基于CT灌注成像参数构建AIS溶栓后出血转化的列线图模型
Construction of a nomogram model of hemorrhage transformation after AIS thrombolysis based on CT perfusion imag-ing parameters
吴静 1徐鹏1
作者信息
- 1. 徐州医科大学附属医院影像科 江苏 徐州 221004
- 折叠
摘要
目的 基于CT灌注成像参数构建急性缺血性脑卒中(AIS)溶栓后出血转化的列线图模型.方法 选取本院行溶栓治疗的 160 例AIS患者作为观察对象,均行头颅CT灌注检查.采用Lasso分析筛选AIS溶栓后出血转化的预测因素,采用Logistic回归筛选AIS溶栓后出血转化的危险因素,采用R软件构建AIS溶栓后出血转化的列线图模型.结果 Logistic回归分析结果显示,大面积梗死、心房颤动、发病至溶栓时间>3h、入院时NIHSS评分、rCBF、rCBV是AIS溶栓后出血转化的危险因素(P<0.05).AIS溶栓后出血转化的列线图模型的C-index为 0.942(95%CI 0.903～0.981);校正曲线的预测值和实际值基本吻合;模型的ROC曲线下面积为 0.929(95%CI 0.888～0.970);决策曲线显示阈值概率为 1%～84%时,列线图预测AIS溶栓后出血转化的净获益值较高.结论 AIS溶栓后出血转化的列线图模型的准确性及临床应用价值较高.
Abstract
Objective Based on the parameters of CT perfusion imaging,a nomogram model of hemorrhage transformation af-ter thrombolysis in acute ischemic stroke(AIS)was constructed.Methods 160 patients with AIS who underwent thrombolytic therapy in our hospital were selected as the study objects,and all patients underwent skull CT perfusion examination.Lasso analysis was used to screen the predictive factors of hemorrhage transformation after AIS thrombolytic therapy,Logistic regres-sion was used to screen the risk factors of hemorrhage transformation after AIS thrombolytic therapy,and R software was used to build the column graph model of hemorrhage transformation after AIS thrombolytic therapy.Results Logistic regression analy-sis showed that large-scale infarction,atrial fibrillation,time from onset to thrombolysis＞3h,NIHSS score at admission,rCBF,and rCBV were risk factors for hemorrhage transformation after AIS thrombolysis(P＜0.05).The C-index of the nomogram model of hemorrhage transformation after AIS thrombolysis was 0.942(95%CI 0.903～0.981).The predicted value of the correction curve was basically consistent with the actual value.The area under ROC curve of the model was 0.929(95%CI 0.888～0.970).When the decision curve showed a threshold probability of 1%-84%,the net benefit value predicted by the nomogram was higher after AIS thrombolysis.Conclusion The accuracy and clinical application value of the nomogram model of hemorrhage transfor-mation after AIS thrombolysis are high.
关键词
急性缺血性脑卒中/出血转化/体层摄影术,X线计算机/灌注成像参数/列线图Key words
Acute ischemic stroke/Bleeding transformation/Tomography,X-ray computed/Perfusion imaging parameters/Nomograph引用本文复制引用
出版年
2024
NETL
NSTL
万方数据