脑小血管负担评分对短暂性脑缺血发作患者复发性脑血管事件的预测价值OA北大核心CSTPCD
Predictive value of cerebral blood tubule burden score for recurrent cerebrovascular events in patients with transient ischemic attack
目的探讨脑小血管(cerebral small vessel disease,CSVD)负担评分对短暂性脑缺血发作(transient ischemic attack,TIA)患者复发性脑血管事件(recurrence cerebrovascular events,RCVEs)的预测价值.材料与方法回顾性分析2019年10月至2022年12月期间于安徽省第二人民医院就诊的182例TIA患者病例资料,依据MRI检查计算CSVD总体负担评分,根据随访1个月内有无发生RCVEs分为RCVEs组(n=46)和未RCVEs组(n=136).比较两组临床资料和CSVD总体负担评分,采用多因素logistic回归分析模型分析RCVEs的独立危险因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析CSVD影像特征得分及总负担评分对TIA患者RCVEs的预测价值.结果RCVEs组和未RCVEs组TIA发作次数、症状持续时间、既往高血压病史、CSVD总负担评分及分级情况比较差异有统计学意义(P<0.05).多因素logistic回归分析结果显示:TIA发作次数、症状持续时间、CSVD总负担评分是TIA患者发生RCVEs的独立危险因素(P<0.05).ROC曲线分析结果显示:CSVD影像特征评分及总负担评分预测TIA患者发生RCVEs的曲线下面积(areas under the curve,AUC)分别为0.771(95％CI:0.673～0.869,P<0.001)、0.745(95％CI:0.655～0.835,P<0.001)、0.664(95％CI:0.549～0.780,P=0.009)、0.845(95％CI:0.766～0.924,P<0.001)、0.945(95％CI:0.896～0.994,P<0.001),其中CVSD总负担评分预测的AUC最高,当最佳截断值为2分时,敏感度为86.05％,特异度为83.02％.结论CSVD总负担评分对TIA患者发生RCVEs的预测价值良好,有助于临床评估TIA患者的短期预后.
Objective: To investigate the predictive value of CSVD burden score for recurrent cerebrovascular events (RCVEs) in patients with transient ischemic attack (TIA). Materials and Methods: A total of 182 patients with TIA who were treated in the Second People's Hospital of Anhui Province from October 2019 to December 2022 were selected as the research objects. The overall burden score of CSVD was calculated according to MRI examination. According to the presence or absence of RCVEs within 1 month of follow-up, they were divided into RCVEs group (n=46) and non-RCVEs group (n=136). The clinical data and CSVD total burden score were compared between the two groups. Multivariate logistic regression analysis model was used to analyze the independent risk factors of RCVEs. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of CSVD image feature score and total burden score for RCVEs in TIA patients. Results: There were significant differences in the number of TIA attacks, duration of symptoms, history of hypertension, total burden score and classification of CSVD between the RCVEs group and the non-RCVEs group (P<0.05). Multivariate Logistic regression analysis showed that the number of TIA attacks, the duration of symptoms, and the total burden score of CSVD were independent risk factors for RCVEs in TIA patients (P<0.05). The results of ROC curve analysis showed that the areas under curve (AUC) of CSVD imaging marker score and total burden score in predicting RCVEs in TIA patients were 0.771 (95％ CI: 0.673-0.869, P<0.001), 0.745 (95％ CI: 0.655-0.835, P<0.001), 0.664 (95％ CI: 0.549-0.780, P=0.009), 0.845 (95％ CI: 0.766-0.924, P<0.001), 0.945 (95％ CI: 0.896-0.994, P<0.001), respectively. The AUC predicted by CVSD total burden score was the highest. When the optimal cutoff value was 2 points, the sensitivity was 86.05％ and the specificity was 83.02％. Conclusions: The CSVD total burden score has a good predictive value for RCVEs in TIA patients, which is helpful for clinical evaluation of short-term prognosis in TIA patients.
江艳柳;王书培;李凤;张璐
安徽省第二人民医院神经内科,合肥 230041
临床医学
短暂性脑缺血发作脑小血管病磁共振成像脑小血管负担评分复发性脑血管事件预后
transient ischemic attackcerebral small vessel diseasemagnetic resonance imagingcerebral vascular burden scorerecurrent cerebrovascular eventsprognosis
《磁共振成像》 2024 (006)
67-71 / 5
2021年安徽省高校研究项目(编号:KJ2021A0350)The 2021 University Research Project of Anhui Province (No.KJ2021A0350).
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