| 傅昱,周伟,孙玉荣.基于CT血管成像、实验室及临床指标构建列线图预测急性轻型脑梗死患者早期神经功能恶化[J].中国医学影像技术,2026,42(6):921~925 |
| 基于CT血管成像、实验室及临床指标构建列线图预测急性轻型脑梗死患者早期神经功能恶化 |
| Nomogram based on CT angiography, laboratory and clinical indicators for predicting early neurological deterioration in patients with acute mild cerebral infarction |
| 投稿时间：2025-11-13 修订日期：2026-06-18 |
| DOI：10.13929/j.issn.1003-3289.2026.06.027 |
| 中文关键词: 脑梗死 CT血管成像 列线图 |
| 英文关键词:cerebral infarction computed tomography angiography nomograms |
| 基金项目:河北省医学科学研究课题计划(20250930)。 |
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| 中文摘要: |
| 目的 观察基于CT血管成像(CTA)、实验室及临床指标构建的列线图预测急性轻型脑梗死(AMIS)患者早期神经功能恶化(ND)效能。方法 回顾性纳入400例AMIS患者,按7∶3比例划分训练集(n=280,含ND 61例、非ND 219例)与验证集(n=120,含ND 31例、非ND 89例)。以多因素logistic回归筛选ND的独立预测因素并绘制列线图;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),并以校准曲线及决策曲线分析(DCA)评估模型区分度、校准度及临床净收益。结果 高龄、美国国立卫生研究院卒中量表(NIHSS)高评分、高超敏C反应蛋白(hs-CRP)水平、高同型半胱氨酸(Hcy)水平、易损斑块及颈动脉狭窄程度≥50%均为ND的独立预测因素(P均＜0.05)。列线图用于预测训练集与验证集ND的AUC分别为0.941、0.935,且校准曲线与理想曲线吻合良好;DCA显示,0.10~0.85阈值范围内呈正向净收益。结论 基于CTA、实验室及临床指标构建的列线图预测AMIS患者ND的效能上佳。 |
| 英文摘要: |
| Objective To observe the efficacy of the nomogram constructed based on CT angiography (CTA), laboratory and clinical indicators for predicting early neurological deterioration (ND) in patients with acute mild ischemic stroke (AMIS). Methods A total of 400 patients with AMIS were retrospectively collected and divided into training set (n=280, with 61 cases of ND and 219 cases of non-ND) and validation set (n=120, with 31 cases of ND and 89 cases of non-ND) at a ratio of 7∶3. Multivariable logistic regression was used to identify independent predictors of ND, and a nomogram was constructed. The discrimination, calibration and clinical net benefit of the nomogram were assessed using area under the curve (AUC) of receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA), respectively. Results Advanced age, high National Institutes of Health stroke scale (NIHSS) score, high high-sensitivity C-reactive protein (hs-CRP), high homocysteine (Hcy), vulnerable plaques and carotid artery stenosis degree ≥50% were all independent predictors of ND (all P＜0.05). The AUC of the nomogram for predicting ND was 0.941 in training set and 0.935 in validation set.The prediction curve was basically consistent with the ideal curve, and the DCA revealed that the nomogram had good positive net benefit within the threshold of 0.10—0.85. Conclusion Nomogram based on CTA, laboratory and clinical indicators demonstrated excellent performance for predicting ND in patients with AMIS. |
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