台州市中心医院台州学院附属医院重症医学科;台州市中心医院台州学院附属医院脑外科;
目的 构建重型颅脑损伤患者术后继发急性脑梗死的预测模型，并进行验证。方法 回顾性分析150例重型颅脑损伤患者临床资料，根据术后是否继发急性脑梗死，分为急性脑梗死组（n=52）和对照组（n=98），比较两组患者临床特征，同时分析重型颅脑损伤患者术后继发急性脑梗死的危险因素。根据相关危险因素，构建预测模型并进行内部验证。结果 两组患者脑疝、低血压、糖尿病、血肌酐和弥散性血管内凝血（disseminated intravascular coagulation,DIC）评分等差异存在统计学意义（均P<0.05）。多因素Logistics回归分析显示：脑疝、低血压、糖尿病和DIC评分≥5是重型颅脑损伤患者术后继发急性脑梗死的危险因素（均P<0.05）。采用R4.0.3统计软件将数据集随机分为训练集和验证集，训练集样本量为105，验证集样本量为45。曲线下面积（area under the curve,AUC）：训练集为0.790(95%CI:0.694～0.887)，验证集为0.753(95%CI:0.599～0.907)。在验证集里对模型进行Hosmer-Lemeshow拟合优度检验，χ~2=13.322,P=0.101，表明本模型具有良好预测价值和可信度。结论 本研究构建的预测模型对识别重型颅脑损伤患者术后继发急性脑梗死的高危人群，具有一定价值。
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基本信息:
DOI：
中图分类号:R651.15;R743.33
引用信息:
[1]张瑞娟,曹倩,金铁托等.重型颅脑损伤术后继发急性脑梗死的预测模型[J].中国微侵袭神经外科杂志,2024,28(07):387-391.
基金信息:
国家自然科学基金项目（编号：82072146）