脑血管狭窄患者狭窄分布及筛查模型的建立

doi:10.6040/j.issn.1671-7554.0.2021.0450

摘要/Abstract

摘要： 目的构建基于Logistic回归的脑血管狭窄筛查模型。方法在体检者中选取经核磁共振血管成像(MRA)检查的1 118例脑血管狭窄阴性者,在体检者中经MRA检查高度怀疑有脑血管狭窄并住院的患者中选取经数字减影脑血管造影(DSA)检查确诊的1 329例脑血管狭窄者。将1 118例脑血管狭窄阴性者作为对照组,将1 329例脑血管狭窄者作为病例组,采用病例-对照研究分析。通过描述脑血管狭窄部位的分布特点,进而使用经济廉价的常规检查指标在男女中构建脑血管狭窄Logistic筛查模型,用ROC曲线下面积(AUC)等指标进行模型评价。结果 1 329例脑血管狭窄者中,男性有985例,女性有344例。调整年龄后的脑血管狭窄Logistic筛查模型中,男性共纳入8个变量:年龄、谷草转氨酶、白蛋白、高密度脂蛋白、中性粒细胞值、高血压、吸烟和饮酒,女性共纳入5个变量:白蛋白、高密度脂蛋白、空腹血糖、中性粒细胞值和高血压。其中高密度脂蛋白、白蛋白、高血压和中性粒细胞值为男女共同纳入的变量。AUC男女分别为0.927和0.888,经十折交叉验证后AUC男女分别为0.928和0.885。结论该模型具有较好的筛查能力,可用来识别脑血管狭窄高风险个体。

关键词: 脑血管狭窄, Logistic回归, 筛查模型

Abstract: Objective To establish a screening model of cerebrovascular stenosis based on Logistic regression. Methods This study selected 1,118 physical examiners without cerebrovascular stenosis by magnetic resonance angiography(MRA)as the control group, and 1,329 with cerebrovascular stenosis diagnosed by digital subtraction angiography(DSA)as the case group. Distribution of the sites of cerebrovascular stenosis was described. Routine and economic examination indicators were adopted to construct a Logistic screening model of cerebrovascular stenosis in both male and female. The model was evaluated with area under the receiver operator characteristic curve(AUC). Results Among the 1,329 cerebrovascular stenosis patients, 985 were male and 344 were female. In the Logistic screening model with age adjustment, 8 variables were screened out for male, including age, aspartate transaminase, albumin, high-density lipoprotein, neutrophil value, hypertension, smoking and drinking, while 5 variables were screened out for female, including albumin, high-density lipoprotein, fasting blood glucose and hypertension. The high-density lipoprotein, albumin, hypertension and neutrophil value were involved in both male and female. The AUC was 0.927 and 0.888 for male and female, respectively. After 10-fold cross validation, the AUC was 0.928 and 0.885, respectively. Conclusion The model has good screening ability and is useful for identifying high-risk individuals with cerebrovascular stenosis.

Key words: Cerebrovascular stenosis, Logistic regression, Screening model

中图分类号:

R543.5

杨九龙,于涛,薛付忠. 脑血管狭窄患者狭窄分布及筛查模型的建立[J]. 山东大学学报 (医学版), 2021, 59(11): 114-119.

YANG Jiulong, YU Tao, XUE Fuzhong. Distribution of cerebrovascular stenosis and construction of a screening model[J]. Journal of Shandong University (Health Sciences), 2021, 59(11): 114-119.

