首页|基于颈动脉斑块的临床特征构建缺血性卒中患者预测模型的研究

基于颈动脉斑块的临床特征构建缺血性卒中患者预测模型的研究

扫码查看
目的 基于颈动脉斑块的临床特征构建缺血性卒中(IS)患者预测模型的研究。方法 纳入苏州大学附属第一医院神经内科、疑似缺血性卒中且首次入院患者189例。根据头部磁共振弥散加权成像(DWI)结果,分为缺血性卒中(IS)组和非缺血性卒中(NIS)组。根据颈部动脉超声评估粥样硬化斑块性质,分为易损斑块和稳定斑块。采用Logistic回归分析IS患者颈动脉斑块性质及临床特征,并计算ROC曲线下面积。结果 (1)斑块与临床特征:IS组患者存在易损斑块的人数、颈动脉狭窄程度、高血压、糖尿病及NLR(中性粒细胞计数/淋巴细胞计数)等与NIS组比差异均有统计学意义(P<0。05);(2)多因素Logistic回归分析:存在颈动脉易损斑块、高血压及糖尿病控制不佳、NLR水平升高是患者发生IS事件的主要影响因素(P<0。05);(3)ROC曲线下面积分析:颈动脉易损斑块联合临床特征(高血压及糖尿病控制不佳、NLR水平升高)预测患者发生IS事件的ROC曲线下面积为 0。776(95%CI 0。709~0。842),其敏感度为0。748,特异度0。758。结论 颈动脉易损斑块联合临床特征构建的联合预测模型具有一定的预测价值。
Construction of a predictive model for patients with ischemic stroke based on clinical features of carotid plaques
Objective To construct a predictive model for patients with ischemic stroke(IS)based on the clinical features of carotid plaques.Methods A total of 189 patients with suspected acute IS who were admitted to the Depart-ment of Neurology at the First Affiliated Hospital of Soochow University for the first time were included in the study.Ac-cording to the results of diffusion-weighted imaging(DWI)of cranial magnetic resonance imaging,these patients were di-vided into IS group and non-ischemic stroke(NIS)group.According to the features of carotid atherosclerotic plaque as-sessed by ultrasound,the lesions were divided into vulnerable plaques and stable plaques.Logistic regression was used to analyze the nature of carotid plaques and clinical features in patients with IS,and the area under the ROC curve was calcu-lated.Results There were significant differences in the number of patients with vulnerable plaques,degree of carotid ste-nosis,hypertension,diabetes,and neutrophil-lymphocyte ratio(NLR)between the IS group and the NIS group(P<0.05).Multivariate logistic regression analysis revealed that the presence of vulnerable carotid plaques,poor control of hypertension and diabetes,and elevated NLR were the main influencing factors for IS events(P<0.05).The area under the ROC curve of vulnerable carotid plaques combined with clinical features(poor control of hypertension and diabetes and elevated NLR)to predict the occurrence of IS events in patients was 0.776(95%confidence interval:0.709‒0.842),with a sensitivity of 0.748 and a specificity of 0.758.Conclusion The predictive model based on vulnerable carotid plaques combined with clinical features shows promise.

Ischemic strokeCarotidAtherosclerotic plaqueInflammationPredictive model

蔡忻懿、惠品晶、颜燕红、张白、丁亚芳、蔡秀英、方琪

展开 >

苏州大学附属第一医院神经外科-颈脑血管超声科,江苏 苏州 215006

苏州大学附属第一医院卒中中心,江苏 苏州 215006

苏州大学附属第一医院神经内科,江苏 苏州 215006

缺血性卒中 颈动脉 粥样硬化斑块 炎症 预测模型

苏州大学技术合作项目

H211064

2024

中风与神经疾病杂志
吉林大学

中风与神经疾病杂志

CSTPCD
影响因子:0.754
ISSN:1003-2754
年,卷(期):2024.41(10)