老年急性心梗患者PCI术后并发焦虑情绪的预测模型构建
Development of a prediction model for anxiety in elderly patients with acute myocardial infarction after percutaneous coronary intervention
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| DOI |
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| 刊名 |
Journal of International Psychiatry
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| 年，卷(期) |
2026, 53(1) |
| 作者 |
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| 作者单位 |
新乡市第一人民医院 心血管内科
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| 摘要 |
【摘要】 目的 基于生物-心理-社会医学模式，系统探讨影响老年急性心肌梗死（acute myocardial infarction, AMI）患者经皮冠状动脉介入治疗（percutaneous coronary intervention, PCI）术后并发焦虑情绪的心理与社会核心因素，并构建个体化预测模型。方法 选取2023年1月至2025年1月于新乡市第一人民医院行PCI治疗的老年AMI患者120例，根据术后3个月医院焦虑抑郁量表-焦虑分量表评分分为焦虑组（n=32）和非焦虑组（n=88）。收集社会人口学、临床指标、手术特征及患者报告结局，单因素分析和多因素Logistic回归筛选独立预测因子，构建列线图预测模型并验证。结果 多因素回归分析显示，独居（OR=3.371，95%CI：1.188-9.563）、Killip分级≥II级（OR=2.970，95%CI：1.015-8.694）、N-末端B型利钠肽原升高（OR=1.114，95%CI：1.038-1.195/100 pg/mL）、匹兹堡睡眠质量指数＞7分（OR=5.951，95%CI：2.165-16.361）和疼痛数字评分法评分升高（OR=1.799，95%CI：1.277-2.535/分）是术后焦虑的独立预测因素。列线图校正后C指数为0.851，校准度理想。结论 本研究构建的预测模型能有效识别老年AMI患者PCI术后焦虑高风险人群，为早期心理干预提供量化依据。
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| Abstract |
[Abstract] Objective: To systematically investigate the core psychosocial factors influencing the development of anxiety in elderly patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) based on the bio-psycho-social model, and to develop a personalized prediction model. Methods: A total of 120 elderly AMI patients who underwent PCI at Xinxiang First People's Hospital between January 2023 and January 2025 were enrolled. Based on Hospital Anxiety and Depression Scale-Anxiety subscale scores at 3 months post-PCI, participants were categorized into an anxiety group (n=32) and a non-anxiety group (n=88). Sociodemographic, clinical, procedural, and patient-reported outcomes were collected. Independent predictors were identified through univariate and multivariate logistic regression, followed by construction and validation of a nomogram prediction model. Results: Multivariate analysis revealed independent predictors: living alone (OR=3.371, 95%CI: 1.188-9.563), Killip class ≥II (OR=2.970, 95%CI: 1.015-8.694), elevated N-terminal pro-B-type natriuretic peptide (OR=1.114, 95%CI: 1.038-1.195 per 100 pg/mL), Pittsburgh Sleep Quality Index >7 (OR=5.951, 95%CI: 2.165-16.361), and higher Numeric Rating Scale score (OR=1.799, 95%CI: 1.277-2.535 per point). The nomogram achieved a corrected C-index of 0.851 with excellent calibration. Conclusion: The developed model effectively identifies elderly AMI patients at high risk for post-PCI anxiety, providing a quantitative tool for early psychological intervention.
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| 关键词 |
【关键词】 急性心肌梗死；经皮冠状动脉介入治疗；焦虑；预测模型；列线图
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| KeyWord |
[Keywords] acute myocardial infarction; percutaneous coronary intervention; anxiety; prediction model; nomogram
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| 基金项目 |
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| 页码 |
202-205 |
牛玉玉.
老年急性心梗患者PCI术后并发焦虑情绪的预测模型构建 [J].
国际精神病学杂志.
2026; 53; (1).
202 - 205.