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作 者:周波 易明亮[1] ZHOU Bo;YI Mingliang(Department of Neurosurgery,The Third People's Hospital of Yibin,Yibin,Sichuan 644000,China)
机构地区:[1]四川省宜宾市第三人民医院神经外科,644000
出 处:《重庆医学》2021年第S01期73-76,共4页Chongqing medicine
摘 要:目的通过对缺血性脑卒中患者合并脑微出血(CMB)发病危险因素的分析,建立相应的列线图预测模型。方法回顾性分析2018年3月至2020年3月该院收治的274例缺血性脑卒中患者的临床资料,根据磁敏感加权成像检查结果分为CMB组(168例)和非CMB组(106例)。采用单因素和多因素logistic回归模型分析发生CMB的相关危险因素,并通过多因素筛选中的变量建立列线图预测模型,并利用C-index和校正曲线对模型进行评估和验证。结果CMB的发生与吸烟、饮酒、糖尿病、高血压、脑白质疏松(LA)、低密度脂蛋白(LDL)、载脂蛋白A(ApoA)相关,差异有统计学意义(P<0.05);吸烟、饮酒、高血压、LA、LDL、ApoA是发生CMB的独立危险因素;成功建立列线图模型,C-index为0.817(95%可信区间:0.791~0.898),校正曲线显示模型拟合程度良好。结论吸烟、饮酒、高血压、LA、LDL、ApoA是发生CMB的独立危险因素,建立的列线图预测模型拟合程度和区分度皆较好,具有十分重要的临床推广应用价值。Objective To establish a corresponding nomogram prediction model by analyzing the risk factors of ischemic stroke patients with cerebral microbleeds.Methods A retrospective study of 274 patients with ischemic stroke admitted to our hospital from March 2018 to March 2020 were divided into CMB group according to the results of Suscepti bility-weighted imaging(n=168 cases)and non-CMB group(n=106 cases).Single factor and multivariate Logistic regression were used to analyze the independent risk factors related to the occurrence of CMB,and the nomogram prediction model was established through the variables selected in the multiple factors,and the model was evaluated and verified by C-index and calibration curve.Results Univariate analysis showed that the occurrence of CMB was related to smoking,drinking,diabetes,hypertension,LA,LDL and ApoA(P<0.05);multivariate logistic regression analysis showed that smoking,drinking,hypertension,LA,LDL and ApoA were Independent risk factors for the occurrence of CMB;the nomogram model was successfully established,with a C-index of 0.817(95%CI:0.791-0.898),and the calibration curve showed that the model fits well.Conclusion Smoking,drinking,hypertension,LA,LDL and ApoA are independent risk factors for the occurrence of CMB.The established nomogram prediction model has good fit and discrimination,which has very important clinical application and promotion value.
关 键 词:缺血性脑卒中 脑微出血 列线图 预测模型 发病风险
分 类 号:R74[医药卫生—神经病学与精神病学]
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