急性缺血性脑卒中合并脑心综合征的列线图预测模型构建

王帮群; 江波

doi:10.13898/j.cnki.issn.2097-5252.2025.07.014

急性缺血性脑卒中合并脑心综合征的列线图预测模型构建

王帮群,
江波

Construction of nomogram prediction model for acute ischemic stroke complicated with cerebral-cardiac syndrome

摘要

摘要:
目的探讨急性缺血性脑卒中(AIS)合并脑心综合征(CCS)的危险因素，并建立AIS合并CCS列线图模型。
方法选取2020-2023年收治的231病人例作为研究对象。采用单因素和多因素logistic回归分析筛选AIS合并CCS的危险因素，应用R软件建立并验证AIS合并CCS的列线图模型。
结果 231例AIS病人有84例发生CCS，发生率约为36.36%，logistic多因素回归分析显示低预后营养指数(PNI)、高卒中评分量表(NIHSS)评分、高总胆固醇、糖尿病、高血压是AIS合并CCS的危险因素。AIS合并CCS的列线图模型的ROC曲线下面积是0.925(95%CI: 0.883~0.966)；校正曲线显示预测值和实际值的一致性良好；决策曲线显示阈值概率大于9%时，列线图预测AIS合并CCS的净收益值较高。
结论低PNI、高NIHSS评分、高总胆固醇、糖尿病、高血压是AIS合并CCS的危险因素，AIS合并CCS的列线图模型具有较高的预测价值。

Abstract:
Objective To investigate the risk factors of acute ischemic stroke(AIS) complicated with cerebral-cardiac syndrome(CCS), and establish a nomogram model of AIS complicated with CCS.
Methods A total of 231 patients from 2020 to 2023 were selected as the study subjects.The univariate and multivariate logistic regression analysis was used to screen the risk factors of AIS combined with CCS, and the R software was used to establish and verify the nomogram model of AIS combined with CCS.
Results Among 231 AIS patients, 84 cases developed CCS, with an incidence of about 36.36%.The results of multivariate logistic regression analysis showed that the low PNI, high NIHSS score, high total cholesterol, diabetes and hypertension were the risk factors of AIS complicated with CCS.The area under ROC curve of AIS complicated with CCS was 0.925(95%CI: 0.883-0.966).The calibration curve showed that the predicted value was in good agreement with the actual value.When the decision curve showed the threshold probability greater than 9%, the net profit value of nomogram predicting AIS complicated with CCS was higher.
Conclusions Low PNI, high NIHSS score, high total cholesterol, diabetes and hypertension are the risk factors of AIS complicated with CCS, and the AIS complicated with CCS nomogram model has high predictive value.

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