基于主成分分析结合频数统计构建不稳定性心绞痛中医临床疗效评价的终点指标
|
摘要
目的:收集中医院不稳定性心绞痛患者终点事件的发生情况,运用主成分分析结合频数统计构建不稳定性心绞痛中医临床疗效评价的终点指标。方法:纳入2008年1月1日—2015年6月30日期间山东中医药大学附属医院不稳定性心绞痛住院患者。通过查阅病案收集患者住院期间一般资料及终点事件发生情况。电话结合门诊随访患者出院至2015年12月31日终点事件发生情况。运用主成分分析分别计算住院、随访期间各终点指标的权重,统计各指标频数,利用乘数合成归一法计算各指标的综合权重,结合临床意义,构建不稳定性心绞痛中医临床疗效评价的终点指标。结果:(1)住院期间:综合权重大小依次为血运重建(0.299)、非致命性心梗(0.286)、非致命性脑卒中(0.277)等。(2)随访期间:综合权重大小依次为心绞痛再入院(0.795)、血运重建(0.049)、心血管再入院(0.033)等。结论:(1)住院期间:主要评价指标为心源性死亡、非致命性心梗、非致命性脑卒中,次要评价指标为急性心力衰竭、严重心律失常、血运重建。(2)随访期间:主要评价指标为心源性死亡、非致命性心梗,次要评价指标为心绞痛再入院、血运重建、急性心力衰竭。
Objective: To collect the end-point events of unstable angina pectoris patients in TCM Hospital and construct the end-point index of clinical curative effect evaluation of unstable angina pectoris using the principal component analysis combined with frequency statistics. Method: The patients with unstable angina admitted to Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 1,2008 to June 30,2015 were erolled. The general data and end-point events were collected by the medical records. The patients were discharged until the end of December 31,2015 by telephone and outpatient. Principal component analysis was used to calculate the weights of during hospitalization and followed up. The frequency of each end-point events was counted. The comprehensive weight of each end-point events was calculated using multiplier synthesis normalization method. The end-point index of clinical curative effect evaluation of unstable angina pectoris was established,referring to clinical significance. Results:( 1) During hospitalization the comprehensive weights were as follows: revascularization( 0. 299),non fatal myocardial infarction( 0. 286),non fatal stroke( 0. 277),etc.( 2) During the follow-up period,the comprehensive weights were as follows: angina pectoris rehospitalization( 0. 795),revascularization( 0. 049),cardiovascular rehospitalization( 0. 033),etc. Conclusion:( 1) During hospitalization,the main evaluation indexes were cardiac death,non fatal myocardial infarction and non fatal stroke. The secondary evaluation indexes included acute heart failure,severe arrhythmia and revascularization.( 2) During the follow-up period,the main evaluation criteria was cardiac death and non fatal myocardial infarction. The secondary evaluation criteria included angina pectoris rehospitalization,revascularization and acute heart failure.
Objective: To collect the end-point events of unstable angina pectoris patients in TCM Hospital and construct the end-point index of clinical curative effect evaluation of unstable angina pectoris using the principal component analysis combined with frequency statistics. Method: The patients with unstable angina admitted to Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 1,2008 to June 30,2015 were erolled. The general data and end-point events were collected by the medical records. The patients were discharged until the end of December 31,2015 by telephone and outpatient. Principal component analysis was used to calculate the weights of during hospitalization and followed up. The frequency of each end-point events was counted. The comprehensive weight of each end-point events was calculated using multiplier synthesis normalization method. The end-point index of clinical curative effect evaluation of unstable angina pectoris was established,referring to clinical significance. Results:( 1) During hospitalization the comprehensive weights were as follows: revascularization( 0. 299),non fatal myocardial infarction( 0. 286),non fatal stroke( 0. 277),etc.( 2) During the follow-up period,the comprehensive weights were as follows: angina pectoris rehospitalization( 0. 795),revascularization( 0. 049),cardiovascular rehospitalization( 0. 033),etc. Conclusion:( 1) During hospitalization,the main evaluation indexes were cardiac death,non fatal myocardial infarction and non fatal stroke. The secondary evaluation indexes included acute heart failure,severe arrhythmia and revascularization.( 2) During the follow-up period,the main evaluation criteria was cardiac death and non fatal myocardial infarction. The secondary evaluation criteria included angina pectoris rehospitalization,revascularization and acute heart failure.
引文
[1]赵晨,戴国华,龙凤玺.心肌梗死临床疗效评价终点指标的文献调查分析[J].山东中医药大学学报,2014,38(4):302-306.
[2]高武霖,戴国华,史晓静,等.基于主成分分析结合频数统计构建心肌梗死中医临床疗效评价的终点指标[J].辽宁中医杂志,2017,44(10):2021-2025.
[3]Thygesen K,Alpert JS,Jaffe AS,et al.Third universal definition of myocardial infarction[J].Nature Reviews Cardiology,2012,9(11):620-633.
[4]史周华,张雪飞.中医药统计学[M].北京:科学出版社,2009:152.
