基于Mimics软件分析自发性小脑出血患者短期死亡的危险因素  

Risk factors for mortality in patients with spontaneous cerebellar hemorrhage based on Mimics software analysis

作　　者：吴嘉诚 刘振宁[1] Wu Jiacheng;Liu Zhenning(Department of Critical Care Medicine,Shengjing Hospital of China Medical University,Shenyang 110004,Liaoning,China)

机构地区：[1]中国医科大学附属盛京医院重症监护病房,辽宁沈阳110004

出　　处：《中华危重病急救医学》2024年第12期1279-1284,共6页Chinese Critical Care Medicine

基　　金：辽宁省应用基础研究计划联合计划项目(2022JH2/101500047)。

摘　　要：目的基于医学影像控制系统Mimics软件探讨自发性小脑出血(SCH)患者短期死亡的独立危险因素。方法回顾性分析2010年1月至2021年12月在中国医科大学附属盛京医院治疗的SCH患者的临床资料,包括性别、年龄、基础疾病、入院时格拉斯哥昏迷评分(GCS)和血压、实验室检查指标、影像学检查资料及短期(发病后3周)生存状态,并进行比较。影像学检查参数均应用Mimics软件准确计算小脑出血的血肿体积、血肿最长径、血肿最大横截面面积等相关变量。运用多因素Logistic回归分析评估SCH患者短期死亡的独立危险因素;绘制受试者工作特征曲线(ROC曲线)分析各因素对SCH患者短期死亡的预测价值。结果共纳入202例SCH患者,其中发病3周内死亡42例(20.8%),存活160例(79.2%)。单因素方差分析显示,死亡组患者入院时血糖、血肿体积、血肿最长径、血肿最大横截面面积、血肿最大横截面面积/血肿所在层面后颅窝面积比值均显著高于存活组,而入院时GCS评分显著低于存活组,血肿边缘至脑干中心和边缘的距离均显著短于存活组,差异均有统计学意义。多因素Logistic回归分析显示,入院时GCS评分〔优势比(OR)=0.875,95%可信区间(95%CI)为0.767~0.998〕、血肿体积(OR=1.068,95%CI为1.022~1.115)、血肿最长径(OR=1.086,95%CI为1.049~1.124)、血肿最大横截面面积/血肿所在层面后颅窝面积比值(OR=1.119,95%CI为1.060~1.181)是影响SCH患者短期死亡的独立危险因素(均P<0.05)。ROC曲线分析显示,上述指标预测SCH患者短期死亡的ROC曲线下面积(AUC)分别为0.738、0.839、0.728和0.727;当入院时GCS评分为12分时,敏感度为85.0%,特异度为57.1%;当血肿体积为8.40 mL时,敏感度为95.2%,特异度为65.0%;当血肿最长径为47.10 mm时,敏感度为57.1%,特异度为80.6%;当血肿最大横截面面积/血肿所在层面后颅窝面积比值为0.11时,敏感度为88.1%,特异度为48.7%。结论入院�Objective To investigate the independent risk factors for short-term mortality in patients with spontaneous cerebellar hemorrhage(SCH)based on Mimics software of medical image control system.Methods The clinical data of SCH patients treated at Shengjing Hospital of China Medical University from January,2010 to December,2021 was retrospectively analyzed and compared,including gender,age,underlyin g diseases,Glasgow coma scale(GCS)and blood pressure at admission,laboratory indicators,imaging data,and short-term(3 weeks after onset)survival status.The imaging examination parameters were accurately calculated using Mimics software,including hematoma volume,longest diameter,and maximum cross-sectional area of cerebellar hemorrhage.Multivariate Logistic regression analysis was used to evaluate the independent risk factors for short-term death in SCH patients.Receiver operator characteristic curve(ROC curve)was drawn to analyze the predictive value of the four significant factors on short-term mortality in SCH patients.Results A total of 202 patients with SCH were included,of which 42 patients(20.8%)died within 3 weeks of onset and 160 patients(79.2%)survived.Univariate analysis showed that,compared with the survival group,the death group had significantly higher blood glucose,hematoma volume,hematoma longest diameter,hematoma maximum cross-sectional area,the ratio of hematoma maximum cross-section area and the corresponding posterior cranial fossa area,while GCS score was significantly lower,the distance from hematoma edge to the cerebral aqueduct center,and the distance from hematoma edge to the edge of brainstem were significantly shorter,the differences were statistically significant.Multivariate Logistic regression analysis showed that GCS score at admission[odds ratio(OR)=0.875,95%confidence interval(95%CI)was 0.767-0.998],hematoma volume(OR=1.068,95%CI was 1.022-1.115),the longest diameter of hematoma(OR=1.086,95%CI was 1.049-1.124),and the ratio of hematoma maximum cross-section area and the corresponding poster

关 键 词：自发性小脑出血 预后 MIMICS软件 危险因素 

分 类 号：R743.34[医药卫生—神经病学与精神病学]