Article(id=1190669165867446504, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1190669163988398295, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.0115.2024.0929, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1706112000000, receivedDateStr=2024-01-25, revisedDate=null, revisedDateStr=null, acceptedDate=1711036800000, acceptedDateStr=2024-03-22, onlineDate=1761807250705, onlineDateStr=2025-10-30, pubDate=1745769600000, pubDateStr=2025-04-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1761807250705, onlineIssueDateStr=2025-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1761807250705, creator=13701087609, updateTime=1761807250705, updator=13701087609, issue=Issue{id=1190669163988398295, tenantId=1146029695717560320, journalId=1189873630562394117, year='2025', volume='50', issue='4', pageStart='367', pageEnd='503', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1761807250258, creator=13701087609, updateTime=1761807667423, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1190670913772339410, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1190669163988398295, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1190670913772339411, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1190669163988398295, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=418, endPage=426, ext={EN=ArticleExt(id=1190669166098133226, articleId=1190669165867446504, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Predictive value of albumin, hemoglobin, and multifactorial model for poor postoperative prognosis in elderly patients with meningiomas, columnId=1190310109000602400, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Clinical Research, runingTitle=null, highlight=null, articleAbstract=

Objective To explore the predictive value of albumin, hemoglobin and multifactorial model for poor postoperative prognosis in elderly patients with meningioma. Methods A retrospective analysis was conducted on 253 elderly patients who underwent meningioma surgery and were transferred to the neurosurgical intensive care unit (NICU) at General Hospital of Northern Theater Command from January 2019 to September 2021, serving as the modeling cohort. Another 227 elderly patients who were treated in NICU after meningioma surgery from November 2021 to June 2023 were used as the validation cohort. Patients in the modeling cohort were categorized into good prognosis group [Glasgow Coma Scale (GCS) score>7, n=161] and poor prognosis group (GCS≤7, n=92) based on the GCS. Univariate and multifactorial logistic regression analyses were performed on the modeling cohort to identify independent risk factors, and a multifactorial model for predicting poor postoperative prognosis in elderly patients with meningioma was constructed based on these factors. The predictive efficacy and accuracy of the model were evaluated using the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, Hosmer-Lemeshow goodness-of-fit test, and calibration curves. The predictive value of postoperative albumin, hemoglobin, and the multifactorial models for postoperative prognosis in elderly meningioma patients was assessed using restricted cubic spline modeling (RCS), decision curves (DCA), and validated using an external validation cohort to assess the stability of the model. Results Meningioma WHO grade Ⅱ and Ⅲ (OR=3.994, 95%CI 1.963-8.126), postoperative hypoalbuminemia (OR=2.194, 95%CI 1.079-4.462), and postoperative anemia (OR=2.117, 95%CI 1.096-4.089) were identified as independent risk factors for poor postoperative prognosis in elderly meningioma patients (P<0.05), while the use of analgesic/sedative medications was a protective factor (OR=0.388, 95%CI 0.201-0.748, P<0.05). The Hosmer-Lemeshow test indicated that the constructed multifactorial model had a good fit accuracy (P=0.161). The AUC for predicting poor postoperative prognosis in elderly meningioma patients for postoperative albumin and hemoglobin were 0.545 (95%CI 0.472-0.617) and 0.632 (95%CI 0.561-0.702), respectively, and showed a nonlinear dose-response relationship with prognosis (P<0.01). DCA analysis results showed that the net benefit rate of multifactorial model was higher than that of postoperative albumin and hemoglobin when the threshold probabilities were between 0.10 and 0.90. The AUC for predicting postoperative prognosis in the elderly meningioma patients in the modeling and validation cohorts were 0.810 and 0.819, respectively, and their calibration curves suggested good discrimination and accuracy. Conclusions Meningioma WHO grades Ⅱ and Ⅲ, postoperative anemia and hypoalbuminemia are independent risk factors for poor postoperative prognosis in elderly meningioma patients, while the use of analgesic/sedative drugs is a protective factor. The multifactorial model constructed based on these factors has a good predictive efficacy and credibility, and can be used as a reference for clinical decision-making.

