超声与临床特征联合预测^(90)Sr敷贴治疗病理性瘢痕起效时间  

Combined ultrasound and clinical characteristics to predict the treatment time of ^(90)Sr radioisotope applicator therapy for pathologic scars

作　　者：陈燕晶 齐永帅 蒋周越 张妍琰[1] 稂婷 林越 昌敏 李颖嘉[1] Chen Yanjing;Qi Yongshuai;Jiang Zhouyue;Zhang Yanyan;Lang Ting;Lin Yue;Chang Min;Li Yingjia(Department of Medical Ultrasound,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Nuclear Medicine,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院超声医学科,广州510515 [2]南方医科大学南方医院核医学科,广州510515

出　　处：《中华超声影像学杂志》2024年第7期603-608,共6页Chinese Journal of Ultrasonography

摘　　要：目的联合超声及临床特征预测^(90)Sr敷贴治疗病理性瘢痕达到临床有效标准时的起效时间。方法前瞻性收集2022年9月至2023年10月于南方医科大学南方医院核医学科行^(90)Sr敷贴治疗的病理性瘢痕患者48例,共计90个病灶。^(90)Sr敷贴治疗病理性瘢痕的临床有效标准定义为瘢痕皮上高度减少≥50%。按达到临床有效标准的治疗时长分为短程治疗组(2个月,38个病灶)和长程治疗组(>2个月,52个病灶)。采用单因素分析比较两组间的超声及临床特征,使用筛选出的自变量行多因素分析,建立Logistic回归模型,分析^(90)Sr敷贴治疗病理性瘢痕起效时间的独立预测因素。结果家族史、血流情况、病程、年龄、瘢痕杨氏模量平均值是^(90)Sr敷贴治疗病理性瘢痕起效时间的独立预测因素(均P<0.05),据此建立预测模型,ROC曲线下面积(AUC)为0.886(95%CI=0.817~0.955,P<0.001),校准曲线显示使用该模型预测起效时间的准确度良好(χ^(2)=5.668,P=0.684)。结论结合家族史、血流情况、病程、年龄、瘢痕杨氏模量平均值构建的回归模型能够用于预测^(90)Sr敷贴治疗病理性瘢痕的起效时间,有助于指导临床设计合理的治疗方案,减少不必要的放射损伤,并提高患者依从性。Objective To combine ultrasound and clinical characteristics for predicting the treatment time of strontium 90(^(90)Sr)radioisotope applicator therapy for pathological scars when the therapeutic effect meets the clinical effective criteria.Methods From September 2022 to October 2023,48 patients(90 lesions)with pathological scars who underwent ^(90)Sr radioisotope applicator therapy at the Department of Nuclear Medicine,Nanfang Hospital,Southern Medical University were prospectively collected.The clinically effective criteria of ^(90)Sr radioisotope applicator therapy for pathological scars were defined as a reduction of the superficial height of the scar higher than 50%.All lesions were divided into short period treatment group(2 months,38 lesions)and long period treatment group(>2 months,52 lesions)according to the duration of treatment when the therapeutic effect met the clinical criteria.Univariate comparative analyses of ultrasound and clinical characteristics between the two groups were performed.The statistically significant variates were used to build a multivariate logistic regression model for analyzing the independent predictors of the treatment time of ^(90)Sr radioisotope applicator therapy for pathological scars.Results Family history,blood flow signal,disease duration,age,and scar Young′s modulus were independent predictors of the effective treatment time of ^(90)Sr radioisotope applicator therapy for pathological scars(all P<0.05).By using the selected variables,a predictive model was developed,area under the ROC curve(AUC)were 0.886(95%CI=0.817-0.955,P<0.001),and the calibration curve showed that the model was well calibrated(χ^(2)=5.668,P=0.684).Conclusions The multivariate logistic regression model with family history,blood flow signal,disease duration,age,and scar Young′s modulus could be used to predict the treatment time of ^(90)Sr radioisotope applicator therapy for pathologic scars,which can help to guide the design of treatment plan,reduce unnecessary radiation damage,and improve pati

关 键 词：超声检查 ^(90)Sr敷贴治疗 病理性瘢痕 起效时间 

分 类 号：R445.1[医药卫生—影像医学与核医学] R751[医药卫生—诊断学]