دورية أكاديمية
China-PAR模型在北方农村人群中预测动脉粥样硬化性心血管疾病发病风险的应用 ; Application of the China-PAR risk prediction model for atherosclerotic cardiovascular disease in a rural northern Chinese population
| العنوان: | China-PAR模型在北方农村人群中预测动脉粥样硬化性心血管疾病发病风险的应用 ; Application of the China-PAR risk prediction model for atherosclerotic cardiovascular disease in a rural northern Chinese population |
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| المؤلفون: | 唐迅, 张杜丹, 何柳, 曹洋, 王晋伟, 李娜, 黄少平, 窦会东, 高培, 胡永华 |
| المساهمون: | 北京大学公共卫生学院流行病与卫生统计学系,北京,100191, 北京市房山区卫生局,北京,102488, 北京市房山区第一医院,北京,102400 |
| المصدر: | 知网 ; 万方 ; CSCD ; http://d.g.wanfangdata.com.cn/Periodical_bjykdxxx201703011.aspxTest |
| بيانات النشر: | 北京大学学报 医学版 |
| سنة النشر: | 2017 |
| المجموعة: | Peking University Institutional Repository (PKU IR) / 北京大学机构知识库 |
| مصطلحات موضوعية: | 心血管疾病, 风险预测, 队列研究, 农村人群, Cardiovascular diseases, Risk prediction, Cohort study, Rural population |
| الوصف: | 目的:在中国北方农村人群的前瞻性队列中,独立验证并比较动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular disease,ASCVD)5年发病风险预测模型的准确性,对模型的实际应用进行评价并提供证据.方法:研究对象为2010年6至8月参加基线调查并随访至2017年1月的6 489名基线调查时未患ASCVD的40~79岁北京房山农村人群,分别采用美国心脏病学会/美国心脏协会指南最新发布的汇总队列公式(pooled cohort equations,PCE)和中国动脉粥样硬化性心血管疾病风险预测研究(prediction for ASCVD risk in China,China-PAR)的模型计算预测的5年发病风险.通过Kaplan-Meier方法调整获得5年实际观察到的新发ASCVD事件(包括急性心肌梗死、冠心病死亡以及致死和非致死性脑卒中)的发病率,并计算预测风险/实际发病率的比值以评价验证队列中是否存在风险高估或低估.研究人群按照ASCVD预测风险分为4个类别(<5.0%、 5.0%~7.4%、 7.5%~9.9%以及≥10.0%)进行比较.采用区分度C统计量、校准度卡方值以及校准图评估模型的预测准确性.结果:在本验证队列6 489名研究对象平均5.82年的随访时间内,共出现新发ASCVD事件955例.China-PAR模型高估了ASCVD的5年发病风险,再校准后对男性和女性的发病风险分别高估了22.2%和33.1%;而PCE模型的高估程度更严重,再校准后男性和女性分别高估了67.3%和53.1%.China-PAR和PCE模型的区分度接近,C统计量及其95%可信区间在男性中分别为0.696(0.669~0.723)和0.702(0.675~0.730),在女性中分别为0.709(0.690~0.728)和0.714(0.695~0.733).China-PAR模型的校准度卡方值在男性和女性中分别为17.2和54.2,但PCE模型的校准度较差(男性和女性分别为192.0和181.2).另外,只有China-PAR模型的校准图显示其预测风险与实际发病率的一致性较好,特别是在男性人群.结论:作为国内开展ASCVD风险评估和一级预防的工具,China-PAR模型对于中国北方农村人群ASCVD 5年发病风险的预测优于PCE模型,特别是在男性中更加准确. ; Objective:To validate five-year risk prediction models for atherosclerotic cardiovascular di-sease (ASCVD) in a contemporary rural Northern Chinese population.Methods: Totally 6 489 rural adults aged 40 to 79 years without clinical ASCVD were enrolled at baseline between June and August 2010, and followed up through January 2017.Expected prediction risk using the China-PAR (prediction for ASCVD risk in China) model was compared with the pooled cohort equations (PCE) reported in the American College of Cardiology / American Heart Association guideline.Kaplan-Meier analysis was used to obtain the observed ASCVD event (including nonfatal myocardial infarction, coronary heart disease death, nonfatal or fatal stroke) rate at 5 years, and the expected-observed ratios were calculated to eva-luate overestimation or underestimation in the cohort.The participants in the cohort were divided into 4 categories (<5.0%, 5.0%-7.4%, 7.5%-9.9%, and ≥10.0%) for comparisons based on ASCVD prediction risk.The models were assessed by ... |
| نوع الوثيقة: | journal/newspaper |
| اللغة: | English |
| تدمد: | 1671-167X |
| العلاقة: | 北京大学学报（医学版）. 2017, 49(3), 439-445.; 1900535; http://hdl.handle.net/20.500.11897/466857Test |
| DOI: | 10.3969/j.issn.1671-167X.2017.03.011 |
| الإتاحة: | https://doi.org/20.500.11897/466857Test https://doi.org/10.3969/j.issn.1671-167X.2017.03.011Test https://hdl.handle.net/20.500.11897/466857Test |
| رقم الانضمام: | edsbas.AB5ADAC9 |
| قاعدة البيانات: | BASE |
| تدمد: | 1671167X |
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| DOI: | 10.3969/j.issn.1671-167X.2017.03.011 |