一种实用的诺莫图,包含炎症标志物,用于预测保守管理的基底动脉出血的短期预后
Jiandong Wang1, Shiqiang Hou1, Xinwei Li1
1Department of Neurosurgery, The Affiliated Chuzhou Hospital of Anhui Medical University, The First People's Hospital of Chuzhou, Chuzhou, China.
概括
系统性炎症指数,包括C-反应蛋白 (CRP) 和中性粒细胞与淋巴细胞的比率 (NLR),显著改善了对保守治疗自发基底腺动脉出血 (BGH) 患者的短期结果预测. 这增强了个性化风险分层,以更好地管理患者.
科学领域:
- 神经学 神经学
- 内部医学 内部医学
- 生物标志物 生物标志物
背景情况:
- 自发的基底动脉出血 (BGH) 是一种严重的神经疾病.
- 预测BGH的短期结果对于治疗规划至关重要.
- 当前的预测模型可能无法完全捕捉所有预后因素.
研究的目的:
- 调查系统性炎症指数是否提高了对保守治疗的BGH的短期结果的预测.
- 将包括炎症标志物在内的模型的预测性能与基本临床模型进行比较.
主要方法:
- 对137名BGH患者 (2020-2023) 的回顾性分析.
- 开发一个基本模型 (年龄,血瘤体积,NIHSS,IVH) 和一个炎症模型 (基本+C反应蛋白[CAR]+中性粒细胞与淋巴细胞比率[NLR]).
- 模型歧视 (ROC/DeLong) 和校准 (Hosmer-Lemeshow) 的评估;通过引导进行内部验证.
主要成果:
- 与基本模型相比,炎症模型的预测性能优于基本模型 (AUC 0.823与0.658).
- 炎症模型显示可接受的校准,优于基本模型.
- 敏感性分析,包括死亡率,证实了炎症模型的优越性能.
结论:
- 结合C反应蛋白 (CAR) 和中性粒细胞与淋巴细胞比率 (NLR),可显著改善保守治疗自发性BGH的短期结果预测.
- 这些炎症标志物支持BGH患者的个性化风险分层.
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