中国医科大学学报2025，Vol.54Issue(9)：808-813,820,7.DOI:10.12007/j.issn.0258-4646.2025.09.008
基于HR-VWI特征构建青年急性缺血性脑卒中患者颅内动脉狭窄的风险因素模型
Constructing a risk factor model for intracranial artery stenosis in young patients with acute ischemic stroke based on HR-VWI features
摘要
Abstract
Objective To establish a risk factor model for intracranial artery stenosis in young patients with acute ischemic stroke(AIS)based on high-resolution magnetic resonance vascular wall imaging(HR-VWI).Methods Young patients with AIS(n=290)treated at Hengshui People's Hospital between January 2021 and January 2023 were retrospectively analyzed and randomly divided into a modeling set(203 cases)and a validation set(n=87)at a ratio of 7∶3.Patients in the modeling set were divided into the stenosis and non-ste-nosis groups according to whether they had intracranial artery stenosis.Multivariate logistic regression was used to analyze the clinical data and HR-VWI characteristics of the patients in the modeling set to screen for factors influencing intracranial artery stenosis in young patients with AIS.R software was used to construct and verify the risk factor model.Results Among the 290 patients,88 had intracranial artery stenosis(30.34％).The proportions of low-density lipoprotein cholesterol(LDL-C),plaque load,smoking history,hypertension,and eccentric plaques were higher in the stenosis group than in the non-stenosis group(P＜0.05),and the minimum lumen area and remode-ling index were lower in the stenosis group than in the non-stenosis group(P＜0.05).Multivariate logistic regression analysis showed that smoking history,hypertension,LDL-C level,plaque load,plaque morphology,and remodeling index were all factors influencing intracra-nial artery stenosis in young patients with AIS(P＜0.05).Based on the above risk factors,R was used to build a nomogram early warning model.The ROC results showed that the AUC of the nomogram model for predicting intracranial artery stenosis in the modelling and vali-dation sets were 0.872(95％CI:0.815-0.902)and 0.850(95％CI:0.789-0.891),respectively.The Hosmer-Lemeshow test results of the modeling and validation sets were x2=0.589,P=0.571 and x2=0.602,P=0.558,respectively.The calibration curves of the two groups were consistent with the standard curves.Conclusion The risk factor model for intracranial artery stenosis in young patients built in this study based on HR-VWI features exhibits good predictive efficacy,providing a new method for clinical prevention and treatment.关键词
高分辨率磁共振血管壁成像/急性缺血性脑卒中/颅内动脉狭窄/列线图模型Key words
high-resolution magnetic resonance vascular wall imaging/acute ischemic stroke/intracranial artery stenosis/nomogram model分类
医药卫生引用本文复制引用
康志雷,石辛景,柴坊,刘朝艳,王心颖..基于HR-VWI特征构建青年急性缺血性脑卒中患者颅内动脉狭窄的风险因素模型[J].中国医科大学学报,2025,54(9):808-813,820,7.基金项目
河北省医学科学研究课题计划(20220453) （20220453）
