摘要
目的探究高血压脑出血(HICH)患者术后行持续腰大池外引流继发癫痫(EP)的危险因素。方法回顾性分析2018年10月至2021年1月于我院治疗的356例HICH患者的临床资料,根据是否继发EP分成发生组(52例)和未发生组(304例)。采用LASSO和logistic回归分析HICH患者继发EP的独立危险因素,并构建列线图预测模型。采用受试者工作曲线(ROC)评价模型的区分度、校准曲线评价其准确度。结果单因素分析和多因素logistic回归分析结果显示,高血压病程、血肿体积、引流管污染、术后再出血、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、神经元特异性烯醇化酶(NSE)是HICH患者术后行持续腰大池外引流继发EP的独立危险因素(P<0.05)。验证结果显示,训练集和验证集的C-index分别为0.880(95%CI:0.833~0.921)、0.870(95%CI:0.825~0.922),ROC曲线下面积(AUC)分别为0.884(95%CI:0.828~0.941)、0.869(95%CI:0.790~0.915)。列线图模型拟合效果良好,区分度和准确度较高。结论高血压病程、血肿体积、引流管污染、术后再出血、TNF-α、IL-6、NSE是HICH患者术后行持续腰大池外引流继发EP的独立危险因素(P<0.05)。
Objective To explore the risk factors of epilepsy after continuous lumbar cistern drainage in hypertensive cerebral hemorrhage(HICH)patients.Methods According to whether they developed secondary epilepsy or not,the clinical data of 356 HICH patients treated in our hospital from October 2018 to January 2021were retrospectively evaluated.They were split into the occurrence group(52 cases)and the non-occurrence group(304 cases).Independent risk factors for secondary epilepsy in HICH patients were screened by LASSO and Logistic regression analysis.,and a nomogram prediction model was constructed.The discrimination and calibration curve of the model were evaluated by the receiver operating curve(ROC).Results Univariate analysis and multivariate logistic regression analysis showed that the course of hypertension,hematoma volume,drainage tube pollution,postoperative rebleeding,tumor necrosis factor-α(TNF-α),Interleukin-6(IL-6)and neuron specific enolase(NSE)were independent risk factors of epilepsy after continuous lumbar cistern drainage in HICH patients(P<0.05).The verification results show that the c-index of the training set and the verification set are 0.880(95%CI:0.833~0.921),0.870(95%CI:0.825~0.922),and the area under the ROC curve(AUC)are 0.884(95%CI:0.828~0.941)and 0.869(95%CI:0.790~0.915)respectively.The nomogram model has strong accuracy,high discrimination,and good fitting.Conclusions Following continuous lumbar cistern drainage in these HICH patients,hypertension course,hematoma volume,drainage tube pollution,postoperative rebleeding,TNF-α,IL-6,and NSE were independent risk factors for epilepsy(P<0.05).
作者
蒋帅
孙美蓉
孙波
张西安
刘展会
侯鹏飞
JIANG Shuai;SUN Meirong;SUN Bo;ZHANG Xi′an;LIU Zhanhui;HOU Pengfei(Department of Neu-rosurgery,the Ninth Hospital of Xi′an,Xi′an 710054,China)
出处
《实用医学杂志》
CAS
北大核心
2022年第22期2807-2812,共6页
The Journal of Practical Medicine
基金
陕西省重点研发计划项目(编号:2018SF-093)
西安市第九医院临床研究项目(编号:2020-13)。
关键词
高血压脑出血
腰大池外引流
癫痫
危险因素
列线图
hypertensive cerebral hemorrhage
hrainage terminal cistern
epilepsy
risk factor
nomogram
