基于多模态超声心动图与血清学指标构建预测急性心肌梗死患者PCI术后不良心脏事件危险因素的LAS-SO-Logistic回归模型
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广东省梅州市医药卫生科研项目(2025-B-96);


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    摘要:

    目的:探讨多模态超声心动图参数联合血清学指标对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后主要不良心脏事件(MACE)的预测价值,并构建LASSO-Logistic回归预测模型。方法:选取80例行PCI手术的AMI患者为研究对象,依据术后是否发生MACE分为MACE组(n=30)和非MACE组(n=50)。采用LASSO-Logistic回归模型筛查影响AMI患者PCI术后发生MACE的危险因素,受试者工作特征(ROC)曲线分析LASSO-Logistic回归模型对AMI患者PCI术后发生MACE的预测效能。结果:基于多模态超声心动图与血清学指标构建LASSO-Logistic回归模型显示,年龄(高)、Killip分级Ⅲ~Ⅳ级、多支冠脉病变、TIMI血流分级<2级、BNP(高)、LDL-C(高)、LVEF(低)、WMSI(高)均是影响AMI患者PCI术后发生MACE的危险因素(P<0.05)。用Bootstrap法对列线图模型进行内部验证,结果显示,LASSO-Logistic回归模型预测AMI患者PCI术后发生MACE的ROC曲线下面积(AUC)为0.921,敏感度为93.16%,特异度为90.83%。结论:基于多模态超声心动图参数联合血清学指标构建的LASSO-Logistic回归模型能有效预测AMI患者PCI术后MACE风险,具有较高临床指导价值。

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    Objective:To investigate the predictive value of combining multimodal echocardiographic parameters with sero-logical indicators for major adverse cardiac events(MACE)following percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI),and to develop a LASSO-Logistic regression-based prediction model.Methods:A retrospec-tive analysis was performed on clinically relevant data from 80 AMI patients who underwent PCI,including 30 patients in the MACE group and 50 patients in the non-MACE group.The LASSO-Logistic regression method was employed to identify risk factors associated with MACE following PCI in AMI patients.Additionally,a receiver operating characteristic(ROC)curve was constructed to assess the predictive performance of the LASSO-Logistic regression model.Results:The development of the LASSO-Logistic regression model based on multimodal echocardiography and serological indicators revealed that advanced age,Killip class Ⅲ-Ⅳ,multiple coronary artery lesions,TIMI blood flow grade less than 2,elevated BNP levels,high LDL-C,re-duced LVEF,and increased WMSI were risk factors influencing the occurrence of MACE following PCI in AMI patients(P<0.05).The nomogram model was internally validated using the Bootstrap method,demonstrating an area under the ROC curve of 0.921,with a sensitivity of 93.16%and specificity of 90.83%.Conclusion:The LASSO-Logistic regression model,construc-ted using multimodal echocardiographic parameters in conjunction with serological indicators,demonstrates effective predictive capability for the risk of MACE following PCI in AMI patients and exhibits significant clinical utility.

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温盼;张又红;王豪;.基于多模态超声心动图与血清学指标构建预测急性心肌梗死患者PCI术后不良心脏事件危险因素的LAS-SO-Logistic回归模型[J].川北医学院学报,2025,40(10):1291-1295.

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