方慧娟　　崔东勤　　曹丹

[摘要] 目的 探討基于常规检测生物标志物应用探索因子分析法构建急性非ST段抬高型心肌梗死患者发生猝死风险的相关性。 方法 选取2017年4月1日至2018年4月1日非ST段抬高型心肌梗死患者280例，依据随访结果有无猝死将基线资料分为猝死组和非猝死组。收集入院患者的基线资料及研究指标，并对所有患者入院后第2天进行常规血液检测。应用探索因子分析法（EFA）和COX比例回归模型建立冠心病风险预测模型。 结果 入选患者280例，发生猝死者6例，未猝死者274例。两组的年龄、高血压病史、心力衰竭史、Killip分级及RDW比较，差异有统计学意义（P<0.05）。COX回归分析显示，Killip分级与RDW为急性非ST段抬高型心肌梗死发生猝死的独立危险因素。探索因子分析结果显示，KMO为0.891，偏相关很弱，Bartlett球形检验P=0.000，表明适于因子分析。结论 Killip分级及RDW为急性非ST段抬高型心肌梗死发生猝死的独立危险因素。

[关键词] 心脏性猝死;急性非ST段抬高型心肌梗死;Killip分级;因子分析

[中图分类号] R542.2          [文献标识码] A          [文章编号] 1673-9701（2021）13-0009-04

Study on the construction of a sudden death risk prediction model for patients with acute non-ST-segment elevation myocardial infarction by applying exploratory factor analysis based on routine detection of biomarkers

FANG Huijuan   CUI Dongqin   CAO Dan

Geriatric Medicine Center， the Fourth People′s Hospital of Shenyang City， Shenyang   110031， China

[Abstract] Objective To explore the construction of the risk of sudden death in patients with acute non-ST-segment elevation myocardial infarction by applying exploratory factor analysis based on the routine detection of biomarkers. Methods A total of 280 patients with non-ST-segment elevation myocardial infarction from April 1， 2017 to April 1， 2018 were continuously enrolled. According to the presence or absence of sudden death of follow-up results， the patients′ baseline data were divided into sudden death group and non-sudden death group. The baseline data and research indicators of admitted patients were collected， and routine blood tests were performed on all patients the next day after admission. Exploratory factor analysis（EFA） and COX proportional regression model were used to establish the coronary heart disease risk prediction model. Results 280 patients were enrolled， 6 of them had a sudden death， and 274 had no sudden death. There was statistically significant differences in age， history of hypertension，history of heart failure，Killip grade， and RDW between the two groups（P<0.05）. COX regression analysis showed that Killip grade and RDW were independent risk factors for sudden death in acute non-ST-segment elevation myocardial infarction. The exploratory factor analysis showed that the KMO was 0.891， with very weak partial correlation and the Bartlett sphere test P=0.000， indicating that it was suitable for factor analysis. Conclusion Killip grade and RDW are independent risk factors for sudden death in acute non-ST-segment elevation myocardial infarction.

[Key words] Sudden cardiac death; Acute non-ST-segment elevation myocardial infarction; Killip grade; Factor analysis

心脏性猝死（Sudden cardiac death，SCD）作为人类疾病主要的死亡方式之一，迄今仍是威胁人类健康的重大问题[1]。在美国每年有30万～40万人死于SCD[2]，而我国每年死于SCD的人数高达54.5万[3]。冠心病心肌梗死是SCD最主要的病因，占80%以上，76%发生在急性心肌梗死发病后[4]。急性心肌梗死分为两类，即急性ST段抬高型心肌梗死和急性非ST段抬高型心肌梗死[5]。我国急性非ST段抬高型心肌梗死仍是AMI的主要类型，但急性非ST段抬高型心肌梗死患者比例正在增加[6]。与急性ST段抬高型心肌梗死相比，急性非ST段抬高型心肌梗死患者较少出现典型的胸痛、发汗和放射性胸痛等症状[7]，急性非ST段抬型高心肌梗死发病呈年轻化趋势，剧烈程度比ST段抬高型心肌梗死相对较轻，有时容易耽误就诊和漏诊，因此对急性非ST段抬高型心肌梗死患者猝死的预防及风险评估显得尤为重要。……