Volume 22 Issue 7
Jul.  2024
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(7): 1108-1111
WANG Yu, LIU Caidan, ZHOU Yunbo, ZHANG Hui, LUO Huanwen. Construction and evaluation the prediction model of vascular reocclusion after intravenous thrombolysis in acute ischemic stroke[J]. Chinese Journal of General Practice, 2024, 22(7): 1108-1111. doi: 10.16766/j.cnki.issn.1674-4152.003577
Citation: WANG Yu, LIU Caidan, ZHOU Yunbo, ZHANG Hui, LUO Huanwen. Construction and evaluation the prediction model of vascular reocclusion after intravenous thrombolysis in acute ischemic stroke[J]. Chinese Journal of General Practice, 2024, 22(7): 1108-1111. doi: 10.16766/j.cnki.issn.1674-4152.003577
shu

Construction and evaluation the prediction model of vascular reocclusion after intravenous thrombolysis in acute ischemic stroke

doi: 10.16766/j.cnki.issn.1674-4152.003577

  • Department of Neurology, the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan 410007, China

Funds:

 202011000475

  • Received Date: 2023-10-17
    Available Online: 2024-09-05
    Abstract
  •   Objective  To establish and validate a nomogram prediction model for vessel re-occlusion after intravenous thrombolysis in acute ischaemic stroke (AIS).  Methods  A total of 316 patients with AIS who received intravenous thrombolysis at the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2020 to June 2023 were retrospectively analyzed, and divided into non-occlusion group (264 cases) and re-occlusion group (52 cases) according to the status of re-occlusion after intravenous thrombolysis. The differences in clinical characteristics between the two groups were compared, factors affecting vessel re-occlusion were analyzed by multivariate logistic regression and a nomogram model was created. The degree of discrimination and calibration of the model was assessed by using receiver operating characteristic (ROC) and calibration curves, and the clinical decision curve was analyzed.  Results  Univariate and multivariate logistic regression analysis showed that history of atrial fibrillation, high baseline National Institutes of Health Stroke Scale (NIHSS) score and longer time from onset to treatment were risk factors for re-occlusion after intravenous thrombolysis in AIS patients, whereas Tirofiban was protective factor (P < 0.05). The area under ROC curve (AUC) of the constructed nomogram model was 0.768 (0.701-0.835). The calibration curve showed that there was good agreement between the prediction of vessel reocclusion by the model and the actual probability of occurrence (Hosmer-Lemeshow χ2=8.246, P=0.410). If the risk of vessel re-occlusion after thrombolysis in AIS patients is predicted to be >0.15 using this model, appropriate interventional measures should be taken. It can make patients get better clinical benefit.  Conclusion  There are many factors that influence vessel re-occlusion after intravenous thrombolytic therapy in AIS patients, and the reasonably constructed column diagram model has good discriminatory power and accuracy, which can be used for risk stratification of patients.

     

    • FullText(HTML)
  • loading
    • References(19)
  • [1]
    《中国脑卒中防治报告》编写组. 《中国脑卒中防治报告2020》概要[J]. 中国脑血管病杂志, 2022, 19(2): 136-144. https://www.cnki.com.cn/Article/CJFDTOTAL-NXGB202311009.htm

    Report on stroke prevention and treatment in China Writing Group. Brief report on stroke prevention and treatment in China, 2020[J]. Chinese Journal of Cerebrovascular Diseases, 2022, 19(2): 136-144. https://www.cnki.com.cn/Article/CJFDTOTAL-NXGB202311009.htm
    [2]
    HERPICH F, RINCON F. Management of acute ischemic stroke[J]. Crit Care Med, 2020, 48(11): 1654-1663. doi: 10.1097/CCM.0000000000004597
    [3]
    钟迪, 张舒婷, 吴波. 《中国急性缺血性脑卒中诊治指南2018》解读[J]. 中国现代神经疾病杂志, 2019, 19(11): 897-901. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJB201911024.htm

    ZHONG D, ZHANG S T, WU B. Interpretation of "Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018"[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2019, 19(11): 897-901. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJB201911024.htm
    [4]
    PSYCHOGIOS K, TSIVGOULIS G. Intravenous thrombolysis for acute ischemic stroke: why not?[J]. Curr Opin Neurol, 2022, 35(1): 10-17. doi: 10.1097/WCO.0000000000001004
    [5]
    中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51(9): 666-682. doi: 10.3760/cma.j.issn.1006-7876.2018.09.004

    Chinese Society of Neurology; Chinese Stroke Society. Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018[J]. Chinese Journal of Neurology, 2018, 51(9): 666-682. doi: 10.3760/cma.j.issn.1006-7876.2018.09.004
    [6]
    吕洋, 郝立鹏, 袁超, 等. 替罗非班治疗阿替普酶静脉溶栓后再闭塞脑梗死患者的有效性和安全性分析[J]. 中华神经医学杂志, 2021, 20(4): 350-355. https://www.cnki.com.cn/Article/CJFDTOTAL-YYGZ202415026.htm

