Construction and Evaluation of a Predictive Model for Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage Based on CT Perfusion Imaging Parameters Combined with Serum NOX2 and MMP-9
Objective:Construction and validation of a predictive model for delayed cerebral ischemia(DCI)after aneurysmal subarachnoid hemorrhage(aSAH)based on CT perfusion imaging parameters combined with serum nicotinamide adenine dinucleotide phosphate oxidase 2(NOX2)and matrix metalloproteinase-9(MMP-9).Methods:227 aSAH patients were divided into DCI group after aSAH(n=68)and non-DCI group after aSAH(n=159)according to the occurrence of DCI.The risk factors were analyzed by multivariate Logistic regression analysis.The predictive value was verified by receiver operating characteristic(ROC)curve.Results:Compared with non-DCI group after aSAH,the proportion of Hunt-Hess grade 4-5 and cerebral vasospasm in DCI group after aSAH was significantly higher,the mean cerebral blood flow and cerebral blood volume in DCI group after aSAH were significantly lower,and the mean transit time,peak time and serum NOX2 and MMP-9 levels were significantly higher(all P＜0.05).Mean cerebral blood flow,cerebral blood volume,mean transit time,peak time,NOX2 and MMP-9 were independent risk factors for DCI after aSAH(P＜0.05).The area under the curve(AUC)of the prediction model based on CT perfusion imaging parameters combined with NOX2 and MMP-9 was 0.866,the speci-ficity was 76.00％,and the sensitivity was 90.38％.Conclusion:The risk factors of DCI in aSAH patients include mean cerebral blood flow,cerebral blood volume,mean transit time,peak time,NOX2 and MMP-9,the model of CT perfusion imaging parameters combined with serum NOX2 and MMP-9 has high predictive value.
CT perfusion imaging parametersNOX2MMP-9Aneurysmal subarachnoid hemorrhageDelayed cerebral ischemiaPrediction model
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