连欢,赵卓妍,王艳芳,张皓然,丁振江,张英

• 1:承德医学院附属医院心脏内科

摘要(Abstract)：

目的 构建冠心病（CHD）多支血管病变（MVD）患者不完全血运重建（ICR）术后预后不良的预测模型。方法 回顾性收集2020年1月至2021年5月在承德医学院附属医院行冠状动脉造影示MVD且经皮冠状动脉介入治疗（PCI）术后ICR患者的临床资料，按照出院时间顺序，将符合入选条件的受试者757例分为训练集530例（70.0%）与验证集227例（30.0%），纳入单因素Logistic回归分析中P<0.2的变量进行多因素Logistic回归分析，按照赤池信息准则（AIC）选取最优Logistic回归模型构建MVD患者ICR术后预后不良的预测模型。采用受试者工作特征（ROC）曲线下面积（AUC）验证及评估该模型的区分能力，并绘制校准曲线和决策曲线分析（DCA）曲线对该模型的校准度、临床净获益及实用性进行评估。结果 用于预测MVD患者ICR术后预后不良预测模型的预测因子包括：尿酸、女性、年龄、PCI术前罪犯血管心肌梗死溶栓治疗试验血流分级、糖耐量异常、非结合胆红素。训练集与验证集的ROC的AUC分别为0.645、0.690。训练集与验证集校准曲线的Hosmer-Lemeshow检验的统计值分别为8.97(P=0.535)、16.45(P=0.087)。DCA曲线显示当主要不良心血管事件的风险阈值在0.10～0.70时本模型临床适用。结论 本研究构建了用于预测MVD患者ICR术后预后不良的预测模型，该预测模型的预测能力、校准能力和临床净获益良好，能够作为临床早期预测MVD患者ICR术后预后不良的有效工具。

关键词(KeyWords)： 冠心病;经皮冠状动脉介入治疗;多支血管病变;不完全血运重建;预测模型

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 连欢,赵卓妍,王艳芳,张皓然,丁振江,张英

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