参考文献

[1] 陈伟伟, 高润霖, 刘力生, 等. 《中国心血管病报告2016》概要[J]. 中国循环杂志, 2017, 32(6): 521-530.
[2] 王宝军, 郭静文, 刘国荣, 等. 缺血性脑血管病患者颅内外动脉狭窄分布及影响因素的研究[J]. 内蒙古医学杂志, 2009, 41(8): 908-911. WANG Baojun, GUO Jingwen, LIU Guorong, et al. Study on the effected factors and the distribution of intra-extracranial cerebral artery stenosis in patients with ischemic cerebrovascular diseases [J]. Inner Mongolia Medical Journal, 2009, 41(8): 908-911.
[3] 陈涛, 李正军, 龚家明, 等. 缺血性脑血管病患者脑动脉狭窄特点及相关危险因素分析[J]. 神经损伤与功能重建, 2011, 6(5): 343-346. CHEN Tao, LI Zhengjun, GONG Jiaming, et al. Characteristics of cerebral artery atherosclerotic stenosis of patients with ischemic cerebrovascular disease and the related risk factors analysis [J]. Neural Injury And Functional Reconstruction, 2011, 6(5): 343-346.
[4] 徐晓萍. 缺血性脑血管病患者颈动脉狭窄的相关危险因素分析[J]. 临床医药文献电子杂志, 2018, 5(78): 87.
[5] Pinto A, Tuttolomondo A, Raimondo DD, et al. Cerebrovascular risk factors and clinical classification of strokes [J]. Semin Vasc Med, 2004, 4(3): 287-303.
[6] Whisnant JP. Epidemiology of stroke: emphasis on transient cerebral ischemia attacks and hypertension[J]. Stroke, 1974,5(1):68-70.
[7] Zhang WW, Cadilhac DA, Donnan GA, et al. Hypertension and TIA [J]. Int J Stroke, 2009, 4(3): 206-214.
[8] 殷聪国. 经DSA观察缺血性脑血管病患者动脉狭窄分布及危险因素分析[D]. 杭州: 浙江大学, 2010.
[9] 谭群, 陈康宁, 史树贵, 等. DSA检测2810例缺血性脑血管病患者脑血管狭窄分布及其危险因素研究[J]. 第三军医大学学报, 2014, 36(5): 499-502.
[10] 黄献, 宋治, 郑文. 短暂性脑缺血发作患者脑动脉狭窄及与脑血管危险因素的研究[J]. 实用心脑肺血管病杂志, 2010, 18(9): 1203-1205. HUANG Xian. SONG Zhi, ZHENG Wen. Cerebral artery dtenosis in patients with transient ischemic attack and related cardiovascular risk factors [J]. Pratical Journal of Cardiac Cerebral Pneumal And Vascular Disease, 2010, 18(9): 1203-1205.
[11] 张成发, 王复新, 吴丽莉, 等. 315例缺血性脑卒中危险因素Logistic回归分析[J]. 黑龙江医药科学, 2015, 38(2): 153-155. ZHANG Chengfa, WANG Fuxin,WU Lili, et al. A Logistic regression analysis on risk factors for ischemic stroke [J]. Heilongjiang Medicine And Pharmacy, 2015, 38(2): 153-155.
[12] 付琳琳, 石静萍, 杨杰. 缺血性脑血管病患者脑大动脉狭窄的分布及相关危险因素的研究[J]. 南京医科大学学报(自然科学版), 2007, 27(8): 867-869+904. FU Linlin, SHI Jingping, YANG Jie. Distribution and analysis of related risky factor of intra and extra cranial arterial stricture in patients with ischemic cerebrovascular disease [J]. Acta Universitatis Medicinalis Nanjing, 2007, 27(8): 867-869,904.
[13] Janghorbani, Mohsen, Tricia, et al. Prospective study of type 1 and type 2 diabetes and risk of stroke subtypes: the Nurses Health Study [J]. Diabetes Care, 2007, 30(7): 1730-1735
[14] Kissela BM, Khoury J, Kleindorfer D, et al. Epidemiology of ischemic stroke in patients with diabetes: the greater Cincinnati/Northern Kentucky Stroke Study [J]. Diabetes Care, 2005, 28(2): 355-359.
[15] Amarenco P, Goldstein LB, Szarek M, et al. Effects of intense low-density lipoprotein cholesterol reduction in patients with stroke or transient ischemic attack: the Stroke Prevention by Aggressive Reduction in Cholesterol Levels(SPARCL)trial [J]. Stroke, 2007, 38(12): 3198-3204.
[16] Haheim LL, Holme I, Hjermann I, et al. Smoking habits and risk of fatal stroke: 18 years follow up of the Oslo Study [J]. J Epidemiol Community Health, 1996, 50(6): 621-624.
[17] Yamagishi K, Iso H, Kitamura A, et al. Smoking raises the risk of total and ischemic strokes in hypertensive men [J]. Hypertens Res, 2003, 26(3): 209-217.
[18] Klatsky AL, Armstrong MA, Friedman GD, et al. Alcohol drinking and risk of hospitalization for ischemic stroke [J]. Am J Cardiol, 2001, 88(6): 703-706.
[19] Eshak ES, Iso H, Kokubo Y, et al. Soft drink intake in relation to incident ischemic heart disease, stroke, and stroke subtypes in Japanese men and women: the Japan Public Health Centre-based study cohort I[J]. Am J Clin Nutr, 2012,96(6):1390-1397.
[20] 袁宏, 黄华泥. 急性脑血管病患者血清超敏C反应蛋白和心肌酶变化分析[J]. 中国中医药现代远程教育, 2012, 10(12): 88-89. YUAN Hong, HUANG Huani. Analysis the changes hs-CRP and myocardial enzymes in patients with acute cerebrovascular disease [J]. International Journal of Laboratory Medicine, 2012, 10(12): 88-89.
[21] 杨宇宏, 张志珺. 外周血中性粒细胞/淋巴细胞值与脑血管病相关性研究进展[J]. 东南大学学报(医学版), 2017, 36(2): 301-305.
[22] 姚翠萍, 吴季婷. 急性脑血管病患者心肌酶谱分析临床评价[J]. 陕西医学杂志, 2011, 40(8): 977-978.
[23] 徐莹. 吸烟指数与脑血管狭窄程度及部位相关性研究[D]. 大连: 大连医科大学, 2017.
[24] 刘扬, 赵莉. 饮酒对血脂的影响及与脑血管病的关系[J]. 吉林医学, 2008, 29(21): 1885-1886.
[25] 伍建中. 简述饮酒与健康[J]. 国外医学(社会医学分册), 1994, 11(4): 161-163.

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