摘要
Abstract
Objective To analyze the influencing factors for severe internal carotid artery stenosis in patients with chronic cerebral circulatory insufficiency(CCCI),and construct and validate a prediction model accordingly.Methods A total of 375 CCCI patients admitted to The Second Hospital of Baoding between June 2024 and February 2025 were included as the modeling group.According to the degree of internal carotid artery stenosis,they were divided into a mild/moderate stenosis group(n=230)and a severe stenosis group(n=145).Clinical data were collected from both groups.Multivariable logistic regression analysis was used to identify the influencing factors for severe internal carotid artery stenosis in CCCI patients,and a prediction model was established.Additionally,125 CCCI patients admitted to the hospital between March 2025 and June 2025 were enrolled using a sampling method for model validation(validation group).Results Multivariable logistic regression analysis showed that smoking history,drinking history,hypertension,diabetes mellitus,homocysteine>15 μmol/L,and D-dimer>0.5 mg/L were influencing factors for severe internal carotid artery stenosis in CCCI patients(all P<0.05).In the modeling group,the area under the receiver operating characteristic curve was 0.915(95%confidence interval:0.878-0.953),with a sensitivity of 86.8%and a specificity of 80.7%.In the validation group,the area under the receiver operating characteristic curve was 0.892(95%confidence interval:0.831-0.953),with a sensitivity of 80.2%and a specificity of 85.8%.Calibration curves demonstrated good model fit(modeling group:χ2=9.328,P=0.315;validation group:χ2=8.642,P=0.471).Decision curve analysis showed positive net benefits within a reasonable threshold probability range.Conclusions Smoking history,drinking history,hypertension,diabetes mellitus,homocysteine>15 μmol/L,and D-dimer>0.5 mg/L are influencing factors for severe internal carotid artery stenosis in CCCI patients.The prediction model constructed based on these factors demonstrates good discriminative ability,calibration,and clinical utility,with satisfactory validation performance,and may serve as a reference for early identification of high-risk patients in clinical practice.关键词
慢性脑供血不足/颈内动脉狭窄/影响因素/风险预测模型Key words
chronic cerebral circulatory insufficiency/internal carotid artery stenosis/influencing factors/risk prediction model分类
医药卫生