[5]祁世梅.“库尔勒香梨”区域品牌战略研究[D].乌鲁木齐:新疆农业大学,2014:31.
[6]刘为民,刘保延,谢雁鸣.循证医学在中医药国际化中的应用研究[J].世界科学技术-中医药现代化,2006,8(3):42-46.
[7]史晓静,戴国华,高武霖,等.中医临床疗效评价终点指标选择的思路与方法[J].山东中医药大学学报,2016,40(5):400-403.
[8]张宏伟,刘建平,万霞,等.临床干预结局指标的分类及效应表达[J].中西医结合学报,2007,5(5):497-501.
[9]范维琥.中西医结合心血管病临床试验的特点和方法[C].江门:广东省中西医结合学会心血管病专业委员会,广东省江门市人民政府,广东省科学技术协会,2010:31-34.
[10]汪楠,王垂杰,李玉锋.中药联合“四联疗法”治疗Hp阳性慢性胃炎疗效观察[J].中国中西医结合杂志,2017,37(4):406-409.
[11]戴国华,赵晨,龙凤玺,等.238例心肌梗死患者终点事件发生情况队列研究[J].中医杂志,2015,42(1):31-35.
[12]万霞,刘建平,张宏伟,等.临床干预研究中结局指标的选择方法[J].中西医结合学报,2007,5(1):11-14.
[13]杨淑菊.主成分分析法在学生成绩评价中的应用[J].数学的实践与认识,2012,42(16):103-112.
[14]王国凤,刘扬,靳宝.基于主成分分析的道路状况评价简化模型[J].北京测绘,2017(S1):282-285.
[15]颜惠琴,牛万红,韩惠丽.基于主成分分析构建指标权重的客观赋权法[J].济南大学学报(自然科学版),2017,31(6):519-523.
[16]李建婷,邓兆智,郭新峰,等.主成分分析法结合马氏距离判别法在类风湿性关节炎中医证候诊断中的应用[J].广州中医药大学学报,2008,25(2):153-156.
[17]毕颖斐,毛静远.对中医证候要素定量与方证对应的思考[J].中华中医药杂志,2012,27(8):1994-1997.
[18]高武霖,戴国华,史晓静,等.基于数学模型的中医临床疗效评价终点指标构建[J].中医杂志,2016,57(20):1746-1749.
[2]高武霖,戴国华,史晓静,等.基于主成分分析结合频数统计构建心肌梗死中医临床疗效评价的终点指标[J].辽宁中医杂志,2017,44(10):2021-2025.
[3]Thygesen K,Alpert JS,Jaffe AS,et al.Third universal definition of myocardial infarction[J].Nature Reviews Cardiology,2012,9(11):620-633.
[4]史周华,张雪飞.中医药统计学[M].北京:科学出版社,2009:152.
[5]祁世梅.“库尔勒香梨”区域品牌战略研究[D].乌鲁木齐:新疆农业大学,2014:31.
[6]刘为民,刘保延,谢雁鸣.循证医学在中医药国际化中的应用研究[J].世界科学技术-中医药现代化,2006,8(3):42-46.
[7]史晓静,戴国华,高武霖,等.中医临床疗效评价终点指标选择的思路与方法[J].山东中医药大学学报,2016,40(5):400-403.
[8]张宏伟,刘建平,万霞,等.临床干预结局指标的分类及效应表达[J].中西医结合学报,2007,5(5):497-501.
[9]范维琥.中西医结合心血管病临床试验的特点和方法[C].江门:广东省中西医结合学会心血管病专业委员会,广东省江门市人民政府,广东省科学技术协会,2010:31-34.
[10]汪楠,王垂杰,李玉锋.中药联合“四联疗法”治疗Hp阳性慢性胃炎疗效观察[J].中国中西医结合杂志,2017,37(4):406-409.
[11]戴国华,赵晨,龙凤玺,等.238例心肌梗死患者终点事件发生情况队列研究[J].中医杂志,2015,42(1):31-35.
[12]万霞,刘建平,张宏伟,等.临床干预研究中结局指标的选择方法[J].中西医结合学报,2007,5(1):11-14.
[13]杨淑菊.主成分分析法在学生成绩评价中的应用[J].数学的实践与认识,2012,42(16):103-112.
[14]王国凤,刘扬,靳宝.基于主成分分析的道路状况评价简化模型[J].北京测绘,2017(S1):282-285.
[15]颜惠琴,牛万红,韩惠丽.基于主成分分析构建指标权重的客观赋权法[J].济南大学学报(自然科学版),2017,31(6):519-523.
[16]李建婷,邓兆智,郭新峰,等.主成分分析法结合马氏距离判别法在类风湿性关节炎中医证候诊断中的应用[J].广州中医药大学学报,2008,25(2):153-156.
[17]毕颖斐,毛静远.对中医证候要素定量与方证对应的思考[J].中华中医药杂志,2012,27(8):1994-1997.
[18]高武霖,戴国华,史晓静,等.基于数学模型的中医临床疗效评价终点指标构建[J].中医杂志,2016,57(20):1746-1749.