目的 了解影响冠心病患者经皮冠状动脉介入治疗(PCI)术后复发的主要因素,并通过生存预测模型对患者的复发风险作出评估,进而为临床医师对预防冠心病的复发作出科学合理个体化方案.方法 对2009年1月至2011年10月在某医院PCI术后患者的病历资料及定期的复诊资料和电话随访资料进行分析,并建立Cox比例风险模型和预后指数方程.根据预后指数将患者分为不同的3个危险组,应用Kaplan-Meier法绘制3组的生存曲线,并预测患者的预期复发率.结果 Cox回归分析表明:高血压病史、不经常运动以及严重抑郁是影响冠心病患者PCI术后复发的危险因素.计算患者的预后指数,并按其分组后,可预测患者在不同时点的复发率.结论 生存预测模型可有效地预测具有不同危险因素的冠心病患者的复发情况,进而为临床医师制定个体化的治疗方案提供依据,对降低冠心病的复发起到至关重要的作用.%Objective To investigate the predominant influencing factors of recurrence of coronary heart disease for subsequent risk assessment by employing a survival prediction model, thus offering rationale for scientific and reasonable individual-based protocol for prevention of coronary heart disease. Methods We did a retrospective analysis on the profiles of clinical charts and telephone follow-up visits in patients who were admitted to receive percutaneous coronary intervention (PCI) between January 2009 and October 2011, which subsequently allowed establishment of Cox proportional hazards ratio model and equation for calculating the prognostic index. This was followed by allocation to three groups with various risks that entailed prediction of individual expected recurrence obtained from three respective Kaplan-Meier survival plots. Results It has been suggested by Cox regression analysis that a history of hypertension, infrequent exercise and severe depression constituted the risks of recurrence in patients with coronary heart disease following PCI. The prognosis index, based on allocation, could effectively predict individual recurrence at different time points. Conclusion Survival prediction model, by offering physicians the rationale for treatment protocols on an individual basis, effectively predicts and plays a pivotal role in reducing the recurrence of coronary artery disease with different risk factors.
展开▼
