高压氧联合血管支架成型术治疗缺血性脑血管病的疗效及再发血管事件列阵图预测模型构建  

Efficacy of hyperbaric oxygen therapy combined with vascular stenting angioplasty in the treatment of ischemic cerebrovascular disease and construction of a predictive model using alignment diagram for recurrent vascular events

作　　者：陈锋 刘红[1] 程坤[1] Chen Feng;Liu Hong;Cheng Kun(Department of Neurology,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,China)

机构地区：[1]长治医学院附属和平医院神经内科,长治046000

出　　处：《中华航海医学与高气压医学杂志》2024年第4期500-504,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：山西省2020年研究生创新项目(2020SY447)。

摘　　要：目的探讨高压氧联合血管支架成型术治疗缺血性脑血管病的疗效,并构建再发血管事件列阵图预测模型。方法选取2019年1月至2021年12月在长治医学院附属和平医院神经内科诊治的缺血性脑血管病患者82例,采用随机数字表法分为对照组和研究组,每组41例。对照组给予血管支架成型术治疗,研究组给予高压氧联合血管支架成型术治疗,比较2组患者治疗后的临床疗效,分析再发血管事件的预测因素,并构建再发血管事件列阵图预测模型。结果研究组的临床治疗总有效率为87.80%,明显高于对照组的60.98%(P<0.05)。研究组的再发血管事件发生率为7.32%,明显低于对照组的24.39%(P<0.05),13例再发血管事件纳入再发组,其余纳入非再发组,经多因素二元Logistic回归分析,糖尿病是再发血管事件的危险因素(P<0.05),服药依从性、高压氧联合血管支架成型术治疗是再发血管事件的保护因素(P<0.05)。Hosmer-Lemeshow拟合度检验显示,χ^(2)=5.280,P=0.508;预测模型受试者工作特征曲线的曲线下面积为0.814,约登指数为0.527,灵敏度、特异度分别为84.6%、68.1%,95%CI为(0.673,0.954),实际应用的准确性为87.80%(72/82)。结论高压氧联合血管支架成型术治疗缺血性脑血管病可有效提高临床疗效,降低再发血管事件发生率;再发血管事件列阵图预测模型效果较好,能够为缺血性脑血管病患者治疗后再发血管事件的预测提供参考。ObjectiveTo explore the efficacy of hyperbaric oxygen(HBO)therapy combined with vascular stenting angioplasty in the treatment of ischemic cerebrovascular disease,and construct a predictive model using alignment diagram for recurrent vascular events.MethodsA total of 82 patients with ischemic cerebrovascular disease who were treated in the Department of Neurology of Heping Hospital Affiliated to Changzhi Medical College from January 2019 to December 2021 were selected.They were divided into control group and study group using the random number table method,with 41 cases in each group.The control group received vascular stenting angioplasty treatment,while the study group received HBO therapy combined with vascular stenting angioplasty treatment.The clinical efficacy of the two groups was compared,and the predictive factors of recurrent vascular events were analyzed,and a predictive model using alignment diagram for recurrent vascular events was constructed.ResultsThe total effective rate of clinical treatment of the study group(87.80%)was significantly higher than that of the control group(60.98%,P<0.05).The incidence of recurrent vascular events in the study group(7.32%)was significantly lower than that 24.39%of the control group(P<0.05).Thirteen cases of recurrent vascular events were classified into the recurrent group,with the rest categorized into the non-recurrent group.Through the multivariate binary Logistic analysis,diabetes was identified as a risk factor for recurrent vascular events(P<0.05),while good medication compliance and the combination therapy of HBO with vascular stenting angioplasty were the protective factors against the recurrent vascular events(P<0.05).The Hosmer-Lemeshow goodness of fit test yielded aχ^(2) value of 5.280 with a P-value of 0.508.The area under curve(AUC)of the receiver operating characteristic(ROC)curve of the recurrent vascular event predictive model was 0.814,with the Youden index at 0.527.The sensitivity and specificity were 84.6%and 68.1%,respectively,with a 95%confid

关 键 词：缺血性脑血管病 血管支架成型术 列阵图 预测模型 高压氧 

分 类 号：R743[医药卫生—神经病学与精神病学] R459.6[医药卫生—临床医学]