复发性急性缺血性中风的风险因素和预测模型:一个回顾性分析
Liuhua Ke1, Hongyu Zhang1, Kang Long1
1Department of Clinical Laboratory, Liuzhou Traditional Chinese Medical Hospital, Liuzhou, Guangxi, China.
PeerJ
|November 29, 2024
概括
复发性缺血性中风在很大程度上受到高血压,先前的中风和特定的血液标志物 (如RDW-CV和MPV) 的影响. 这项研究确定了关键的风险因素,以有效预测中风复发.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 生物统计学 生物统计学
背景情况:
- 缺血性中风是全球死亡和残疾的主要原因.
- 高复发率显著损害了患者的生活质量.
- 确定复发性缺血性中风的危险因素对于预防和管理至关重要.
研究的目的:
- 分析复发性和初始缺血性中风患者的临床数据.
- 确定与缺血性中风复发相关的重大风险因素.
- 开发和评估中风复发的预测模型.
主要方法:
- 对比了114名复发性缺血性中风患者和409名初始缺血性中风患者的临床数据.
- 采用单因素分析,LASSO回归和机器学习进行变量选.
- 构建了一个多因素的COX比例危险模型来预测复发风险.
- 使用一致性指数 (C指数) 评估模型性能.
主要成果:
- 确定的显著风险因素包括高血压史,脑梗塞史,脑动脉狭窄,心动脉硬化,静脉血压,红细胞分布宽度变化系数 (RDW-CV),平均血小板体积 (MPV) 和尿酸 (UA).
- 多变量COX回归分析为每个确定的风险因素提供了危险比率 (HR) 和95%置信区间 (CI).
- 完整的COX模型表现出良好的预测性能,C指数为0.777 (0.7320.821).
结论:
- 急性缺血性中风复发的关键风险因素包括高血压,先前的脑梗塞,脑动脉狭窄,动脉样硬化,静脉血压,UA,RDW-CV和MPV.
- 开发的COX模型有效地预测了急性缺血性中风的复发.
- 这些发现可以帮助临床管理和预防策略,对于患有复发性中风风险的患者.
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