【摘要】 目的 分析血管内介入治疗急性缺血性脑卒中（AIS）后继发脑出血的影响因素，并构建预测血管内介入治疗后继发脑出血列线图预测模型。方法 回顾性分析2021年7月至2022年9月西峡县人民医院收治的137例AIS患者临床资料，依据病历系统记录按照脑出血发生情况将患者分为出血组和未出血组，收集对比2组患者临床资料及实验室指标，针对差异指标进行共线性分析，未存在共线性问题的指标纳入Logistic回归模型中分析患者脑出血发生的相关因素。将回归分析中具有统计学意义的变量作为预测因子，构建患者脑出血发生的列线图风险预测模型，通过绘制决策曲线及校准曲线对模型进行验证。结果 2组患者D-二聚体（D-D）、纤维蛋白原（FIB）、前循环梗死、合并心房颤动方面对比差异有统计学意义（均P<0.05），上述指标均未存在共线性问题（VIF≤10，容忍度≥0.1），并通过Logistic回归方程计算可知，上述指标均为AIS患者发生脑出血独立影响因素。基于Logistic建立上述4项预测因子在内的预测模型，画出对应列线图，并绘制决策曲线及校准曲线，阈值范围中预测模型的净获益率较高，表明该预测模型准确性良好。结论 D-D、FIB、前循环梗死、合并心房颤动均为AIS患者血管内介入治疗后发生脑出血的影响因素，根据上述因素构建列线图模型可帮助临床筛查高危群体，为防治措施实施提供理论依据。更多还原

【Abstract】 Objective To analyze the influencing factors of secondary cerebral haemorrhage after endovascular intervention for acute ischemic stroke(AIS) and to construct a prediction model for predicting secondary cerebral hemorrhage after endovascular intervention in a columnar graph. Methods Retrospectively analyze the clinical data of 137 AIS patients admitted to Xixia County People ′ s Hospital from July 2021 to September 2022, the patients were divided into hemorrhage group and non-hemorrhage group according to the occurrence of cerebral hemorrhage in the records of medical record system, collect and compare the clinical data and laboratory indexes of the two groups of patients, analyze the covariance of the difference indexes, and incorporate indexes that did not have covariance problems into the Logistic regression model to analyze the factors related to the occurrence of cerebral hemorrhage in patients. The statistically significant variables in the regression analysis were used as predictors to construct a line graph risk prediction model of cerebral hemorrhage in patients, and the model was validated by drawing decision curves and calibration curves to predict the relevant influencing factors. Results The differences between the two groups of patients in terms of D-dimer(D-D),fibrinogen(FIB), anterior circulation infarction, and combined atrial fibrillation were statistically significant when compared(all P <0.05), and none of the above indexes had covariance problems(VIF ≤ 10, tolerance ≥ 0.1)and the Logistic regression equation calculation showed that all the above indicators were independent influencing factors for the occurrence of cerebral hemorrhage in AIS patients. A prediction model including the above four predictors was established using Logistic regression. The corresponding column line graphs were drawn, and decision curves and calibration curves were plotted. The net benefit rate of the prediction model in the threshold range was high, indicating that the accuracy of the prediction model was good. Conclusion D-D, FIB, anterior circulation infarction, and combined atrial fibrillation are all influential factors for the occurrence of cerebral hemorrhage after endovascular intervention in patients with AIS, and the construction of a column-line diagram model based on the above factors can help clinical screening of high-risk groups and provide a theoretical basis for the implementation of preventive measures.更多还原