摘要
目的:本研究旨在分析冠心病合并2型糖尿病(T2DM)患者经皮冠状动脉介入治疗(PCI)术后再入院的影响因素,并构建列线图模型。方法:回顾性选取2019年5月至2023年5月于盐城市第三人民医院接受PCI治疗的260例冠心病合并T2DM患者,收集其临床资料并随访1年,根据1年后再入院情况将其分为未再入院组、再入院组,多因素Logistic回归分析确定危险因素,利用R软件构建列线图模型并评估其预测效能。结果:260例患者中,65例术后再入院,再入院率为25.00%(65/260)。单因素分析表明,左心室射血分数(LVEF)、年龄、左主干病变、高血压病史、冠状动脉病变支数、血脂异常、糖化血红蛋白(HbA1c)、糖尿病病程、空腹血糖(FBG)、支架数量以及术后规律服药情况与PCI术后1年再入院有关(P<0.05)。年龄≥70岁、高血压病史、冠状动脉多支病变、糖尿病病程≥10年、HbA1c≥7%、左主干病变、血脂异常、LVEF<50%、支架数量≥3枚是PCI术后1年再入院的危险因素(P<0.05)。基于上述危险因素构建的列线图模型,其C-index为0.835,受试者工作特征(ROC)曲线下面积(AUC)为0.826。结论:本研究确定了冠心病合并T2DM患者PCI术后1年再入院的多个危险因素,构建的列线图模型可为临床预测患者再入院风险提供有效工具,有助于医护人员制定个性化干预措施,改善患者预后。
Objective:The purpose of this study was to analyze the influencing factors of readmission after percutaneous coronary intervention(PCI)in patients with coronary heart disease and type 2 diabetes(T2DM),and to build a nomogram model.Methods:A retrospective study was conducted on 260 patients with coronary heart disease and T2DM who received PCI treatment in Yancheng Third People's Hospital from May 2019 to May 2023,clinical data were collected and followed up for 1 year.They were divided into on readmission group and unreadmission group based on their readmission after 1 year.Multivariate logistic regression analysis was conducted to determine risk factors,and a nomogram model was constructed using R software to evaluate its predictive efficiency.Results:Among the 260 patients,65 were readmitted after surgery,with a readmission rate of 25.00%(65/260).Univariate analysis showed that,left ventricular ejection fraction(LVEF),age,left main artery disease,hypertension history,number of coronary artery lesions,dyslipidemia,glycosylated hemoglobin(HbA1c),course of diabetes,fasting blood glucose(FBG),number of stents,and regular postoperative medication were related to readmission 1 year after PCI(P<0.05).Age≥70 years,hypertension history,coronary artery multi vessel disease,course of diabetes≥10 years,HbA1c≥7%,left main artery disease,dyslipidemia,LVEF<50%,number of stents≥3 were risk factor for readmission 1 year after PCI(P<0.05).The nomogram model constructed based on the above risk factors has a C-index of 0.835 and an area under the receiver operating characteristic(ROC)the area under the curve(AUC)of 0.826.Conclusion:This study identified multiple risk factors for readmission in patients with coronary heart disease and T2DM 1 year after PCI.The constructed nomogram model can provide an effective tool for predicting the risk of readmission in clinical practice,and help medical staff develop personalized intervention measures to improve patient prognosis.
作者
杨顺清
唐庚
陈静静
王呈丽
YANG Shun-qing;TANG Geng;CHEN Jing-jing;WANG Cheng-li(Department of Cardiology,Yancheng Third People's Hospital,Yancheng,Jiangsu,224000,China)
出处
《现代生物医学进展》
2025年第12期1955-1960,1975,共7页
Progress in Modern Biomedicine
基金
盐城市医学科技发展计划项目(YK2019096)。
关键词
冠心病
2型糖尿病
经皮冠状动脉介入治疗
再入院
影响因素
列线图模型
Coronary heart disease
Type 2 diabetes
Percutaneous coronary intervention therapy
Readmission
Influencing factors
Nomogram model
作者简介
杨顺清(1979-),男,硕士,副主任医师,主要研究方向:介入心脏病学,E-mail:18205102791@163.com;通讯作者:唐庚(1993-),男,硕士,主治医师,主要研究方向:冠心病,E-mail:1542340002@qq.com。
