陈桂坚,彭志坚,黄华

• 1:汕头市第二人民医院心血管内科一病区

摘要(Abstract)：

目的探讨ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)术后校正心肌梗死溶栓治疗试验帧数(CTFC)的影响因素,并建立临床预测模型。方法入选2013年1月至2018年1月于汕头市第二人民医院心内科就诊的160例STEMI行急诊PCI患者。收集患者基本临床资料、血管造影资料、心电图资料、超声心动图资料。以CTFC 23为界限,将患者分为高CTFC组(65例)和低CTFC组(95例)。通过logistic多元回归分析辨别高CTFC的风险因子,并建立临床预测模型。通过ROC曲线评估预测模型的诊断效能。结果中性粒细胞与淋巴细胞比值(NLR)(OR 2.111,95%CI 0.818～3.198,P=0.001)、心率校正的QT间期离散度(QTcd)(OR2.821,95%CI 1.660～4.797,P<0.001)、ST段回落(OR 1.962,96%CI 1.023～3.962,P=0.002)是高CTFC的独立预测因子。基于β系数给予以上变量各赋值1分,构成高CTFC临床预测模型——NQST(y=1.37x_1+1.62x_2+1.22x_3+0.297,x_1、x_2、x_3分别代表NLR、QTcd和ST段回落)评分,而且该模型具有良好的诊断效能(AUC 0.791,95%CI 0.705～0.877,P<0.001)。结论NQST临床评分模型能很好地预测STEMI患者急诊PCI后的高CTFC风险,提高该人群临床预后判断,并制定个体化治疗方案。

关键词(KeyWords)： ST段抬高型心肌梗死;校正心肌梗死溶栓治疗试验帧数;临床预测模型

Abstract:

Keywords:

基金项目(Foundation): 2019年汕头市第二批医疗卫生科技计划(自筹经费类)项目(汕府科[2019]70号)

作者(Author): 陈桂坚,彭志坚,黄华

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