摘要
目的探究高尿酸血症并发主要不良心血管事件(MACE)的因素并建立其风险评估模型。方法回顾性分析北京市石景山医院441例高尿酸血症患者资料,将其分为建模组(n=309)和验证组(n=132)。根据是否并发MACE将其进一步分组,比较2组临床资料;采用Logistic回归分析法分析高尿酸血症并发MACE的影响因素,基于此构建nomogram模型并验证其效能。结果MACE发生率为30.61%;年龄、身体质量指数(BMI)、血糖控制未达标、脂代谢调节未达标、血尿酸(BUA)、半胱氨酸蛋白酶抑制剂C(Cys C)、超敏C反应蛋白(hs-CRP)均是高尿酸血症并发MACE的影响因素(P<0.05);基于以上影响因素建立nomogram模型评估建模组和验证组高尿酸血症并发MACE的曲线下面积(AUC)为0.939、0.872;校准曲线显示模型在建模组与验证组中预测的高尿酸血症并发MACE概率与实际概率一致性高,Hosmer-Lemeshow检验结果表明模型拟合良好。结论年龄、BMI、血糖控制未达标、脂代谢调节未达标、BUA、Cys C、hs-CRP是高尿酸血症并发MACE的影响因素,据此建立的风险评估nomogram模型评估效能良好。
Objective To explore the factors associated with major adverse cardiovascular events(MACE)in patients with hyperuricemia and to establish a corresponding risk assessment model.Methods A retrospective analysis was conducted on the data of 441 patients with hyperuricemia treated at Shijingshan Hospital,Beijing.Patients were divided into a modeling cohort(n=309)and a validation cohort(n=132),and further stratified based on the occurrence of MACE.The clinical data of the two groups were compared.Logistic regression analysis was used to analyze the influencing factors of hyperuricemia complicated with MACE.Based on these factors,a nomogram model was constructed and its predictive performance was validated.Results The overall incidence of MACE was 30.61%.The age,body massindex(BMI),suboptimal glycemic control,inadequate lipid management,blood uric acid(BUA),cystatin C(Cys C),and hypersensitive C-reactive protein(hs-CRP)were identified as the influencing factors of hyperuricemia combined with MACE(P<0.05).The nomogram incorporating these variables demonstrated excellent discrimination,with area under the receiver operating characteristic curve(AUC)values of 0.939 in the modeling cohort and 0.872 in the validation cohort.The calibration curve showed high consistency between the predicted and actual probabilities of hyperuricemia complicated with MACE in both cohort.Furthermore,the Hosmer-Lemeshow test indicated good model fit.Conclusions Age,BMI,poor glycemic control,suboptimal lipid regulation,BUA,Cys C,hs-CRP are the influencing factors of hyperuricemia combined with MACE.The developed nomogram exhibits robust predictive accuracy and may serve as a practical tool for individualized risk assessment.
作者
郭丽敏
史丽
佘其美
谷贵燕
李爱玲
GUO Limin;SHI Li;SHE Qimei;GU Guiyan;LI Ailing(Department of General Practice,Beijing Shijingshan Hospital,Shijingshan Teaching Hospital of Capital Medical University,Beijing 100043;Department of International Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)
出处
《基础医学与临床》
2026年第4期566-571,共6页
Basic and Clinical Medicine
基金
河北省“三三三人才工程”(A202103006)。
