摘要
目的:在前期工作基础上,提出并验证新的预测下肢动脉硬化闭塞症大截肢平面的数字减影血管造影(DSA)评分方法。方法:总结我院5年来90例因下肢动脉硬化闭塞症大截肢患者的病例资料和DSA图像,应用Logistic回归分析原DSA评分、新DSA评分和经皮氧分压(tcPO2)对预测截肢平面的贡献度,进而对比2种DSA评分方法的受试者工作特征曲线(ROC)下面积,应用聚类分析明确新评分系统的分类界值。结果:原DSA评分正确预测百分率提高了14.3%,新DSA评分正确预测百分率提高了23.9%。在0.05检验水准下,仅有新DSA评分对预测截肢平面具有统计学意义(P=0.04)。2者ROC曲线下的面积无统计学意义。新DSA评分方法聚类分析的整体均数界值被定义为17。结论:将股深动脉纳入到新DSA评分,正确预测截肢平面的百分率提高了9.6%,ROC曲线下面积增加了12%,可选取17作为新评分标准大截肢的临界值。
Objective：To assume and testify a new DSA scoring system, by which to predict major amputation levels of patients suffered lower limb arteriosclerosis obliterans （ASO） based on our established DSA score system. Method：To retrospectively summary clinical and DSA data of 90 cases of major amputees because of ASO. By applying Logistic regression analysis, predictive contribution degree was compared between the established DSA scoring, assumed DSA scoring and transcutaneous pressure of oxygen （ tcPO2 ）. Area under the receiver operating characteristic （ROC） curve was evaluated. By cluster analysis, grouping value was identified. Result： Correct predictive contribution rate in the established system raised 14.3 %, while in assumed system raised 23.9 %. Only the assumed scoring make a statistical significance （ P = 0.04）. Area under ROC curve in the established one was comparable to the assumed one. In the assumed system, group value of mean by cluster analysis was identified as 17. Conclusion： By internalizing item of profound femoral artery into the assumed DSA scoring system, correct predictive contribution rate raised 9.6%, Area under ROC curve raised 12%, compared to the established one. In new system score 17 may be defined as grouping value in predicting major amputation level in ASO sufferers.
出处
《心肺血管病杂志》
CAS
2009年第1期24-26,35,共4页
Journal of Cardiovascular and Pulmonary Diseases
关键词
下肢动脉硬化闭塞症
大截肢
截肢平面
血管造影术
数字减影
Arteriosclerosis obliterans
Major amputation
Level of amputation
Angiography, Digital Subtraction