, correspAuthors=Hong Qu, authorNote=null, correspAuthorsNote=
E-mail:
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目的 探讨白蛋白、血红蛋白及多因素模型对老年脑膜瘤患者术后预后不良的预测价值。方法 回顾性纳入北部战区总医院2019年1月-2021年9月收治的253例老年脑膜瘤术后转入神经外科重症监护病房(NICU)治疗的患者作为建模集,2021年11月-2023年6月收治的227例老年脑膜瘤术后转入NICU治疗的患者作为验证集。根据格拉斯哥昏迷评分(GCS)将建模集患者分为预后良好组(GCS评分>7分,n=161)与预后不良组(GCS评分≤7分,n=92)。使用建模集进行单因素和多因素logistic回归分析以确定独立危险因素,并据此构建预测老年脑膜瘤患者术后预后不良的多因素模型。通过受试者操作特征(ROC)曲线下面积(AUC)、敏感度、特异度、Hosmer-Lemeshow拟合优度检验以及校准曲线评价模型的预测效能和准确度。通过限制性立方样条模型(RCS)、决策曲线(DCA)评估术后白蛋白、血红蛋白及多因素模型对老年脑膜瘤患者术后预后的预测价值,使用验证集进行验证以评估模型的稳定性。结果 脑膜瘤WHO Ⅱ级和Ⅲ级(OR=3.994,95%CI 1.963~8.126)、术后低蛋白血症(OR=2.194,95%CI 1.079~4.462)、术后贫血(OR=2.117,95%CI 1.096~4.089)是老年脑膜瘤患者术后预后不良的独立危险因素(P<0.05),而使用镇痛/镇静药物是其保护因素(OR=0.388,95%CI 0.201~0.748,P<0.05)。Hosmer-Lemeshow检验显示,所构建的多因素模型拟合准确度良好(P=0.161)。术后白蛋白、血红蛋白预测老年脑膜瘤患者术后预后不良的AUC分别为0.545(95%CI 0.472~0.617)、0.632(95%CI 0.561~0.702),且与预后不良呈非线性剂量反应关系(P<0.01)。DCA分析结果显示,阈值概率为0.10~0.90时,多因素模型较术后白蛋白、血红蛋白的净获益率高。该模型在建模集和验证集中预测老年脑膜瘤患者术后预后的AUC分别为0.810和0.819,其校准曲线提示区分度、准确度较好。结论 脑膜瘤WHO Ⅱ级和Ⅲ级、术后贫血及低蛋白血症是老年脑膜瘤患者术后预后不良的独立危险因素,而使用镇痛/镇静药物为其保护因素;基于此构建的多因素模型具有良好的预测效能,可信度较高,可用于临床决策的参考。

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拱艳羽,硕士研究生,主要从事神经重症基础与临床方面的研究

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拱艳羽,硕士研究生,主要从事神经重症基础与临床方面的研究

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拱艳羽,硕士研究生,主要从事神经重症基础与临床方面的研究

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CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the united states in 2016-2020[J]. Neuro Oncol, 2023, 25(12 Suppl 2): iv1-iv99., articleTitle=CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the united states in 2016-2020, refAbstract=null), Reference(id=1190669342007243469, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2020, volume=169, issue=null, pageStart=3, pageEnd=15, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=Walsh KM, journalName=Handb Clin Neurol, refType=null, unstructuredReference=Walsh KM. Epidemiology of meningiomas[J]. Handb Clin Neurol, 2020, 169: 3-15., articleTitle=Epidemiology of meningiomas, refAbstract=null), Reference(id=1190669342061769422, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2023, volume=48, issue=9, pageStart=1061, pageEnd=1068, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=黄冠又, 郝淑煜, 冯洁, journalName=解放军医学杂志, refType=null, unstructuredReference=黄冠又, 郝淑煜, 冯洁, 等. NF2基因多态性与脑膜瘤预后的相关性[J]. 解放军医学杂志, 2023, 48(9): 1061-1068., articleTitle=NF2基因多态性与脑膜瘤预后的相关性, refAbstract=null), Reference(id=1190669342116295375, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=163, issue=12, pageStart=3401, pageEnd=3415, url=null, language=null, rfNumber=[4], rfOrder=3, authorNames=Nakasu S, Notsu A, Nakasu Y, journalName=Acta Neurochir (Wien), refType=null, unstructuredReference=Nakasu S, Notsu A, Nakasu Y. Prevalence of incidental meningiomas and gliomas on MRI: a meta-analysis and meta-regression analysis[J]. Acta Neurochir (Wien), 2021, 163(12): 3401-3415., articleTitle=Prevalence of incidental meningiomas and gliomas on MRI: a meta-analysis and meta-regression analysis, refAbstract=null), Reference(id=1190669342170821328, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=127, issue=19, pageStart=3579, pageEnd=3590, url=null, language=null, rfNumber=[5], rfOrder=4, authorNames=Withrow DR, Devesa SS, Deapen D, journalName=Cancer, refType=null, unstructuredReference=Withrow DR, Devesa SS, Deapen D, et al. Nonmalignant meningioma and vestibular schwannoma incidence trends in the United States, 2004-2017[J]. Cancer, 2021, 127(19): 3579-3590., articleTitle=Nonmalignant meningioma and vestibular schwannoma incidence trends in the United States, 2004-2017, refAbstract=null), Reference(id=1190669342242124497, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2023, volume=null, issue=12, pageStart=7, pageEnd=null, url=null, language=null, rfNumber=[6], rfOrder=5, authorNames=安娜, journalName=社会与公益, refType=null, unstructuredReference=安娜. 