文章摘要
李追风,翁志雄,吴 健,陈 旭,刘正峤.脑血管畸形破裂出血的影响因素及受试者工作特征曲线预测价值分析[J].,2019,19(22):4371-4375
脑血管畸形破裂出血的影响因素及受试者工作特征曲线预测价值分析
Influencing Factors of Ruptured Hemorrhage of Cerebrovascular Malformation and Predictive Value of ROC Curve
投稿时间:2019-02-26  修订日期:2019-03-22
DOI:10.13241/j.cnki.pmb.2019.22.037
中文关键词: 脑血管畸形  破裂出血  畸形血管团大小  引流静脉方向  ROC曲线
英文关键词: Cerebral vascular malformation  Rupture hemorrhage  Size of malformed vascular mass  Direction of drainage vein  ROC curve
基金项目:云南省卫生计生委项目(201610266A)
作者单位E-mail
李追风 云南省第二人民医院神经外科 云南 昆明 650000 748563001@qq.com 
翁志雄 云南省第二人民医院神经外科 云南 昆明 650000  
吴 健 云南省第二人民医院神经外科 云南 昆明 650000  
陈 旭 云南省第二人民医院神经外科 云南 昆明 650000  
刘正峤 云南省第二人民医院神经外科 云南 昆明 650000  
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中文摘要:
      摘要 目的:探讨脑血管畸形破裂出血的影响因素,并进行受试者工作特征(ROC)曲线分析。方法:回顾性分析我院2015年6月至2018年1月收治的138例脑血管畸形患者的临床资料,根据患者是否并发破裂出血,将其分为出血组(n=76)和未出血组(n=62)。采用单因素和多因素Logistic回归分析法对两组患者的临床资料进行研究,并采用ROC曲线评价各影响因素对脑血管畸形破裂出血的预测价值。结果:两组患者在与畸形血管团位置关系、是否合并硬脑膜动静脉瘘、合并动脉瘤数目、合并动脉瘤大小、合并瘤样变、供血动脉位置、引流静脉方向以及畸形血管团大小方面差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,引流静脉方向、畸形血管团大小以及合并动脉瘤数目是脑血管畸形破裂出血的独立危险因素(P<0.05)。引流静脉方向的ROC曲线下面积为0.921,特异度和灵敏度分别为0.832和0.801,是三种影响因素中预测价值最高的,其次是合并动脉瘤数目和畸形血管团大小。结论:合并动脉瘤、引流静脉方向以及畸形动脉血管团大小是脑血管畸形破裂出血的重要危险因素,且对脑血管畸形破裂出血具有一定的预测价值,可为脑血管畸形破裂出血的预防诊治提供参考。
英文摘要:
      ABSTRACT Objective: To explore the influencing factors of ruptured hemorrhage of cerebrovascular malformation and to analyze the ROC curve of subjects. Methods: The clinical data of 138 patients with cerebrovascular malformation admitted to our hospital from June 2015 to January 2018 were retrospectively analyzed. According to whether the patient had concurrent rupture, they were divided into hemorrhage group (n=76) and non-bleeding group (n=62). The clinical data of the two groups were studied by single factor and multivariate logistic regression analysis. The ROC curve was used to evaluate the predictive value of various influencing factors on cerebral vascular malformation rupture. Results: There were statistically significant differences between the two groups in the relationship with the location of malformed blood vessels, whether dural arteriovenous fistula was combined, the number of aneurysms, the size of aneurysms, the size of aneurysms, the location of blood supply arteries, the direction of drainage veins, and the size of malformed blood vessels (P<0.05). Multivariate logistic regression analysis showed that the direction of drainage vein, the size of malformed vascular mass and the number of aneurysms were independent risk factors for cerebral vascular malformation (P<0.05). The area under the ROC curve in the direction of the drainage vein was 0.921, and the specificity and sensitivity were 0.832 and 0.801, respectively, which were the highest predictive value among the three influencing factors, followed by the number of aneurysms and the size of the deformed vascular mass. Conclusion: The combination of aneurysm, drainage vein and abnormal vascular mass is an important risk factor for cerebral vascular malformation rupture, and it has certain predictive value for cerebral vascular malformation rupture, which can provide reference for the prevention and treatment of cerebral vascular malformation rupture.
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