摘要
目的探讨大血管闭塞所致脑梗死的独立危险因素,构建及验证列线图风险预测模型。方法选取2021年9月至2022年7月北京大学第三医院神经内科收治的脑梗死患者335例,根据是否因大血管闭塞所致脑梗死分为大血管梗死组58例及非大血管梗死组277例。收集患者的临床资料,采用单因素及多因素筛选大血管闭塞所致脑梗死的独立危险因素,构建并验证列线图风险预测模型。结果本研究因大血管闭塞所致脑梗死发生率为17.31%。大血管梗死组年龄≥60岁、高血压、脑卒中史、吸烟史、美国国立卫生研究院卒中量表(NIHSS)评分>5分、改良的Rankin量表(mRS)评分>2分比例明显高于非大血管梗死组,差异有统计学意义(P<0.05,P<0.01)。logistic回归分析显示,年龄、高血压、脑卒中史、吸烟史、NIHSS评分、mRS评分是大血管闭塞所致脑梗死的独立危险因素(95%CI:1.477~8.654,P=0.005;95%CI:1.202~6.514,P=0.017;95%CI:1.117~1.680,P=0.002;95%CI:1.332~4.745,P=0.004;95%CI:2.145~20.594,P=0.001;95%CI:1.203~3.808,P=0.010)。基于上述因素建立大血管闭塞所致脑梗死的列线图风险预测模型。模型验证结果显示,该列线图模型的一致性指数为0.791(95%CI:0.653~0.887)。结论年龄、高血压、脑卒中史、吸烟史、NIHSS评分、mRS评分是大血管闭塞所致脑梗死的独立危险因素,建立的列线图预测模型可有效评估大血管闭塞发生脑梗死的风险。
Objective To investigate the independent risk factors of cerebral infarction caused by large vessel occlusion,and to construct and validate a nomogram risk prediction model.Methods A total of 335patients with cerebral infarction admitted to Department of Neurology of Peking University Third Hospital from September 2021to July 2022were selected as the research objects.According to whether cerebral infarction was caused by large vessel occlusion,they were divided into large vessel infarction group(n=58)and non-large vessel infarction group(n=277).The clinical data of the patients were collected,and the independent risk factors of cerebral infarction caused by large vessel occlusion were screened by univariate and multivariate analyses,and the nomogram risk prediction model was constructed and verified.Results The incidence of cerebral infarction caused by occlusion of large vessels was 17.31%in the cohort.The large vessel infarction group had significantly larger proportions of aged≥60years,hypertension,stroke history,smoking history,NIHSS score>5,and mRS score>2when compared with the non-large vessel infarction group(P<0.05,P<0.01).Logistic regression analysis showed that age,hypertension,history of stroke,smoking history,and NIHSS and mRS scores were independent risk factors for cerebral infarction caused by large vessel occlusion(95%CI:1.477-8.654,P=0.005;95%CI:1.202-6.514,P=0.017;95%CI:1.117-1.680,P=0.002;95%CI:1.332-4.745,P=0.004;95%CI:2.145-20.594,P=0.001;95%CI:1.203-3.808,P=0.010).A nomogram risk prediction model for cerebral infarction caused by large vessel occlusion was established based on the above factors.Model validation results showed that the consistency index of the nomogram model was 0.791(95%CI:0.653-0.887).Conclusion Age,hypertension,stroke history,smoking history,NIHSS and mRS scores are independent risk factors for cerebral infarction caused by large vessel occlusion.Our established nomogram prediction model can effectively assess the risk of cerebral infarction caused by large vessel occlusion.
作者
韩志华
李小刚
Han Zhihua;Li Xiaogang(Department of Neurology,Wuyishan City Hospital,Wuyishan 354300,Fujian Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2023年第4期408-411,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
脑血管障碍
脑梗死
危险因素
普查
列线图
预测
cerebrovascular disorders
brain infarction
risk factors
mass screening
nomograms
forecasting