《2022年度国家老龄事业发展公报》发布[J]. 社会与公益, 2023, (12): 7., articleTitle=《2022年度国家老龄事业发展公报》发布, refAbstract=null), Reference(id=1190669342305039058, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2018, volume=14, issue=2, pageStart=106, pageEnd=115, url=null, language=null, rfNumber=[7], rfOrder=6, authorNames=Preusser M, Brastianos PK, Mawrin C, journalName=Nat Rev Neurol, refType=null, unstructuredReference=Preusser M, Brastianos PK, Mawrin C. Advances in meningioma genetics: novel therapeutic opportunities[J]. Nat Rev Neurol, 2018, 14(2): 106-115., articleTitle=Advances in meningioma genetics: novel therapeutic opportunities, refAbstract=null), Reference(id=1190669342372147923, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=23, issue=11, pageStart=1821, pageEnd=1834, url=null, language=null, rfNumber=[8], rfOrder=7, authorNames=Goldbrunner R, Stavrinou P, Jenkinson MD, journalName=Neuro Oncol, refType=null, unstructuredReference=Goldbrunner R, Stavrinou P, Jenkinson MD, et al. EANO guideline on the diagnosis and management of meningiomas[J]. Neuro Oncol, 2021, 23(11): 1821-1834., articleTitle=EANO guideline on the diagnosis and management of meningiomas, refAbstract=null), Reference(id=1190669342456034004, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2023, volume=165, issue=5, pageStart=1345, pageEnd=1353, url=null, language=null, rfNumber=[9], rfOrder=8, authorNames=Akimoto T, Yoshikawa H, Fushimi S, journalName=Acta Neurochir (Wien), refType=null, unstructuredReference=Akimoto T, Yoshikawa H, Fushimi S, et al. Surgical complications and recurrence factors for asymptomatic meningiomas: a single-center retrospective study[J]. Acta Neurochir (Wien), 2023, 165(5): 1345-1353., articleTitle=Surgical complications and recurrence factors for asymptomatic meningiomas: a single-center retrospective study, refAbstract=null), Reference(id=1190669342510559957, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=207, issue=null, pageStart=106772, pageEnd=null, url=null, language=null, rfNumber=[10], rfOrder=9, authorNames=Rafiq R, Katiyar V, Garg K, journalName=Clin Neurol Neurosurg, refType=null, unstructuredReference=Rafiq R, Katiyar V, Garg K, et al. Comparison of outcomes of surgery for intracranial meningioma in elderly and young patients-a systematic review and meta-analysis[J]. Clin Neurol Neurosurg, 2021, 207: 106772., articleTitle=Comparison of outcomes of surgery for intracranial meningioma in elderly and young patients-a systematic review and meta-analysis, refAbstract=null), Reference(id=1190669342565085910, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2020, volume=148, issue=3, pageStart=481, pageEnd=488, url=null, language=null, rfNumber=[11], rfOrder=10, authorNames=Li Y, Lu D, Feng D, journalName=J Neurooncol, refType=null, unstructuredReference=Li Y, Lu D, Feng D, et al. Management of incidental anterior skull base large and giant meningiomas in elderly patients[J]. J Neurooncol, 2020, 148(3): 481-488., articleTitle=Management of incidental anterior skull base large and giant meningiomas in elderly patients, refAbstract=null), Reference(id=1190669342644777687, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2023, volume=48, issue=5, pageStart=489, pageEnd=500, url=null, language=null, rfNumber=[12], rfOrder=11, authorNames=中国医师协会心脏重症专业委员会, 中国医药教育协会重症医学专业委员会, 中国研究型医院学会神经再生与修复专业委员会心脏重症脑保护学组, journalName=解放军医学杂志, refType=null, unstructuredReference=中国医师协会心脏重症专业委员会, 中国医药教育协会重症医学专业委员会, 中国研究型医院学会神经再生与修复专业委员会心脏重症脑保护学组, 等. 