摘要
Abstract
Objective To analyze the risk factors for in-stent restenosis(ISR)after cerebrovascular interventional surgery and to construct a nomogram model for predicting ISR risk.Methods A retrospective analysis was conducted on the data of 307 patients who underwent cerebrovascular interventional surgery at Xuanhan County People's Hospital from March 2020 to June 2023.Patients were divided into an ISR group(52 cases)and a control group(255 cases)based on whether ISR occurred within 1 year after surgery.General information,lesion characteristics,surgical indicators,and preoperative laboratory indicators of the two groups were compared.Logistic regression was used to identify risk factors for postoperative ISR.A nomogram model was constructed to predict ISR risk after cerebrovascular interventional surgery,and the predictive effect was verified.Results Among 307 patients,the incidence of ISR within 1 year after surgery was 16.94%(52/307).The proportions of patients with smoking,diabetes,severe lesion stenosis,stent length>16 mm,and the levels of low-density lipoprotein cholesterol(LDL-C)and uric acid(UA)in the ISR group were significantly different from those in the control group(all P<0.05).Logistic regression analysis showed that smoking(OR=4.515,95%CI=1.768-5.526),diabetes(OR=6.247,95%CI=2.813-8.180),stent length>16 mm(OR=2.872,95%CI=1.224-3.735),elevated LDL-C(OR=2.260,95%CI=1.330-3.838),and elevated UA(OR=2.420,95%CI=1.780-4.289)were risk factors for ISR after cerebrovascular interventional surgery(all P<0.05).An model for predicting the occurrence of ISR after cerebrovascular intervention was constructed.Internal validation revealed an area under the ROC curve of 0.839(95%CI=0.769-0.910),with a sensitivity of 80.80%and a specificity of 78.00%.Calibration curve of the model indicated that the predicted probability was close to the actual probability(slope approaching 1).The Hosmer-Lemeshow test yielded χ2=10.026,P>0.05,indicating good calibration.Conclusion Smoking,diabetes,stent length>16 mm,elevated LDL-C,and elevated UA are risk factors for ISR after cerebrovascular interventional surgery.The nomogram prediction model constructed based on these factors can effectively predict the risk of ISR after cerebrovascular interventional surgery.关键词
脑血管介入术/支架内再狭窄/危险因素/列线图预测模型Key words
Cerebrovascular interventional surgery/In-stent restenosis/Risk factors/Nomogram prediction model
