中国实用神经疾病杂志2023，Vol.26Issue(12)：1475-1481,7.DOI:10.12083/SYSJ.231053
基于颅内压BDNF及临床因素构建颅内出血患者预后诺莫图预测模型及验证
Establishment and verification of Nomogram prediction model of prognosis of patients with intracranial hemorrhage based on intracranial pressure,BDNF and clinical factors
摘要
Abstract
Objective To investigate the prognostic factors for patients with intracranial hemorrhage based on intracranial pressure,brain-derived neurotrophic factor(BDNF)and clinical factors,and to construct a Nomogram prediction model,so as to provide reference for clinical development of reasonable prevention and treatment measures and improvement of patient prognosis.Methods Totally 212 patients with intracranial hemorrhage admitted to Hebei Province Chest Hospital from January 2020 to June 2022 were selected as the study objects,and were divided into the good prognosis group and the poor prognosis group according to Glasgow outcome scale(GOS)6 months after removal of neuroendoscopic hematoma.The levels of BDNF,tissue matrix metalloproteinase-1(TIMP-1)and matrix metalloproteinase-9(MMP-9)were statistically compared between the two groups.The influencing factors for prognosis were analyzed by univariate analysis,and collinear diagnosis was carried out.Variables were screened and included in COX regression equation analysis to construct Nomogram prediction model.According to 3︰1 ratio,the data set was divided into training set and validation set.Receiver operating characteristic(ROC)curve,Calibration curve and decision curve were used to verify the distinguishing ability,calibration degree and clinical validity of the model.Results There were significant differences between the two groups in age,hematoma clearance rate,GCS score,intracranial pressure,BDNF,TIMP-1,MMP-9,operation timing,blood loss,ventricle rupture,standard postoperative rehabilitation exercise and postoperative rebleeding(P<0.05).Collinear diagnosis showed that age,hematoma clearance rate,and operation timing were excluded to analyze the influencing factors for prognosis.GCS score,postoperative rebleeding,MMP-9,BDNF,TIMP-1,amount of blood loss,intracranial pressure,standard postoperative rehabilitation exercise,and ventricle rupture were the adverse influencing factors for prognosis(P<0.05).In the training set and validation set,the AUC of Nomogram prediction model for predicting poor prognosis was 0.953 and 0.980,respectively,with good calibration degree and clinical benefit.Conclusion GCS score,postoperative rebleeding,MMP-9,BDNF,TIMP-1,amount of bleeding,intracranial pressure,standardized rehabilitation exercise after surgery,and ventricle rupture are the influential factors for the adverse prognosis of patients with intracranial hemorrhage.Based on the above influential factors,the Nomogram prediction model was constructed,which has certain predictive value for the adverse prognosis and has clinical practical value.The model can be used to screen high-risk groups and formulate early intervention measures to improve the prognosis of patients.关键词
颅内出血/颅内压/脑源性神经营养因子/预后/诺莫图模型/COX回归/预测模型Key words
Intracranial hemorrhage/Intracranial pressure/Brain-derived neurotrophic factor/Prognosis/Nomogram model/COX regression/Prediction model分类
医药卫生引用本文复制引用
岳世元,刘欣,付琳,景艳色,李硕,王宝,李烨..基于颅内压BDNF及临床因素构建颅内出血患者预后诺莫图预测模型及验证[J].中国实用神经疾病杂志,2023,26(12):1475-1481,7.基金项目
河北省卫生健康委员会2019年度医学科学研究课题(编号:20191022) （编号:20191022）