心脏重症围手术期脑损伤中西医结合诊治专家共识[J]. 解放军医学杂志, 2023, 48(5): 489-500., articleTitle=心脏重症围手术期脑损伤中西医结合诊治专家共识, refAbstract=null), Reference(id=1190669342707692248, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2018, volume=null, issue=null, pageStart=238, pageEnd=441, url=null, language=null, rfNumber=[13], rfOrder=12, authorNames=万学红, 卢雪峰, journalName=诊断学, refType=null, unstructuredReference=万学红, 卢雪峰. 诊断学[M]. 9版. 北京: 人民卫生出版社, 2018: 238-441., articleTitle=null, refAbstract=null), Reference(id=1190669342774801113, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=23, issue=8, pageStart=1215, pageEnd=1217, url=null, language=null, rfNumber=[14], rfOrder=13, authorNames=Wen PY, Packer RJ, journalName=Neuro Oncol, refType=null, unstructuredReference=Wen PY, Packer RJ. The 2021 WHO classification of tumors of the central nervous system: clinical implications[J]. Neuro Oncol, 2021, 23(8): 1215-1217., articleTitle=The 2021 WHO classification of tumors of the central nervous system: clinical implications, refAbstract=null), Reference(id=1190669342829327066, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2023, volume=46, issue=1, pageStart=288, pageEnd=null, url=null, language=null, rfNumber=[15], rfOrder=14, authorNames=Guo ZQ, Xia XY, Cao D, journalName=Neurosurg Rev, refType=null, unstructuredReference=Guo ZQ, Xia XY, Cao D, et al. A nomogram for predicting the risk of major postoperative complications for patients with meningioma[J]. Neurosurg Rev, 2023, 46(1): 288., articleTitle=A nomogram for predicting the risk of major postoperative complications for patients with meningioma, refAbstract=null), Reference(id=1190669342879658715, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2022, volume=24, issue=7, pageStart=1, pageEnd=6, url=null, language=null, rfNumber=[16], rfOrder=15, authorNames=王壮壮, 刘彦廷, 艾文兵, journalName=中国现代医药杂志, refType=null, unstructuredReference=王壮壮, 刘彦廷, 艾文兵, 等. 脑膜瘤临床特点和预后影响因素分析[J]. 中国现代医药杂志, 2022, 24(7): 1-6., articleTitle=脑膜瘤临床特点和预后影响因素分析, refAbstract=null), Reference(id=1190669342934184668, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2023, volume=48, issue=11, pageStart=1328, pageEnd=1337, url=null, language=null, rfNumber=[17], rfOrder=16, authorNames=卢珮宇, 杨艳, 周华, journalName=解放军医学杂志, refType=null, unstructuredReference=卢珮宇, 杨艳, 周华, 等. 接受PD-1抑制剂治疗的肿瘤患者发生肾损伤的风险预测模型构建与评价[J]. 解放军医学杂志, 2023, 48(11): 1328-1337., articleTitle=接受PD-1抑制剂治疗的肿瘤患者发生肾损伤的风险预测模型构建与评价, refAbstract=null), Reference(id=1190669342992904925, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2022, volume=134, issue=null, pageStart=115, pageEnd=118, url=null, language=null, rfNumber=[18], rfOrder=17, authorNames=Mijderwijk HJ, Nieboer D, journalName=Acta Neurochir Suppl, refType=null, unstructuredReference=Mijderwijk HJ, Nieboer D. Is my clinical prediction model clinically useful? A primer on decision curve analysis[J]. Acta Neurochir Suppl, 2022, 134: 115-118., articleTitle=Is my clinical prediction model clinically useful? A primer on decision curve analysis, refAbstract=null), Reference(id=1190669343055819486, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=21, issue=10, pageStart=1643, pageEnd=1648, url=null, language=null, rfNumber=[19], rfOrder=18, authorNames=Vickers AJ, Holland F, journalName=Spine J, refType=null, unstructuredReference=Vickers AJ, Holland F. Decision curve analysis to evaluate the clinical benefit of prediction models[J]. Spine J, 2021, 21(10): 1643-1648., articleTitle=Decision curve analysis to evaluate the clinical benefit of prediction models, refAbstract=null), Reference(id=1190669343118734047, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2024, volume=49, issue=5, pageStart=557, pageEnd=569, url=null, language=null, rfNumber=[20], rfOrder=19, authorNames=徐天波, 刘德国, 顾增辉, journalName=解放军医学杂志, refType=null, unstructuredReference=徐天波, 刘德国, 顾增辉, 等. 