来源：风湿病与关节炎,2019,8（12）:9-12,16.

强直性脊柱炎患者心功能参数变化的数据挖掘（临床研究）

龙　琰¹，刘　健²，忻　凌²，黄　旦²，鲍丙溪¹，孙广瀚¹，张　颖¹

　　【摘　要】目的：基于数据挖掘方法探究强直性脊柱炎患者的超声心动图相关参数与炎症、免疫、代谢指标的相关性、关联性及危险因素。方法：对2012年6月至2018年6月强直性脊柱炎住院患者的病例资料进行整理，研究以下指标：心功能参数包括主动脉内径（AODd）、每搏输出量（SV）、左心房舒张期内径（LADd）、左室舒张末期内径（LVDd）、肺动脉压（Pmax）、射血分数（EF）、左心室短轴缩短率（FS），炎症指标包括超敏C-反应蛋白（hs-CRP），免疫指标包括免疫球蛋白（IgA、IgG、IgM）、补体（C3、C4），代谢指标包括低密度脂蛋白胆固醇（LDL-C）、肌酐（CREA）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、尿素氮（BUN）、同型半胱氨酸（Hcy）、α1-酸性糖蛋白（α1-AGP）。运用SPSS 22.0、SPSS Clementine 11.1 Aprior等统计学软件对指标进行相关性分析、关联性分析、二元Logistic回归分析。结果：①共纳入强直性脊柱炎患者72例，与正常值相比，AODd升高22例，SV降低23例。②相关性分析显示：超声心动图相关参数AODd与ALT呈正相关（P < 0.05），与Hcy呈正相关（P < 0.01），与IgM呈负相关（P < 0.05），与其余项无相关性（P > 0.05）；SV与hs-CRP呈正相关 （P < 0.05），与其余项无相关性（P > 0.05）。③关联性分析：AODd升高与hs-CRP、α1-AGP升高呈强关联；SV降低与hs-CRP升高呈强关联。④二元Logistic回归分析得出，C4、IgG、hs-CRP、AST是 AODd升高的危险因素（OR > 1），α1-AGP、IgM、IgG升高是SV降低的危险因素（OR > 1）。结论：强直性脊柱炎患者超声心动图相关参数的下降，与炎症、免疫、代谢指标的升高具有相关性，且部分指标呈有效的强关联性，hs-CRP升高可作为超声心动图相关参数值异常的危险因素，参与强直性脊柱炎心功能变化的发病及活动，具体机制有待进一步研究。

　　【关键词】　脊柱炎，强直性；心功能参数；相关性分析；关联规则；数据挖掘

Data Mining of Cardiac Function Parameters in Patients with Ankylosing Spondylitis

LONG Yan,LIU Jian,XIN Ling,HUANG Dan,BAO Bing-xi,SUN Guang-han,ZHANG Ying

　　【ABSTRACT】Objective:To explore the correlation between the parameters of echocardiography and the indexes of inflammation,immunity and metabolism in patients with ankylosing spondylitis based on data mining and related risk factors.Methods:The data of the patients with ankylosing spondylitis from June 2012 to June 2018 were collected and the following indexes were studied:heart function parameters including AODd,SV,LADd,LVDd,Pmax,EF and FS;inflammatory markers including hs-CRP;immune indexes including IGA,IgG,IgM,C3,C4;the metabolic indexes inclu-ding LDL-C,CREA,BUN,Hcy and α1-AGP.Statistical softwares such as SPSS 22.0 and SPSS Clementine 11.1 Aprior were used forcorrelation analysis and binary logistic regression analysis.Results:①Seventy-two cases of ankylosing spondylitis were included.Compared with the normal value,AODd increased in 22 cases and SV decreased in 23 cases.②Correlation analysis showed that AODd was positively correlated with ALT（P < 0.05）and Hcy（P < 0.01）,negatively correlated with IgM（P < 0.05）,and of no correlation with the rest（P > 0.05）.SV was positively correlated with hs-CRP（P < 0.05）,and of no correlation with the rest（P > 0.05）.③Correlation analysis showed that there was a strong correlation between the increase of AODD and the increase of hs-CRP and α1-AGP;and there was a strong correlation between the decrease of SV and the increase of hs-CRP.④Binary logistic regression analysis showed that C4,IgG,hs-CRP and AST were the risk factors for the increase of AODd（OR > 1）,and the increase of α1-AGP,IgM and IgG was the risk factor for the decrease of SV（OR > 1）.Conclusion:The decrease of echocardiographic parameters in patients with ankylosing spondylitis is closely related to the increase of inflammation,immunity and metabolism,and are highly related with some of them.The increase of hs-CRP can be used as a risk factor for the abnormal values of echocardiographic parameters,participating in the pathogenesis and activities of cardiac function changes in patients with ankylosing spondylitis.The specific mechanism needs further study.

　　【Keywords】 spondylitis,ankylosing;cardiac function parameters;correlation analysis;association rules;data mining