冠脉介入术后造影剂肾病的危险因素及预警模型建立
发布时间:2021-09-17 02:21
造影剂肾病(contrast-induced nephropathy,CIN)是心导管介入术后常见的并发症,与不良预后相关。目前,CIN有多种定义,由此造成对其发病率及预后的差异性报道。同时,CIN的发生发展机制并不完全明确。因此,针对高危患者建立简单可靠的新型预警模型以尽早评估CIN风险是关键。目的和意义:1.通过比较4种常用CIN定义的人群归因危险度(population attributable risk,PAR)以识别与长期预后最为相关的CIN定义及其独立危险因素,并通过估算各危险因素的PAR,寻找最有价值的干预靶标。2.通过分析CIN高危人群(充血性心衰/慢性肾脏病)构建新型预警模型。研究方法:1.患者选择:连续入组广东省人民医院行心导管术的3450名患者。2.观察终点:主要终点:CIN,分别根据4个定义进行定义:(1)CINa,术后72小时内血清肌酐较基线升高≥50%或≥0.3mg/dL;(2)CINb,升高≥0.5 mg/dL;(3)CINc,升高≥25%;(4)CINd,升高≥25%或≥0.5mg/dL;次要终点:全因死亡。3.统计学方法:计量资料的组间比较采用两独立样...
【文章来源】:南方医科大学广东省
【文章页数】:90 页
【学位级别】:硕士
【部分图文】:
图3-2?4种CIN定义的人群归因危险度??r-nrlrierniniin
—?non-CINc? ̄?C,Nd??15???90-l?—?—CINd??!?8。_?1??,???1/1?JM?卜?一^?^?l??|?|?W??l?60_?%?n? ̄ ̄??a.?s??7<l_?1???40?-?i?i?i?I?60-?i?i?i?i??0?1000?2000?3000?4000?0?1000?2000?3000?4000??Days?elapsed?Days?elapsed??图3-4?4种CIN定义的人群归因危险度(AMI亚组)??Figure?3-4?Population?attributable?risks?of?4?different?definitions?of?CIN?(AMI?subgroup)??变量名?PAR%?95%?Cl??CINa?I???1?11.62?4.99-19.71??CINb?I???1?9.20?4.22-16.00??CINc?I???1?7.26?0.21-15.62??CINd?m?1?8.37?1.16—16.86??I?I?I?I?I?I??-5?0?5?10?15?20??3.2?CIN的独立危险因素及其人群归因危险度??34??
?颂士学位论文???1??to?I?Z?,???o?__r1?.?’??|?/?/??。7/?....,??s-?//.,??■?"'"????AIK?-0.7fc??Mcliroii?Score.?AUC?-?0.68??S? ̄?.???"?I*-O.U25??00?02?04?06?08?10??I特异度??图3-9列线图的校准曲线(CKD亚组)??Figure?3-9?Calibration?cur\?e?of?tlie?nomogram?(CKD?subgroup)??〇?I?1||||||1|||||1|111|,1,,,",,","1'"??? ̄'?'?' ̄??CD??O??<〇??O?.-...Z???,??o?-????m?jt'?Apparenl??°??./??Bias?corrected????-??S?-?.?'???Weal??00?02?04?06?08?10??fl.l犮生T??3.3.4?模型的临床应用??该列线图界定CIN高危患#的总评分最佳临界值(cut-off)为M7分。该临界值用f?鉴??43??
本文编号:3397765
【文章来源】:南方医科大学广东省
【文章页数】:90 页
【学位级别】:硕士
【部分图文】:
图3-2?4种CIN定义的人群归因危险度??r-nrlrierniniin
—?non-CINc? ̄?C,Nd??15???90-l?—?—CINd??!?8。_?1??,???1/1?JM?卜?一^?^?l??|?|?W??l?60_?%?n? ̄ ̄??a.?s??7<l_?1???40?-?i?i?i?I?60-?i?i?i?i??0?1000?2000?3000?4000?0?1000?2000?3000?4000??Days?elapsed?Days?elapsed??图3-4?4种CIN定义的人群归因危险度(AMI亚组)??Figure?3-4?Population?attributable?risks?of?4?different?definitions?of?CIN?(AMI?subgroup)??变量名?PAR%?95%?Cl??CINa?I???1?11.62?4.99-19.71??CINb?I???1?9.20?4.22-16.00??CINc?I???1?7.26?0.21-15.62??CINd?m?1?8.37?1.16—16.86??I?I?I?I?I?I??-5?0?5?10?15?20??3.2?CIN的独立危险因素及其人群归因危险度??34??
?颂士学位论文???1??to?I?Z?,???o?__r1?.?’??|?/?/??。7/?....,??s-?//.,??■?"'"????AIK?-0.7fc??Mcliroii?Score.?AUC?-?0.68??S? ̄?.???"?I*-O.U25??00?02?04?06?08?10??I特异度??图3-9列线图的校准曲线(CKD亚组)??Figure?3-9?Calibration?cur\?e?of?tlie?nomogram?(CKD?subgroup)??〇?I?1||||||1|||||1|111|,1,,,",,","1'"??? ̄'?'?' ̄??CD??O??<〇??O?.-...Z???,??o?-????m?jt'?Apparenl??°??./??Bias?corrected????-??S?-?.?'???Weal??00?02?04?06?08?10??fl.l犮生T??3.3.4?模型的临床应用??该列线图界定CIN高危患#的总评分最佳临界值(cut-off)为M7分。该临界值用f?鉴??43??
本文编号:3397765
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