急性脑梗死溶栓治疗后慢性脑积水预测模型的构建及验证  

Construction and validation of a predictive model for chronic hydrocephalus in patients with acute cerebral infarction after thrombolytic therapy

作　　者：李伟伟 赵丙瑞 Li Weiwei;Zhao Bingrui(Department of Neurology,Linfen People′s Hospital,Linfen 041000,China)

机构地区：[1]临汾市人民医院神经内科,临汾041000

出　　处：《中国医师进修杂志》2024年第12期1089-1093,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的建立并验证急性脑梗死溶栓治疗后慢性脑积水的预测模型。方法回顾性收集临汾市人民医院2020年1月至2022年12月收治的急性脑梗死溶栓治疗患者288例,根据患者是否出现慢性脑积水分为脑积水组(62例)和对照组(226例),比较两组临床特征,采用多因素Logistic回归分析急性脑梗死溶栓治疗后慢性脑积水的危险因素,采用R4.0.3统计软件进行急性脑梗死溶栓治疗后慢性脑积水预测模型的建立及验证。结果脑积水组年龄、合并糖尿病比例、大面积脑梗死比例高于对照组[(70.81±10.34)岁比(63.46±10.34)岁、50.00%(31/62)比16.81%(38/226)、38.71%(24/62)比15.93%(36/226)],差异有统计学意义(P<0.05)。多因素Logistic回归分析结果表明,年龄>65岁、糖尿病、大面积脑梗死是急性脑梗死溶栓治疗后慢性脑积水的危险因素(P<0.05)。采用R4.0.3统计软件将数据集随机分为训练集(202例)和验证集(86例),训练集受试者工作特征曲线下面积(AUC)为0.774(95%CI 0.694~0.855),验证集AUC为0.807(95%CI 0.664~0.950)。在验证集里对模型进行拟合优度检验,χ^(2)=8.35,P=0.400,说明本模型具有较好的可信度。结论本模型对急性脑梗死溶栓治疗后慢性脑积水具有较高的预测价值,可用于识别慢性脑积水的高危人群。ObjectiveTo establish and validate a predictive model for chronic hydrocephalus in patients with acute cerebral infarction after thrombolytic therapy.MethodsThe clinical data of 288 patients with acute cerebral infarction admitted to Linfen People′s Hospital from January 2020 to December 2022 were retrospectively collected,based on whether the patients had chronic hydrocephalus or not,they were divided into the hydrocephalus group(62 cases)and the control group(226 cases).The clinical characteristics of the two groups were compared,and the risk factors for chronic hydrocephalus in patients with acute cerebral infarction after thrombolysis treatment were analyzed by multivariate Logistic regression.Based on relevant risk factors,the predictive model for chronic hydrocephalus in patients with acute cerebral infarction after thrombolytic therapy were established and validated it by R4.0.3 software.ResultsThe age,rate of diabetes mellitus and massive cerebral infarction in the hydrocephalus group were higher than those in the control group:(70.81±10.34)years old vs.(63.46±10.34)years old,50.00%(31/62)vs.16.81%(38/226),38.71%(24/62)vs.15.93%(36/226),there were statistical differences(P<0.05).The results of multivariate Logistic regression analysis showed that the age>65 years old,diabetes mellitus and massive cerebral infarction were the risk factors of chronic hydrocephalus after thrombolytic therapy for acute cerebral infarction(P<0.05).A prediction model and randomly divided the dataset into a training set(202 cases)and a validation set(86 cases)by R4.0.3 software,the area under curve(AUC)of the receiver operating characteristic curve in the training set was 0.774(95%CI 0.694-0.855),and the AUC of the validation set was 0.807(95%CI 0.664-0.950).In the validation set,the model was subjected to the Hosmer-Lemeshow Goodness-of-Fit test,χ^(2)=8.35,P=0.400,indicating that the model had good reliability.ConclusionsThe present predictive model has high value in predicting chronic hydrocephalus in patients with acute

关 键 词：脑梗死 脑积水 溶栓治疗 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R742.7[医药卫生—临床医学]