比较两个国内模型在高血压脑出血术后近期疗效预测中的作用  

Comparing the roles of two domestic models in predicting the shortterm efficacy of hypertensive intracerebral hemorrhage after surgery

作　　者：姜胜军 张云玉 袁洁 陈岩玉 严高 Jiang Shengjun;Zhang Yunyu;Yuan Jie;Chen Yanyu;Yan Gao(Poyang County People’s Hospital,Shangrao,Jiangxi 333100,China)

机构地区：[1]江西省上饶市鄱阳县人民医院,江西上饶333100

出　　处：《首都食品与医药》2025年第7期47-50,共4页Capital Food Medicine

基　　金：江西省卫生健康委科技计划项目(编号:202312353)。

摘　　要：目的比较两个国内模型在高血压脑出血(HICH)术后近期疗效预测中的作用,并构建新的预测模型。方法通过分析屠传建版(模型1)和黄梅英版(模型2)模型,提取患者术前9个指标[年龄、糖尿病史、血糖、脑出血量、D-二聚体、格拉斯哥昏迷量表(GCS)评分、瞳孔对光反射、低氧血症、出血破入脑室]作为本研究的变量进行后续分析。前瞻性选取2023年1月-2024年6月拟于本院接受血肿清除术HICH患者90例,根据患者随访3个月的GOS分级将其分为预后良好组(n=63)和预后不良组(n=27),以模型1和模型2对患者进行预测,并通过单因素和多因素分析构建新的预测模型(模型3),比较模型1、模型2和模型3的预测效能。结果本研究通过因素分析将年龄、糖尿病史、血糖、脑出血量、D-二聚体、出血破入脑室纳入方程构建。模型1的AUC为0.840,敏感度为0.815,特异度为0.730;模型2的AUC为0.870,敏感度为0.741,特异度为0.857;模型3的AUC为0.968,敏感度为0.889,特异度为0.911;模型ROC比较的delong测试结果显示Z 1vs2=0.704,P 1vs2=0.481,Z 1vs3=3.172,P 1vs3=0.002,Z 2vs3=2.913,P 2vs3=0.004。结论3个模型均有较好的预测效能,其中模型1、模型2预测效能相当,模型3表现出更好的预测效能,临床工作者可根据需要选择合适的预测模型。Objective To compare the roles of two domestic models in predicting the short-term efficacy of hypertensive intracerebral hemorrhage(HICH)after surgery and construct a new prediction model.Methods By analyzing the Tu Chuanjian version(model 1)and Huang Meiying version(model 2)models,nine preoperative indicators of patients[age,history of diabetes,blood glucose,volume of intracerebral hemorrhage,D-dimer,Glasgow Coma Scale(GCS)score,pupillary light reflex,hypoxemia,and hemorrhage breaking into the cerebral ventricle]were extracted as variables in this study for subsequent analysis.Prospectively,90 patients with HICH who were scheduled to undergo hematoma evacuation in our hospital from January 2023 to June 2024 were selected.According to the Glasgow Outcome Scale(GOS)scores of patients during the 3-month follow-up,they were divided into the good-prognosis group(n=63)and the poor-prognosis group(n=27).Patients were predicted by model 1 and model 2,and a new prediction model(model 3)was constructed through univariate and multivariate analyses.The predictive efficacies of model 1,model 2 and model 3 were compared.Results In this study,age,history of diabetes,blood glucose,volume of intracerebral hemorrhage,D-dimer,and hemorrhage breaking into the cerebral ventricle were included in the equation construction through factor analysis.The area under the curve(AUC)of model 1 was 0.840,with a sensitivity of 0.815 and a specificity of 0.730;the AUC of model 2 was 0.870,with a sensitivity of 0.741 and a specificity of 0.857;the AUC of model 3 was 0.968,with a sensitivity of 0.889 and a specificity of 0.911;the Delong test results of the receiver operating characteristic(ROC)comparison of the models showed that Z 1vs2=0.704,P 1vs2=0.481,Z 1vs3=3.172,P 1vs3=0.002,Z 2vs3=2.913,P 2vs3=0.004.Conclusion All three models have good predictive efficacies.Among them,the predictive efficacies of model 1 and model 2 are equivalent,and model 3 shows better predictive efficacy.Clinical workers can select appropriate prediction models accor

关 键 词：高血压脑出血 预后不良 预测模型 比较分析 

分 类 号：R743.34[医药卫生—神经病学与精神病学]