实用心电与临床诊疗2026，Vol.35Issue(3)：461-465,5.DOI:10.13308/j.issn.2097-5716.xd20250504
后循环侧支评分联合D-二聚体对后循环急性缺血性脑卒中患者血管内治疗预后的预测价值
Predictive value of posterior circulation collateral score combined with D-dimer for prognosis of patients with posterior circulation acute ischemic stroke undergoing endovascular treatment
陈惠云 1李世超 1刘春林 1蒋菲菲 1冯康康 1谢悦 1徐祥辉1
作者信息
- 1. 453000 河南新乡,新乡市第一人民医院神经内科
- 折叠
摘要
Abstract
Objective To investigate the predictive value of posterior circulation collateral score(PC-CS)combined with D-dimer for the prognosis of patients with posterior circulation acute ischemic stroke(AIS)undergoing endovascular treatment.Methods A retrospective analysis was conducted on 139 patients with posterior circulation AIS who had received endovascular treatment.Based on the 90-day modified Rankin scale score,these patients were divided into a good prognosis group(n=71)and a poor prognosis group(n=68).Differences in baseline characteristics between the two groups were compared.Logistic regression analysis was used to identify risk factors affecting the prognosis.ROC curves were plotted to evaluate the predictive performance of PC-CS combined with D-dimer for the prognosis in patients with posterior circulation AIS.Results The poor prognosis group had significantly older age,higher baseline National Institutes of Health stroke scale(NIHSS)score and D-dimer level,and significantly lower PC-CS compared with the good prognosis group(all P＜0.001).Logistic regression analysis showed that older age,higher baseline NIHSS score,lower PC-CS,and higher D-dimer level were risk factors for poor prognosis in patients with posterior circulation AIS undergoing endovascular treatment(all P＜0.001).ROC curve analysis showed that the AUC value for PC-CS,D-dimer,and their combination in predicting poor prognosis of patients with posterior circulation AIS undergoing endovascular treatment was 0.812,0.938 and 0.975,respectively.The combined prediction model had a significantly higher AUC value than either single indicator,indicating better discriminant efficacy.Internal validation was performed using Bootstrap resampling for 500 times,yielding a C-index of 0.870,indicating good discrimination.The calibration curve showed good agreement between model-predicted probabilities and actual observed probabilities,suggesting ideal calibration consistency.Conclusion The combination of PC-CS and D-dimer has high predictive value for the prognosis of patients with posterior circulation AIS undergoing endovascular treatment.关键词
后循环急性缺血性脑卒中/血管内治疗/侧支循环/D-二聚体/预后Key words
posterior circulation acute ischemic strokes/endovascular treatment/collateral circulation/D-dimer/prognosis分类
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陈惠云,李世超,刘春林,蒋菲菲,冯康康,谢悦,徐祥辉..后循环侧支评分联合D-二聚体对后循环急性缺血性脑卒中患者血管内治疗预后的预测价值[J].实用心电与临床诊疗,2026,35(3):461-465,5.
