目的:应用磁共振成像技术探讨锁骨下动脉盗血综合征与后循环梗死的相关性。
方法:回顾性分析294例经颈动脉多普勒超声诊断为锁骨下动脉盗血综合征的患者。根据磁共振成像结果,分为后循环梗死组和非后循环梗死组。收集患者临床指标及颈动脉多普勒超声参数,并对其进行筛选,建立多元logistic回归模型。对建立的多元logistic回归模型进行受试者工作特征曲线分析,并计算曲线下面积以评估模型的预测效率。
结果:对两组患者的所有参数进行统计分析后,共纳入10个参数进行多元logistic回归建立模型。结果显示后循环梗死与锁骨下动脉闭塞有相关性,III级锁骨下动脉盗血综合征,性别,脆弱的斑块,美国国立卫生研究院卒中量表评分,和年龄。经过模型的接收机工作特性曲线分析,多元logistic回归模型的曲线下面积为0.773.
结论:基于临床基线数据和颈动脉多普勒超声参数的多参数复合模型可以有效预测后循环梗死,为临床诊断提供新的见解。
BACKGROUND: To investigate the correlation between subclavian steal syndrome and posterior circulation infarction using magnetic resonance imaging.
METHODS: A total of 294 patients diagnosed with subclavian steal syndrome using carotid Doppler ultrasonography were retrospectively included. According to the magnetic resonance imaging results, they were divided into posterior circulation infarction group and nonposterior circulation infarction group. Clinical indicators and carotid Doppler ultrasound parameters of patients were collected, and they were screened to establish a multiple logistic regression model. Receiver operating characteristic curve analysis of the established multiple logistic regression model was performed, and the area under the curve was calculated to evaluate the predictive efficiency of the model.
RESULTS: After statistical analysis of all parameters of the 2 groups of patients, a total of 10 parameters were included in multiple logistic regression to establish a model. The results showed a correlation between posterior circulation infarction and subclavian artery occlusion, grade III subclavian steal syndrome, gender, vulnerable plaques, National Institutes of Health Stroke Scale score, and age. After the receiver operating characteristic curve analysis of the model, the area under the curve for the multiple logistic regression model was 0.773.
CONCLUSIONS: The multiparameter composite model based on clinical baseline data and carotid Doppler ultrasonography parameters can effectively predict posterior circulation infarction and offer novel insight for clinical diagnosis.