心脑血管病防治2025，Vol.25Issue(11)：15-19,5.DOI:10.3969/j.issn.1009-816x.2025.11.004
高血压脑出血患者预后的预测模型构建
Construction of a prediction model for the prognosis of patients with hypertensive intracerebral hemorrhage
摘要
Abstract
Objective To construct and validate a prognostic prediction model for patients with hypertensive intracerebral hemorrhage(HICH)based on N-myc downstream regulated gene 3(NDRG3)and neurotrophic factors.Methods Data of 126 patients with HICH admitted in Handan First Hospital from January 2020 to December 2023 were retrospectively analyzed.Patients were randomly devided(8:2)into a training set(101 cases)and a validation set(25 cases).All patients underwent puncture drainage and were divided into a good prognosis group and a poor prognosis group according to the Glasgow Outcome Score(GOS)after 3 months follow-up.Factors affecting the prognosis of HICH were analyzed.A prognostic prediction model for HICH patients was established,and the model was validated and its performance was evaluated.Results Thirty-four cases in the training set had poor prognosis,while 10 cases in the validation set had poor prognosis.Logistic regression analysis showed that hematoma volume,ventricular extension,brain-derived neurotrophic factor(BDNF),and NDRG3 levels were factors affecting poor prognosis of HICH patients[OR(95%CI)=5.043(2.075-12.256),4.433(1.824-10.773),3.540(1.456-8.602),3.979(1.637-9.669);all P<0.05).A nomogram prediction model was established based on the influencing factors.Bootstrap internal validation of the nomogram demonstrated a C-index of 0.791(95%CI=0.723-0.801),and the calibration curve demonstrated that the observed outcomes closely approached the ideal line(χ2=0.289,P>0.05).ROC curve analysis revealed that the nomogram achieved an AUC of 0.854(95%CI=0.772-0.935)in predicting the prognosis of HICH in the training set,with a sensitivity of 76.47%and a specificity of 89.55%,while the AUC of the validation set was 0.869(95%CI=0.789-0.941),with a sensitivity of 80.00%and a specificity of 86.67%.Conclusion The hematoma volume,ventricular extension,BDNF and NDRG3 levels are risk factors for the poor prognosis of HICH patients.The prediction model constructed based on the influencing factors including NDRG3 and BDNF demonstrates excellent discriminative performance for the prognosis of HICH.关键词
高血压脑出血/N-myc下游调节基因3/神经营养因子/预后/列线图模型Key words
Hypertensive intracerebral hemorrhage/N-myc downstream regulated gene 3/Neurotrophic factor/Prognosis/Nomogram model引用本文复制引用
郭静川,周涛,李晓鹏,刘吉祥,张延虎,马岩朋,高小恒,耿炜,胡艳芳,肖丽平..高血压脑出血患者预后的预测模型构建[J].心脑血管病防治,2025,25(11):15-19,5.基金项目
河北省2024年度医学科学研究课题计划(20240383) （20240383）
