,China;Department of Nephrology and Rheumatology,Guiyang Second People′s Hospital,Guiyang,Guizhou 550000,China)
出处
《岭南心血管病杂志》
CAS
2021年第3期308-312,378,共6页
South China Journal of Cardiovascular Diseases
关键词
下肢动脉硬化闭塞症
血管介入治疗
复发率
危险因素
列线图
lower extremity atherosclerotic occlusive diseases
vascular intervention
the recurrence rate
risk factors
the column chart
