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中华医学超声杂志(电子版) ›› 2018, Vol. 15 ›› Issue (01) : 43 -47. doi: 10.3877/cma.j.issn.1672-6448.2018.01.008

所属专题: 文献

头颈部超声影像学

超声造影评估颈动脉斑块新生血管分级预测脑梗死再发的Logistic回归模型分析
邬午龙1, 宋则周2,(), 张艳明2, 傅燕飞3, 耿昱4   
  1. 1. 315500 宁波市奉化区人民医院超声科
    2. 310014 杭州,浙江省人民医院超声科
    3. 310051 浙江省杭州市滨江区西兴街道社区卫生服务中心
    4. 310014 杭州,浙江省人民医院神经内科
  • 收稿日期:2017-02-26 出版日期:2018-01-01
  • 通信作者: 宋则周

The prediction of recurrent cerebral infarction by the neovascularization grade of carotid plaque using contrast enhanced ultrasonography: a Logistic regression model analysis

Wulong Wu1, Zezhou Song2,(), Yanming Zhang2, Yanfei Fu3, Yu Geng4   

  1. 1. Department of Ultrasound, Fenghua People Hospital, Ningbo 315500, China
    2. Department of Ultrasound, Zhejiang Provincial People′s Hospital, Hangzhou 310014, China
    3. Community Health Centre in Binjiang District, Hangzhou 310051, China
    4. Department of Neurology, Zhejiang Provincial People′s Hospital, Hangzhou 310014, China
  • Received:2017-02-26 Published:2018-01-01
  • Corresponding author: Zezhou Song
  • About author:
    Corresponding author: Song Zezhou, Email:
引用本文:

邬午龙, 宋则周, 张艳明, 傅燕飞, 耿昱. 超声造影评估颈动脉斑块新生血管分级预测脑梗死再发的Logistic回归模型分析[J/OL]. 中华医学超声杂志(电子版), 2018, 15(01): 43-47.

Wulong Wu, Zezhou Song, Yanming Zhang, Yanfei Fu, Yu Geng. The prediction of recurrent cerebral infarction by the neovascularization grade of carotid plaque using contrast enhanced ultrasonography: a Logistic regression model analysis[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(01): 43-47.

目的

采用Logistic回归模型分析超声造影评估颈动脉斑块新生血管分级预测脑梗死再发的价值。

方法

选取2013年4月至2014年5月在浙江省人民医院神经内科就诊的初发脑梗死患者89例,行常规超声与超声造影检查并进行颈动脉斑块的二维回声及新生血管分级,随访1年后入选者脑梗死再发情况,以脑梗死再发与否作为因变量,以年龄、性别、高血压、糖尿病、高脂血症、吸烟史、饮酒史、颈动脉斑块二维回声分级及新生血管分级为自变量,采用Logistic回归模型分析脑梗死再发的独立风险因素,并采用ROC曲线评估独立风险因素预测脑梗死再发的价值。

结果

单因素Logistic回归模型分析显示颈动脉斑块二维超声分级(P=0.028)与新生血管分级(P=0.006)为脑梗死再发的风险预测因素,多因素Logistic回归模型分析显示颈动脉斑块新生血管分级是脑梗死再发的独立风险预测因素(OR=1.916,P=0.043),ROC分析示以新生血管分级>Ⅱ级预测脑梗死再发的敏感度与特异度分别为67.74%、70.69%,其曲线下面积为0.684(95%CI:0.577~0.779,P=0.0017)。

结论

超声造影评估颈动脉斑块新生血管分级是预测脑梗死再发的独立风险因素。

Objective

To evaluate the utility of neovascularization grade of carotid plaque using contrast enhanced ultrasonography in the prediction of recurrent cerebral infarction by Logistic regression model analysis.

Methods

Eight-nine patients with first cerebral infarction were studied by conventional and contrast enhanced ultrasonography, then the two-dimensional echoic grade and neovascularization grade of carotid plaque was assessed. The condition of recurrent cerebral infarction in next year was followed up. The independent risk and predictive factors of recurrent cerebral infarction were analyzed by Logistic regression model and the utility of the independent risk and predictive factors in the prediction of recurrent cerebral infarction was evaluated by ROC curve.

Results

Both two-dimensional echoic grade of carotid plaque (P=0.028) and neovascularization grade of carotid plaque (P=0.006) were the risk and predictive factors of recurrent cerebral infarction in single-factor Logistic regression model. However, only the neovascularization grade of carotid plaque was the independent risk and predictive factor in multiple-factor Logistic regression model (P=0.043) with an OR value of 1.916. The sensitivity and specificity of the neovascularization grade of carotid plaque in prediction of recurrent cerebral infarction (cut-off value>Ⅱ) were 67.74% and 70.69% respectively and the area under ROC curve was 0.684 (95%CI: 0.577~0.779, P=0.0017).

Conclusion

The neovascularization grade of carotid plaques on contrast enhanced ultrasonography is the independent risk and predictive factor in prediction of recurrent cerebral infarction.

表1 脑梗死再发风险预测因素的单因素Logistic回归分析
表2 脑梗死再发风险预测因素的多因素Logistic回归分析
图1 以颈动脉斑块超声造影分级>Ⅱ级为标准预测脑梗死再发的受试者工作特征曲线
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