一种风险预警模型对急性眩晕起病的aPCI的诊断价值  

Diagnostic value of a risk warning model for aPCI of acute vertigo onset

作　　者：樊艳泓 刘晓蕾[1] 侯苗苗 张凯丽[1] 李新毅[1] FAN Yanhong;LIU Xiaolei;HOU Miaomiao;ZHANG Kaili;LI Xinyi(Department of Neurology,The Third Hospital of Shanxi Medical University/Shanxi Bethune Hospital/Shanxi Academy of Medical Sciences,Taiyuan,Shanxi 030032,China)

机构地区：[1]山西医科大学第三医院/山西白求恩医院/山西医学科学院神经内科,太原030032

出　　处：《重庆医学》2023年第19期2919-2923,2929,共6页Chongqing medicine

基　　金：山西省回国留学人员科研资助项目(HGKY2019019);山西省留学人员科技活动择优资助项目(2018-1059-13);山西省基础研究青年项目(202103021223415)。

摘　　要：目的建立一种眩晕起病的急性后循环缺血性卒中(aPCI)的风险预警模型,分析其诊断价值。方法将2021年12月至2022年10月共461例以急性眩晕起病的该院神经内科住院患者,按照是否患有aPCI分为两组,aPCI组(375例,出院诊断为aPCI)和非aPCI组(86例,出院诊断为其他眩晕相关疾病),纳入分析的风险因素包含6个方面、共25项临床资料。通过单因素logistic回归分析得到有统计学意义的风险因素(P<0.05),再将这些风险因素纳入多因素logistic回归分析得出风险预警模型,绘制受试者工作特征(ROC)曲线,评价模型诊断价值。结果(1)通过logistic回归分析得到风险预警模型,吸烟史、饮酒史、糖尿病史、中性粒细胞/淋巴细胞比值(NLR)、国际标准化比值(INR)、共济失调是aPCI发生的风险因素;(2)利用ROC曲线,得到风险预警模型AUC为0.819,灵敏度0.640,特异度0.872,95%CI:0.773~0.866。结论(1)吸烟史、饮酒史、糖尿病史、NLR、共济失调与aPCI的发生呈正相关,INR与aPCI呈负相关。(2)该风险预警模型可帮助临床医生筛选出aPCI的高危患者,具有较高的诊断价值。Objective To establish a risk early warning model for acute posterior-circulation ischemia(aPCI)with vertigo onset,and analyze its diagnostic value.Methods A total of 461 inpatients with acute vertigo onset from December 2021 to October 2022 were collected and divided into two groups according to whether they had aPCI:the aPCI group(375 patients diagnosed with aPCI at discharge)and the non-APCI group(86 patients diagnosed with other vertigo related diseases at discharge).The risk factors included in the analysis included six aspects and 25 clinical data.Statistically significant risk factors were obtained through univariate logistic regression analysis(P<0.05),and these significant risk factors were incorporated into multivariate logistic regression to analyze the risk early warning model,and the ROC curve was drawn to evaluate the diagnostic value of the model.Results(1)The risk warning model was obtained through logistic regression analysis.Smoking history,drinking history,diabetes history,neutrophil/lymphocyte ratio(NLR),international standardized ratio(INR)and ataxia were the risk factors for aPCI.(2)Using the ROC curve,the AUC of the risk early warning model was 0.819,the sensitivity was 0.640,the specificity was 0.872,and the 95%CI was 0.773-0.866.Conclusion(1)Smoking history,drinking history,diabetes history,NLR and ataxia were positively correlated with the occurrence of aPCI,while INR was negatively correlated with aPCI.(2)This risk early warning model can help clinicians to screen out high-risk patients with aPCI,and has high diagnostic value.

关 键 词：后循环缺血性卒中 眩晕 风险预警模型 受试者工作特征曲线 

分 类 号：R743.33[医药卫生—神经病学与精神病学]