Wang Lijing, Li Yao, Hu Yadong, Ling Li, Jia Nan, Chen Yajing, Meng Yanan, Jiang Ye, Li Ning
Department of Neurology, Affiliated Hospital of Hebei University, Baoding, China.
Department of Neurosurgery, Affiliated Hospital of Hebei University, Baoding, China.
Front Neurosci. 2024 Dec 13;18:1429088. doi: 10.3389/fnins.2024.1429088. eCollection 2024.
Cerebral Microbleeds (CMBs) serve as critical indicators of cerebral small vessel disease and are strongly associated with severe neurological disorders, including cognitive impairments, stroke, and dementia. Despite the importance of diagnosing and preventing CMBs, there is a significant lack of effective predictive tools in clinical settings, hindering comprehensive assessment and timely intervention.
This study aims to develop a robust predictive model for CMBs by integrating a broad range of clinical and laboratory parameters, enhancing early diagnosis and risk stratification.
We analyzed extensive data from 587 neurology inpatients using advanced statistical techniques, including Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression. Key predictive factors such as Albumin/Globulin ratio, gender, hypertension, homocysteine levels, Neutrophil to HDL Ratio (NHR), and history of stroke were evaluated. Model validation was performed through Receiver Operating Characteristic (ROC) curves and Decision Curve Analysis (DCA).
The model demonstrated strong predictive performance with significant clinical applicability. Key predictors identified include the Albumin/Globulin ratio, homocysteine levels, and NHR, among others. Validation metrics such as the area under the ROC curve (AUC) and decision curve analysis confirmed the model's utility in predicting CMBs, highlighting its potential for clinical implementation.
The comprehensive predictive model developed in this study offers a significant advancement in the personalized management of patients at risk for CMBs. By addressing the gap in effective predictive tools, this model facilitates early diagnosis and targeted intervention, potentially reducing the incidence of stroke and cognitive impairments associated with cerebral microbleeds. Our findings advocate for a more nuanced approach to cerebrovascular disease management, emphasizing the importance of multi-factorial risk profiling.
脑微出血(CMBs)是脑小血管疾病的关键指标,与包括认知障碍、中风和痴呆在内的严重神经系统疾病密切相关。尽管诊断和预防CMBs很重要,但临床环境中严重缺乏有效的预测工具,这阻碍了全面评估和及时干预。
本研究旨在通过整合广泛的临床和实验室参数,开发一种强大的CMBs预测模型,以加强早期诊断和风险分层。
我们使用先进的统计技术,包括最小绝对收缩和选择算子(LASSO)和逻辑回归,分析了587名神经科住院患者的大量数据。评估了关键预测因素,如白蛋白/球蛋白比值、性别、高血压、同型半胱氨酸水平、中性粒细胞与高密度脂蛋白比值(NHR)和中风病史。通过受试者操作特征(ROC)曲线和决策曲线分析(DCA)进行模型验证。
该模型表现出强大的预测性能和显著的临床适用性。确定的关键预测因素包括白蛋白/球蛋白比值、同型半胱氨酸水平和NHR等。ROC曲线下面积(AUC)和决策曲线分析等验证指标证实了该模型在预测CMBs方面的效用,突出了其临床应用潜力。
本研究开发的综合预测模型在CMBs风险患者的个性化管理方面取得了重大进展。通过填补有效预测工具的空白,该模型有助于早期诊断和靶向干预,可能降低与脑微出血相关的中风和认知障碍的发生率。我们的研究结果倡导采用更细致入微的方法来管理脑血管疾病,强调多因素风险评估的重要性。