脑桥旁正中梗死的评分模型预测早期神经功能恶化的价值  

The predictive value of the scoring model of paramedian pontine infarction in early neurological deterioration

作　　者：宋杨柳 刘碧华[1] 王芳[1] SONG Yangliu;LIU Bihua;WANG Fang(Department of Radiology,Dongguan People’s Hospital,Dongguan,Guangdong Province 523058,China)

机构地区：[1]东莞市人民医院放射科,广东东莞523058

出　　处：《实用放射学杂志》2024年第9期1413-1416,共4页Journal of Practical Radiology

摘　　要：目的 探讨脑桥旁正中梗死(PPI)相关早期神经功能恶化(END)的独立危险因素,并根据独立危险因素构建评分模型,评估其预测END的价值.方法 回顾性纳入PPI患者163例,并将其分为END组(35例)和非END组(128例).筛选可能的临床因素及MRI特征后基于预测价值进行赋分建立评分模型,对模型的预测效能进行相关评价.结果 以患者出现END为终点事件,同型半胱氨酸(Hcy)水平、病灶最大面积、重度脑白质疏松(LA)、病灶平均表观扩散系数(ADC)值、桥下部梗死是PPI相关END的独立危险因素(P<0.05).根据比值比(OR)值对其进行赋分,分别为1、1、3、1、4,并建立评分模型预测END,该模型预测END的曲线下面积(AUC)值为0.910,当分值≥6分时,敏感度为0.743,特异度为0.898.结论 基于Hcy及MRI特征构建的评分模型对于预测PPI相关END具有良好效能,能为预后评估提供依据.Objective To investigate the independent risk factors for early neurological deterioration(END)associated with para-median pontine infarction(PPl),to construct a scoring model based on the independent risk factors,and to evaluate its predictive value in END.Methods A total of 163 patients with PPI were retrospectively included and divided into END group(n=35)and non-END group(n=128).After screening possible clinical factors and MRI features,a scoring model was established based on the predictive value,and the predictive efficacy of the model was evaluated.Results Taking END as the endpoint event,homocysteine(Hcy)level,maximum infarct size,severe leukoaraiosis(LA),mean apparent diffusion coefficient(ADC)value and inferior pontine infarction were independent risk factors for PPI related END(P<0.05).Scores were assigned according to odds ratio(OR)value,which were 1,1,3,1,4,respectively,and a scoring model was further established.The model predicted END with an area under the curve(AUC)value of 0.910 and sensitivity of 0.743 and specificity of 0.898 when the score was≥6 points.Conclusion The scoring model based on Hcy and MRI features has good efficacy in predicting PPI related END,and can provide a basis for prognostic evaluation.

关 键 词：脑桥旁正中梗死 早期神经功能恶化 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R338.6[医药卫生—临床医学]