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冠状动脉造影术前非特异性胸痛患者的识别研究 被引量:5
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作者 丁峰 郭琳 +3 位作者 刘喜 赵兴胜 斯琴高娃 张洁 《中国全科医学》 CAS 北大核心 2020年第3期289-293,共5页
背景冠状动脉造影阴性的胸痛患者经反复检查仍找不出明确的躯体疾病原因时统称为非特异性胸痛(NSCP),目前尚缺乏有效识别NSCP的方法,主要依靠冠状动脉造影等来排除,但冠状动脉造影有创、价格高,本研究试图研究NSCP患者的临床特点及其心... 背景冠状动脉造影阴性的胸痛患者经反复检查仍找不出明确的躯体疾病原因时统称为非特异性胸痛(NSCP),目前尚缺乏有效识别NSCP的方法,主要依靠冠状动脉造影等来排除,但冠状动脉造影有创、价格高,本研究试图研究NSCP患者的临床特点及其心理状况,从而在冠状动脉造影前对NSCP进行识别。目的对比分析拟诊冠心病、心绞痛患者中NSCP、缺血性胸痛(ICP)患者的临床资料及心理状况。评估包括心理因素在内的多因素联合预测模型区分ICP与NSCP的诊断价值,实现冠状动脉造影术前对NSCP的初步识别。方法选择2016年7月2017年3月以发作性胸痛为主诉就诊于内蒙古自治区人民医院心脏中心拟诊冠心病、心绞痛,具有冠状动脉造影指征且首次接受冠状动脉造影检查的患者为研究对象。根据冠状动脉造影与心电图检查结果分为NSCP组和ICP组。入选患者均使用躯体症状自评量表(SSS)、抑郁自评量表(PHQ-9)、广泛性焦虑量表(GAD-7)进行评估。对比两组患者的临床资料及各量表得分。对拟诊冠心病、心绞痛患者发生NSCP的影响因素进行多因素Logistic回归分析。绘制各指标识别NSCP的受试者工作特征(ROC)曲线,分析各指标及联合预测变量P对NSCP的识别价值。结果完成以上3种量表的受试者共239例(78.4%),纳入本研究。其中NSCP组136例、ICP组103例。与ICP组相比,NSCP组年龄、有吸烟史患者比例、有糖尿病史患者比例及三酰甘油(TG)较低,女性患者比例、无业患者比例、有高血压史患者比例较高(P<0.05)。NSCP组SSS、PHQ-9和GAD-7得分高于ICP组(P<0.05)。多因素Logistic回归分析显示,年龄、性别、TG、SSS得分、PHQ-9得分是NSCP的影响因素,其OR值分别为0.935、0.235、0.376、1.522、1.204(P<0.05)。以上各指标识别NSCP的ROC曲线下面积(AUC)分别为0.527、0.625、0.564、0.873、0.637。联合测试变量P识别NSCP的AUC为0.921,以≥0.344为诊断截点诊断NSCP的灵敏度和特异度分别为0.882和0.837。结论女性、相对年轻、TG低,躯体症状障碍及抑郁程度重是心内科拟诊冠心病、心绞痛患者发生NSCP的影响因素。单个指标中以SSS评分对NSCP的识别价值最大,多指标联合预测可进一步提高对NSCP的早期识别价值,从而实现早期无创的对NSCP患者进行初步识别。 展开更多
关键词 胸痛 非特异性胸痛 冠状动脉疾病 冠状血管造影术 躯体型障碍 自评量表 多因素数字模型
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Human Settlement Analysis Based on Multi-temporal Remote Sensing Data: A Case Study of Xuzhou City, China 被引量:5
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作者 ZHU Jishuai TIAN Shufang +1 位作者 TAN Kun DU Peijun 《Chinese Geographical Science》 SCIE CSCD 2016年第3期389-400,共12页
To evaluate urban human settlement, we propose a human settlement environment development index(HSEDI) model by choosing vegetation coverage, land surface temperature, impervious surfaces, slope, wetness, and water co... To evaluate urban human settlement, we propose a human settlement environment development index(HSEDI) model by choosing vegetation coverage, land surface temperature, impervious surfaces, slope, wetness, and water condition as the evaluation factors. We applied the proposed model to Xuzhou City, Jiangsu Province, China. Landsat-5 Thematic Mapper(TM) images from 1998 to 2010 and digital elevation model(DEM) data with a 30-m resolution were used to calculate the values of the six evaluation factors. The HSEDI value in Xuzhou City was found to be between 2.24 and 8.10 from 1998 to 2010, and it was further divided into five levels, uninhabitable, moderately uninhabitable, generally inhabitable, moderately inhabitable, and inhabitable. The best HSEDI value was in 2007. The generally inhabitable region was about 100.98 km^2, covering 30.87% of the total area in 2007; the moderately inhabitable region was about 170.58 km2 covering 52.15% of the total area; the inhabitable region was about 32.03 km^2, covering 9.79% of the total area; the percentage of the uninhabitable region was zero; and that of the moderately uninhabitable region was very small, less than 1.00%. Moreover, we analyzed the habitability in the respect of spatial patterns and change detection. Results show that the degraded regions of habitability quality are mainly located in the urban fringe and the improved regions are mainly located in the main urban and rural areas. Reason for the degraded habitability quality is the rapid progress of urbanization. However, the increase in urban green spaces and the construction of the main urban area promoted the improved habitability quality. Besides, we further analyzed socio-economic and socio-demographic data to confirm the results of the habitability analysis. The results indicate that the human settlement in Xuzhou City is in a satisfactory condition, but some efforts should be made to control the possible uninhabitable and moderately uninhabitable regions, and to improve the quality of the generally inhabitable regions. 展开更多
关键词 habitability human settlement Landsat human settlement environment development index(HSEDI) model
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