倾向性评分匹配法评价冠心病支架置入术后再狭窄

发布时间：2018-03-02 04:23

本文关键词： 冠状动脉疾病糖尿病支架再狭窄倾向性评分匹配　出处：《中国介入影像与治疗学》2015年04期 　论文类型：期刊论文

【摘要】：目的引入倾向性评分匹配法(PSM)比较伴糖尿病的冠心病患者与单纯冠心病患者支架置入术后再狭窄的差异。方法回顾性分析在本院接受冠状动脉支架植入术患者资料,伴糖尿病的冠心病患者137例(CHD+DM组),单纯冠心病283例(CHD组)。使用SPSS软件的PSM功能对两组采用1∶1最邻近匹配法,得到组间协变量均衡的样本。匹配后的样本采用Cox比例风险模型评估支架术后再狭窄的危险因素。结果两组匹配成功各120例。Cox比例风险模型多因素分析,吸烟史(HR=2.50,95%CI:1.34~4.64,P=0.004)、高血压史(HR=2.24,95%CI:1.08~4.63,P=0.030)、肌酐清除率110ml/min(HR=3.12,95%CI:1.22~5.03,P=0.024)、冠状动脉多支病变(HR=2.15,95%CI:1.14~4.07,P=0.018)和伴糖尿病(HR=2.22,95%CI:1.14~4.33,P=0.020)是冠心病支架术后再狭窄的独立危险因素。PSM后,CHD+DM组1、3、5年的累计狭窄率分别为10.70%,40.30%和43.80%,CHD组为4.70%,23.70%和29.60%,差异有统计学意义(P=0.023)。结论应用PSM可以有效地均衡非随机研究组间的协变量,糖尿病是冠心病患者支架置入术再狭窄的危险因素。
[Abstract]:Objective to compare the difference of restenosis between coronary heart disease patients with diabetes mellitus and patients with coronary artery disease after stent implantation by using the tendentiousness score matching method. Methods the data of patients undergoing coronary stent implantation in our hospital were retrospectively analyzed. There were 137 CHD patients with diabetes mellitus and 283 CHD patients with CHD. The PSM function of SPSS software was used in the two groups by using 1: 1 nearest neighbor matching method. Cox proportional risk model was used to evaluate the risk factors of restenosis after stent implantation. Smoking history HR2.5095 CI1.344.64P0.004, hypertension history HR2.2495CI1.084.63P0.030, creatinine clearance rate 110ml / min HR3.1295CIV: 1.225.03P0.02424, coronary artery disease 2.1595CIW 1.144.04.0P0.018) and with diabetes HR2.2295CIA 2.2295CIA 2.2295CIA 2.2295CIA 1.144.33 P0.020 are independent risk factors for coronary artery disease restenosis. The cumulative rates of coronary artery disease in CHD DM group after PSM are 10.7040.30% and 704.704.704.704.704.704.704.70% respectively. The difference was statistically significant between 29.60 and 29.600.Conclusion PSM can effectively balance the covariates between non-random study groups, Diabetes is a risk factor for restenosis after stent implantation in patients with coronary heart disease.
【作者单位】：上海市徐汇区大华医院心内科;上海交通大学医学院附属新华医院放射介入科;
【分类号】：R541.4;R816.2

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