中老年高血压病患者中重度脑白质高信号列线图模型的构建  

Construction of a nomogram model for predicting moderate‑to‑severe white matter hyperintensity in middle‑aged and elderly patients with hypertension

作　　者：徐瑞辰 赵峰[1] 鄢潞潞 郭炫汐 林子贺 庞华军 XU Ruichen;ZHAO Feng;YAN Lulu(Department of Radiology,The 8th Division General Hospital of Xinjiang Production and Construction Corps,Shihezi 832000,China)

机构地区：[1]新疆生产建设兵团第八师总医院医学影像科,新疆石河子832000

出　　处：《中风与神经疾病杂志》2024年第1期58-62,共5页Journal of Apoplexy and Nervous Diseases

基　　金：新疆石河子市科技计划项目(2022NY05)。

摘　　要：目的分析中老年高血压病患者脑白质高信号(WMH)的影响因素,建立列线图预测模型并验证。方法纳入2022年1月―2023年4月在我院住院的中老年高血压病合并WMH患者198例,分析患者临床资料,记录患者相关数据,采用二元Logistic回归分析WMH的独立危险因素并构建列线图,通过受试者工作特征(ROC)曲线及校准曲线等评估列线图的诊断效能。结果年龄、高血压病程、胱抑素C、同型半胱氨酸、红细胞分布宽度、认知障碍是中老年高血压病患者WMH的独立影响因素,所构建的列线图表现出较高的诊断效能[ROC曲线下面积:0.815(95%CI 0.756~0.874,P<0.001)]和校准能力(C指数=0.794)。结论该列线图在预测中老年高血压病患者存在中重度脑白质高信号上显示出良好的预测能力,对临床工作者具有一定的辅助作用。Objective To investigate the influencing factors for white matter hyperintensity(WMH)in middleaged and elderly patients with hypertension,and to establish and verity a nomogram prediction model.Methods A total of 198 middle-aged and elderly patients with hypertension and WMH who were hospitalized in our hospital from January 2022 to April 2023 were enrolled.Related clinical data were analyzed,and related data were recorded.A binary logistic regression analysis was used to investigate the independent risk factors for WMH and establish a nomogram,and the receiver operating characteristic(ROC)curve and the calibration curve were used to evaluate the diagnostic efficacy of the nomogram.Results Age,course of hypertension,cystatin C,homocysteine,red blood cell distribution width,and cognitive impairment were the independent influencing factors for WMH in the middle-aged and elderly patients with hypertension.The nomogram established showed good diagnostic efficacy(AUC=0.815,95%CI 0.756~0.874,P<0.001)and calibration ability(C index=0.794).Conclusion The nomogram established in this study has a good predictive ability for moderate-to-severe WMH in middle-aged and elderly patients with hypertension and can provide certain help for clinical workers.

关 键 词：脑白质高信号 MRI 列线图 影响因素 

分 类 号：R743[医药卫生—神经病学与精神病学]