预测冠心病患者冠状动脉搭桥术心肌血运重建效率的多模态logit模型。

V V Kundina, T M Babkina
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引用次数: 0

摘要

目的:建立基于心肌活力(MV)评估的不同组冠心病(CHD)患者冠状动脉旁路移植术(CABG)手术治疗效果的数理逻辑模型。材料与方法:为完成既定的临床任务,对62例心脏收缩功能保留和收缩功能不全的冠心病患者进行了检查。受试者平均年龄为(59.6±8.2)岁。35例(56%)患者有一种变型心力衰竭(HF),射血分数(EF)为45%或更低。27例(44%)患者EF≥46%。5例(8.0%)患者否认心肌梗死(MI)。心肌显像(MSG)在Infinia Hawkeye联合伽马照相机(GE, USA)和集成CT上进行。研究采用SPECT和ECG同步(门控SPECT)模式的SPECT / CT进行。使用99mTc-MIBI,活度为555-740 mbq。根据一天休息方案,在治疗动态(冠脉搭桥前和冠脉搭桥后)中进行MSG。总共进行了124项科学研究。结果:使用非参数Wilcoxon检验(Wilcoxon matching Pairs test)比较治疗前和治疗后研究的患者样本。建立多因素回归模型,反映治疗前lvf(%)、冠状动脉床损面积、MV水平(%)等心脏活动指标对治疗后治疗反应(MV)的影响有统计学意义。上述三种治疗前心脏活动功能因子与治疗效果以MV变化的形式之间的回归关系可以解释为预测治疗结果的诊断模型。结论:本科学研究可以建立logit模型来预测不同组患者冠心病手术治疗的预期预后。所提出的多元回归模型具有足够高的生物统计学校正决定系数(校正R2 = 0.893 (F = 173,4;P < 0.001))。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MULTIMODAL LOGIT MODEL FOR PREDICTING THE EFFICIENCY OF MYOCARDIAL REVASCULARIZATION BY THE METHOD OF CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH CORONARY HEART DISEASE.

Objective: building of a mathematical logit model for possible prediction of the outcome of surgical treatment bythe method of coronary artery bypass grafting (CABG) in patients of different groups with coronary heart disease(CHD) based on myocardial viability (MV) assessment.

Material and methods: To implement the set clinical tasks, 62 patients with coronary heart disease with preservedsystolic function and systolic dysfunction were examined. The mean age of the subjects was (59.6 ± 8.2) years. 35(56 %) patients had a variant of heart failure (HF) with an ejection fraction (EF) of 45 % or less. 27 (44 %) patientshad EF of 46 % or more. 5 (8.0 %) patients denied myocardial infarction (MI). Myocardial scintigraphy (MSG) wasperformed on Infinia Hawkeye combined gamma-camera (GE, USA) with integrated CT. The studies were performedin SPECT and SPECT / CT with ECG synchronization (Gated SPECT) modes. 99mTc-MIBI with an activity of 555-740 MBqwas used. MSG was performed in the dynamics of treatment (before CABG and after CABG) according to One Day Restprotocol. A total of 124 scintigraphic studies were performed.

Results: Samples of patients studied «before» and «after» the treatment were compared using nonparametricWilcoxon test (Wilcoxon Matched Pairs Test). A multivariate regression model, that reflects a statistically significanteffect on the treatment response (MV after treatment) of such cardiac activity indicators as LV EF (%), coronary bedlesion area and MV level (%) before treatment, was built. The above-described regression relationship between thethree above-defined functional factors of cardiac activity before treatment and the therapeutic effect in the formof the change in MV can be construed as a diagnostic model that predicts the treatment outcome.

Conclusions: This scientific study allows to build logit models to predict the expected outcome of coronary heartdisease surgical treatment in patients of different groups. The presented multivariate regression model is characterised by a sufficiently high for biostatistical studies adjusted coefficient of determination (Adjusted R2 = 0,893 (F = 173,4; p < 0,001)).

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Problemy radiatsiinoi medytsyny ta radiobiolohii
Problemy radiatsiinoi medytsyny ta radiobiolohii Medicine-Radiology, Nuclear Medicine and Imaging
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