    LYU Y, HAO L P, YUAN C, et al. Tirofiban in patients with re-occlusive ischemic stroke after intravenous thrombolysis with alteplase: an effectiveness and safety analysis[J]. Chinese Journal of Neuromedicine, 2021, 20(4): 350-355. https://www.cnki.com.cn/Article/CJFDTOTAL-YYGZ202415026.htm
    [7]
    CETIN K O, MYLONAKIS G, SEXTOS A, et al. Reconnaissance of 2020 M 7.0 Samos Island (Aegean Sea) earthquake[J]. Bull Earthq Eng, 2022, 20(14): 7707-7712. doi: 10.1007/s10518-021-01212-y
    [8]
    LEI Y S, LI H, LEI J Y, et al. Effect of intravenous thrombolysis in acute ischemic stroke patients with cerebral microbleeds and analysis of risk factors for hemorrhagic transformation[J]. Eur Rev Med Pharmacol Sci, 2022, 26(3): 779-786.
    [9]
    TAKEDA Y, HASHIDA A, FUTATSUYA K, et al. A case of the internal carotid artery occlusion immediately after intravenous recombinant tissue plasminogen activator treatment for contralateral middle cerebral artery occlusion[J]. J UOEH, 2023, 45(2): 133-139. doi: 10.7888/juoeh.45.133
    [10]
    苏建, 张津华, 蒋超. 阿替普酶静脉溶栓治疗急性脑梗死血管再闭塞的影响因素[J]. 中国老年学杂志, 2019, 39(4): 775-777. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ201904003.htm

    SU J, ZHANG J H, JIANG C. Analysis of prognostic after intravenous thrombolysis with alteplase in acute cerebral infarction[J]. Chinese Journal of Gerontology, 2019, 39(4): 775-777. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ201904003.htm
    [11]
    CHOI S E, SAGRIS D, HILL A, et al. Atrial fibrillation and stroke[J]. Expert Rev Cardiovasc Ther, 2023, 21(1): 35-56. doi: 10.1080/14779072.2023.2160319
    [12]
    GÓMEZ-OUTES A, SUÁREZ-GEA M L, PÉREZ-CABEZA A I, et al. Pharmacotherapy for stroke prevention in nonvalvular atrial fibrillation: current strategies and future directions[J]. Expert Opin Pharmacother, 2022, 23(17): 1941-1955. doi: 10.1080/14656566.2022.2149323
    [13]
    李欣彦, 汤颖, 孙红伟, 等. 合并阵发性心房颤动的急性缺血性脑卒中患者临床特征及预后研究[J]. 中华全科医学, 2019, 17(8): 1403-1407. doi: 10.16766/j.cnki.issn.1674-4152.000955

    LI X Y, TANG Y, SUN H W, et al. The study of clinical characteristics and prognosis in acute ischemic stroke patients with paroxysmal atrial fibrillation[J]. Chinese Journal of General Practice, 2019, 17(8): 1403-1407. doi: 10.16766/j.cnki.issn.1674-4152.000955
    [14]
    ESCUDERO-MARTíNEZ I, MORALES-CABA L, SEGURA T. Atrial fibrillation and stroke: a review and new insights[J]. Trends Cardiovasc Med, 2023, 33(1): 23-29. doi: 10.1016/j.tcm.2021.12.001
    [15]
    张为艳, 杨帆, 张晋欣. 急性脑梗死患者应用阿替普酶静脉溶栓后血管再闭塞相关因素分析[J]. 中国药物与临床, 2022, 22(1): 72-75. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC202201023.htm

    ZHANG W Y, YANG F, ZHANG J X. Analysis of the correlative factors of blood vessel re-occlusion in patients with acute cerebral infarction after intravenous thrombolysis with alteplase[J]. Chinese Remedies & Clinics, 2022, 22(1): 72-75. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC202201023.htm
    [16]
    ZI W J, SONG J X, KONG W L, et al. Tirofiban for stroke without large or medium-sized vessel occlusion[J]. N Engl J Med, 2023, 388(22): 2025-2036. doi: 10.1056/NEJMoa2214299
    [17]
    中国卒中学会, 中国卒中学会神经介入分会, 中华预防医学会卒中预防与控制专业委员会介入学组. 替罗非班在动脉粥样硬化性脑血管疾病中的临床应用专家共识[J]. 中国卒中杂志, 2019, 14(10): 1034-1044. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJB202005007.htm

    Neurointerventional Branch of Chinese Stroke Society, Interventional Group of Stroke Prevention and Control Professional Committee of Chinese Preventive Medical Association. Chineses Experts Consensus on Clinical Application of Tirofiban in Atherosclerotic Cerebrovascular Diseases[J]. Chinese Journal of Stroke, 2019, 14(10): 1034-1044. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJB202005007.htm
    [18]
    LIANG Z G, ZHANG J L, HUANG S F, et al. Safety and efficacy of low-dose rt-PA with tirofiban to treat acute non-cardiogenic stroke: a single-center randomized controlled study[J]. BMC Neurol, 2022, 22(1): 280. doi: 10.1186/s12883-022-02808-w
    [19]
    杨扬, 陈玲玲. 静脉溶栓治疗急性脑梗死血管再闭塞的影响因素分析[J]. 临床急诊杂志, 2020, 21(2): 153-156. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZLC202002012.htm

    YANG Y, CHEN L L. Analysis of the factors of reocclusion in acute cerebral infarction after intravenous thrombolysis treated[J]. Journal of Clinical Emergency, 2020, 21(2): 153-156. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZLC202002012.htm
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(4)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (66) PDF downloads(7) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return