临床外科杂志 ›› 2026, Vol. 34 ›› Issue (6): 666-670.doi: 10.3969/j.issn.1005-6483.20250893

• 论著 • 上一篇    下一篇

结肠癌病人根治术后出现不良心血管事件的影响因素及其列线图预测模型构建

于晓飞,周敏,高璐,周燕燕   

  1. 海军军医大学第二附属医院肛肠外科
  • 收稿日期:2025-09-08 出版日期:2026-08-18 发布日期:2026-08-18
  • 通讯作者: 周燕燕
  • 作者简介:于晓飞,周敏,高璐,周燕燕

Influencing factors andnomogram prediction model construction for adverse cardiovascular events after radical surgery in colon cancer patients

YU Xiaofei,ZHOU Min,GAO Lu,ZHOU Yanyan   

  1. Department of Colorectal Surgery,Second Affiliated Hospital of Naval Medical University
  • Received:2025-09-08 Online:2026-06-20 Published:2026-08-18

摘要: 目的 探讨结肠癌病人根治术后出现不良心血管事件的影响因素,并构建列线图预测模型。方法 2022年1月~2025年1月收治的结肠癌病人150例,均行根治性手术。根据术后30天内是否发生不良心血管事件分为发生组和未发生组。Logistic回归分析结肠癌病人根治术后出现不良心血管事件的影响因素,采用R软件构建结肠癌病人根治术后出现不良心血管事件的列线图预测模型,Hosmer-Lemeshow检验评估模型的拟合优度,受试者工作特征(ROC)曲线、校准曲线、决策曲线评价列线图预测模型效能。结果 150例行根治性手术的结肠癌病人术后30天内发生不良心血管事件21例(14.0%)。两组年龄、冠心病、心律失常、陈旧性心肌梗死、慢性肾功能不全、改良心脏风险指数(RCRI)评分、术前N末端B型利钠肽前体(NT-proBNP)、D-二聚体、中性粒细胞/淋巴细胞比值(NLR)水平比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,年龄、RCRI评分(≥2分)、术前NT-proBNP水平、NLR水平为结肠癌病人根治术后出现不良心血管事件的危险因素(P<0.05)。列线图模型预测结肠癌病人根治术后出现不良心血管事件的ROC曲线下面积为0.988(95%CI 0.975~1.000),Hosmer-Lemeshow拟合优度检验χ2=4.472,P=0.812,校准曲线和决策曲线结果显示,该模型的预测效能和临床应用价值较高。结论 结肠癌病人根治术后出现不良心血管事件受年龄、RCRI评分、术前NT-proBNP、NLR水平的影响,据此构建列线图模型可预测术后不良心血管事件发生风险。

关键词: 结肠癌; 不良心血管事件; 影响因素; 列线图

Abstract: Objective To explore the influencing factors for adverse cardiovascular events after radical surgery in colon cancer patients and construct a nomogram prediction model. Methods A total of 150 colon cancer patients admitted to our hospital from January 2022 to January 2025 were selected,all of whom underwent radical surgery.They were divided into occurrence group and non-occurrence group according to whether adverse cardiovascular events occurred within 30 days after surgery.Logistic regression analysis was used to analyze the influencing factors of adverse cardiovascular events after radical surgery in colon cancer patients.The nomogram prediction model for adverse cardiovascular events after radical surgery in colon cancer patients was constructed using R software.Hosmer-Lemeshow test was used to evaluate the goodness of fit of the model.receiver operating characteristic(ROC)curve,calibration curve,and decision curve were used to evaluate the efficacy of the nomogram prediction model. Results Among 150 colon cancer patients who underwent radical surgery,21 cases (14.0%) developed adverse cardiovascular events within 30 days after surgery.There were statistically significant differences between the two groups in age,coronary heart disease,arrhythmia,old myocardial infarction,chronic renal insufficiency,Revised Cardiac Risk Index(RCRI) score,preoperative NT-proBNP level,D-dimer,and NLR level (P<0.05).Logistic regression analysis showed that age,RCRI score (≥2 points),preoperative NT-proBNP,and NLR level were all risk factors for adverse cardiovascular events after radical surgery in colon cancer patients (P<0.05).The area under the ROC curve of the nomogram model for predicting adverse cardiovascular events after radical surgery in colon cancer patients was 0.988 (95%CI 0.975-1.000).Hosmer-Lemeshow goodness of fit test χ?su2> =4.472,P=0.812.The results of calibration curve and decision curve showed that the model had high predictive efficacy and clinical application value. Conclusions Adverse cardiovascular events after radical surgery in colon cancer patients are influenced by age,RCRI score,preoperative NT-proBNP,and NLR level.A nomogram model constructed accordingly can predict the risk of postoperative adverse cardiovascular events.

Key words: colon cancer; adverse cardiovascular events; influencing factors; nomogram

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