[1]王浩,王晨潮,董阳,等.脑底异常血管网症合并颅内动脉瘤破裂风险评分系统的建立和验证[J].中国临床神经外科杂志,2024,29(06):332-336.[doi:10.13798/j.issn.1009-153X.2024.06.003]
　WANG Hao,WANG Chen-chao,DONG Yang,et al.Establishment and validation of risk score for intracranial aneurysm rupture in patients with moyamoya disease[J].,2024,29(06):332-336.[doi:10.13798/j.issn.1009-153X.2024.06.003]
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脑底异常血管网症合并颅内动脉瘤破裂风险评分系统的建立和验证()

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年06期
页码:
332-336
栏目:
论著
出版日期:
2024-06-30

文章信息/Info

Title:
Establishment and validation of risk score for intracranial aneurysm rupture in patients with moyamoya disease
文章编号:
1009-153X（2024）06-0332-05
作者:
王浩; 王晨潮; 董阳; 李东朋; 李红伟; 杨波
450000郑州，郑州大学第一附属医院神经外科（王浩、王晨潮、董阳、李东朋、李红伟、杨波）
Author(s):
WANG Hao1;  WANG Chen-chao1; 2;  DONG Yang1;  LI Dong-peng1;  LI Hong-wei1;  YANG Bo1
Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
关键词:
脑底异常血管网症; 烟雾病; 颅内动脉瘤; 破裂风险; 预测评分系统
Keywords:
Moyamoya disease;  Aneurysm rupture;  Risk score
分类号:
R 743; R 743.9
DOI:
10.13798/j.issn.1009-153X.2024.06.003
文献标志码:
A
摘要:
目的 建立脑底异常血管网症（MMD）合并动脉瘤破裂风险评分并评估其预测效果。方法 回顾性分析2019年10月至2023年10月收治的191例MMD合并颅内动脉瘤的临床资料。按7:3比例随机分为建模队列（142例）和验证队列（49例）。基于建模队列资料，采用多因素logistic回归模型分析动脉瘤破裂危险因素，再根据危险因素β值建立预测评分（烟雾病合并动脉瘤评分），ROC曲线评价预测能力，并与PHASES评分、ELAPSS评分、日本动脉瘤评分进行比较。结果 建模队列142例中，动脉瘤破裂51例，未破裂91例；验证队列49例中，动脉瘤破裂17例，未破裂32例。多因素logistic回归分析显示，外周动脉瘤、后循环动脉瘤和动脉瘤较大是动脉瘤破裂的独立危险因素（P<0.05）。根据多因素logistic回归分析结果成功建立烟雾病合并动脉瘤评分，ROC曲线显示，预测动脉瘤破裂的AUC为0.782（95% CI 0.700~0.856），敏感度为0.686，特异度为0.780，约登指数为0.466；其AUC明显优于ELAPSS评分、PHASES评分和日本动脉瘤评分（P<0.05）。结论 根据外周动脉瘤、后循环动脉瘤和动脉瘤大小3个因素构建的烟雾病合并动脉瘤评分对MMD合并动脉瘤的破裂风险具有一定的预测价值。
Abstract:
Objective To establish a risk scoring system for aneurysm rupture in patients with moyamoya disease (MMD) and evaluate its predictive efficacy. Methods The clinical data of 191 patients with MMD associated with intracranial aneurysms admitted from October 2019 to October 2023 were retrospectively analyzed. They were randomly divided into a modeling cohort (142 cases) and a validation cohort (49 cases) at a ratio of 7:3. Based on the data of the modeling cohort, a multivariate logistic regression model was used to analyze the risk factors for aneurysm rupture. Then, a predictive scoring system (MMD-aneurysm score) was established based on the β values of the risk factors. The predictive ability was evaluated by ROC curves and compared with the PHASES score, the ELAPSS score, and the Japanese aneurysm score. Results Among the 142 cases in the modeling cohort, 51 cases had aneurysm rupture and 91 cases did not; among the 49 cases in the validation cohort, 17 cases had aneurysm rupture and 32 cases did not. The multivariate logistic regression analysis indicated that peripheral aneurysm, posterior circulation aneurysm, and large aneurysm were independent risk factors for aneurysm rupture (P<0.05). The MMD-aneurysm score was successfully established based on the results of the multivariate logistic regression analysis. The ROC curve showed that the area under the curve (AUC) for predicting aneurysm rupture was 0.782 (95% CI 0.700~0.856), the sensitivity was 0.686, the specificity was 0.780, and the Youden index was 0.466. Its AUC was significantly superior to that of the ELAPSS score, the PHASES score, and the Japanese aneurysm score (P<0.05). Conclusions The MMD-aneurysm score constructed based on three factors, namely peripheral aneurysm, posterior circulation aneurysm, and aneurysm size, has certain predictive value for the rupture risk of intracranial aneurysms in patients with MMD.

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备注/Memo

备注/Memo:
（2023-12-25收稿，2024-03-22修回）
通信作者：李红伟，Email：hongwei706@126.com
杨　波，Email：yangbo96@163.com
更新日期/Last Update: 2024-06-30