摘要
目的:探讨髂静脉支架置入术后支架闭塞的危险因素并构建临床预测模型。方法:纳入接受髂静脉支架置入术的150例患者的临床资料,根据术后1年内髂静脉支架通畅与否分为闭塞组(50例)和对照组(100例)。对患者年龄、性别等临床资料进行单因素分析,将组间比较有统计学差异的单因素进行独立危险因素检验,筛选髂静脉支架置入术后支架闭塞的危险因素,建立预测模型并绘制列线图。绘制模型校准曲线并计算一致性指数,绘制受试者工作特征曲线(ROC)和临床决策曲线(DCA)验证预测模型的准确性。结果:两组患者性别、CRP水平、APTI、病因、合并高血压病、合并动静脉瘘、髂外静脉再通率、支架总长度差异均有统计学意义(P<0.05)。Logistic分析结果表明,性别、病因、合并动静脉瘘、APTI和髂外静脉再通率是髂静脉支架闭塞的独立危险因素(P<0.05)。构建预测模型,计算模型预测一致性指数为0.865,运用内部验证方法验证后的一致性指数为0.861。模型校准曲线与实际曲线重合良好。验证模型准确性的ROC曲线下面积为0.859,证实该模型的准确性较好。结论:性别、病因、合并动静脉瘘、APTI和髂外静脉再通率是影响髂静脉支架置入术后支架闭塞的独立危险因素;本研究构建的髂静脉支架置入术后支架闭塞的临床预测模型准确性较好。
Objective:To identify the risk factors associated with stent occlusion following iliac vein stenting and develop a clinical prediction model.Methods:Clinical data from 150 patients who underwent iliac vein stenting were collected.Based on the patency of the iliac vein stent within one year post-surgery,patients were categorized into an occlusion group(50 patients)and a control group(100 patients).Univariate analysis was conducted to compare and select single factors with significant differences between groups,which were then included in binary logistic regression analysis to identify independent risk factors for stent occlusion after iliac vein stent placement.The accuracy of the prediction model was assessed through calibration curve plotting,consistency index calculation,receiver operating characteristic(ROC)curve analysis,as well as decision curve analysis.Results:Statistically significant differences were observed in gender,etiology,comorbid hypertension and arteriovenous fistula status,C-reactive protein(CRP)levels,activated partial thromboplastin time(APTT),total stent length,and external iliac vein recanalization rate between the two groups(P<0.05).Logistic regression results revealed that gender,etiology,arteriovenous fistula status APTT level and external iliac vein recanalization rate were independent risk factors for iliac vein stent occlusion(P<0.05).These variables were used to construct a prediction model along with a corresponding scoring system.The consistency index was calculated at 0.865;internal validation yielded a consistency index of 0.861.The calibration curve of the model closely aligned with actual observations.The area under the ROC curve for verifying model accuracy was determined to be 0.859 indicating good clinical applicability.Conclusion:Gender,etiology,arteriovenous fistula status,APTT level,and external iliac vein recanalization rate are identified as independent risk factors influencing stent occlusion following iliac vein stenting and clinical prediction model denonstrated good
作者
魏磊
金星
WEI Lei;JIN XING(Department of Cardiac and Macrovascular Surgery,Shandong Provincial Third Hospital,Jinan 250031,China;Department of Vascular Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)
出处
《中国现代普通外科进展》
CAS
2024年第8期633-638,共6页
Chinese Journal of Current Advances in General Surgery
关键词
髂静脉狭窄
髂静脉支架置入
髂静脉闭塞
危险因素
预测模型
Iliac vein stenosis
Iliac vein stent placement
Iliac vein occlusion
Risk factors
Prediction model
