摘要
目的分析急性脑梗死(ACI)患者颅内侧支循环形成的影响因素并构建风险因素模型。方法纳入2020年7月至2021年12月该院收治的ACI患者100例进行研究,根据患者颅内侧支循环形成情况将患者分为无侧支循环组(34例)、侧支循环组(66例)。回顾性收集所有患者临床资料。通过单因素分析及多因素Logistic回归分析法分析ACI患者无侧支循环的影响因素,建立风险因素模型,并绘制受试者工作特征(ROC)曲线分析风险因素模型对ACI患者无颅内侧支循环的预测价值。结果多因素Logistic分析结果显示,合并高血压、有吸烟史、血清同型半胱氨酸(Hcy)、全血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比率(PLR),血清神经元特异性烯醇化酶(NSE)水平升高为ACI患者无颅内侧支循环的危险因素(OR=1.929、2.361、2.382、2.375、2.275、2.022,均P<0.05);血清高密度脂蛋白胆固醇(HDL-C)、碱性成纤维细胞生长因子(bFGF)水平升高为ACI患者无颅内侧支循环的保护因素(OR=0.446、0.517,均P<0.05)。将上述因素纳入风险因素模型:logit(P)=-15.173+高血压×0.657+吸烟史×0.859-HDLC×0.807+Hcy×0.868+NLR×0.865+PLR×0.822-bFGF×0.659+NSE×0.704,绘制ROC曲线。结果显示,当logit(P)>15.46时,曲线下面积(AUC)为0.883,诊断灵敏度88.0%、特异度为80.0%。结论ACI患者颅内侧支循环无法建立与高血压、有吸烟史、血清Hcy、NSE水平升高,全血NLR、PLR水平升高,血清HDL-C、bFGF水平降低密切相关,据此建立风险因素模型预测ACI患者无颅内侧支循环价值较高,临床可对高危患者采取相应干预策略,以改善其预后。
Objective To investigate the influencing factors for the formation of intracranial collateral circulation in patients with acute cerebral infarction(ACI),and to establish a risk factor model.Methods A total of 100 patients with ACI who were admitted to our hospital from July 2020 to December 2021 were enrolled in this study,and according to the formation of intracranial collateral circulation,the patients were divided into non-collateral circulation group with 34 patients and collateral circulation group with 66 patients.A retrospective analysis was performed for their clinical data.Univariate analysis and multivariate logistic regression analysis were used to investigate the influencing factors for the absence of collateral circulation in ACI patients.A risk factor model was established,and the receiver operating characteristic(ROC)curve was plotted to investigate the value of the risk factor model in predicting the absence of intracranial collateral circulation in ACI patients.Results The multivariate logistic regression analysis showed that hypertension,smoking history,and increases in serum homocysteine(Hcy),neutrophil-to-lymphocyte ratio(NLR)in whole blood,platelet-to-lymphocyte ratio(PLR)in whole blood,and serum neuron-specific enolase(NSE)were the risk factors for the absence of intracranial collateral circulation in ACI patients(odds ratio[OR]=1.929,2.361,2.382,2.375,2.275,and 2.022,P<0.05),and increases in serum high-density lipoprotein cholesterol(HDL-C)and basic fibroblast growth factor(bFGF)were protective factors against the absence of intracranial collateral circulation in ACI patients(OR=0.446 and 0.517,P<0.05).The above factors were included in the risk factor model of logit(P)=-15.173+hypertension×0.657+smoking history×0.859-HDL-C×0.807+Hcy×0.868+NLR×0.865+PLR×0.822-bFGF×0.659+NSE×0.704,and the ROC curve was plotted.The results showed that when logit(P)>15.46,the area under the ROC curve was 0.883,with a diagnostic sensitivity of 88.0%and a specificity of 80.0%.Conclusions The absence of
作者
谭慧敏
TAN Hui-Min(Department of Neurology,City Center Hospital of Zengcheng District in Guangzhou(Zengcheng Hospital,Southern Hospital,Southern Medical University),Guangzhou,Guangdong 511300,China)
出处
《国际神经病学神经外科学杂志》
2022年第6期13-17,共5页
Journal of International Neurology and Neurosurgery
基金
广东省医学科学技术研究基金项目(20211128182437730)。
关键词
急性脑梗死
颅内
侧支循环
危险因素
模型
受试者工作特征曲线
acute cerebral infarction
intracranial
collateral circulation
risk factors
model
receiver operating characteristic curve