衰老基因在骨肉瘤治疗、预后及肿瘤微环境中的作用研究[J]. 解放军医学杂志, 2024, 49(5): 557-569., articleTitle=衰老基因在骨肉瘤治疗、预后及肿瘤微环境中的作用研究, refAbstract=null), Reference(id=1190669343173260000, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2023, volume=46, issue=9, pageStart=4068, pageEnd=4069, url=null, language=null, rfNumber=[21], rfOrder=20, authorNames=Qi C, Wang L, Duan G, journalName=Asian J Surg, refType=null, unstructuredReference=Qi C, Wang L, Duan G. Nutritional and inflammatory immune-based hemoglobin, albumin, lymphocyte, and platelet (HALP) score as a prognostic biomarker in patients with high-risk neuroblastoma[J]. Asian J Surg, 2023, 46(9): 4068-4069., articleTitle=Nutritional and inflammatory immune-based hemoglobin, albumin, lymphocyte, and platelet (HALP) score as a prognostic biomarker in patients with high-risk neuroblastoma, refAbstract=null), Reference(id=1190669343236174561, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=75, issue=3, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[22], rfOrder=21, authorNames=Kaya C, Caliskan S, Sungur M, journalName=Int J Clin Pract, refType=null, unstructuredReference=Kaya C, Caliskan S, Sungur M, et al. HALP score and albumin levels in men with prostate cancer and benign prostate hyperplasia[J]. Int J Clin Pract, 2021, 75(3): e13766., articleTitle=HALP score and albumin levels in men with prostate cancer and benign prostate hyperplasia, refAbstract=null), Reference(id=1190669343299089122, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=92, issue=null, pageStart=283, pageEnd=292, url=null, language=null, rfNumber=[23], rfOrder=22, authorNames=Yalav O, Topal U, Unal AG, journalName=Ann Ital Chir, refType=null, unstructuredReference=Yalav O, Topal U, Unal AG, et al. Prognostic significance of preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) in patients undergoing curative resection for colorectal cancer[J]. Ann Ital Chir, 2021, 92: 283-292., articleTitle=Prognostic significance of preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) in patients undergoing curative resection for colorectal cancer, refAbstract=null), Reference(id=1190669343370392291, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2016, volume=24, issue=1, pageStart=118, pageEnd=121, url=null, language=null, rfNumber=[24], rfOrder=23, authorNames=Kurtz P, Helbok R, Claassen J, journalName=Neurocrit Care, refType=null, unstructuredReference=Kurtz P, Helbok R, Claassen J, et al. The effect of packed red blood cell transfusion on cerebral oxygenation and metabolism after subarachnoid hemorrhage[J]. Neurocrit Care, 2016, 24(1): 118-121., articleTitle=The effect of packed red blood cell transfusion on cerebral oxygenation and metabolism after subarachnoid hemorrhage, refAbstract=null), Reference(id=1190669343475249892, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=49, issue=3, pageStart=254, pageEnd=256, 260, url=null, language=null, rfNumber=[25], rfOrder=24, authorNames=孙彪, 李保银, 韩宏光, journalName=临床军医杂志, refType=null, unstructuredReference=孙彪, 李保银, 韩宏光, 等. 寒区非体外循环下冠状动脉旁路移植术后低氧血症危险因素分析[J]. 临床军医杂志, 2021, 49(3): 254-256, 260., articleTitle=寒区非体外循环下冠状动脉旁路移植术后低氧血症危险因素分析, refAbstract=null), Reference(id=1190669343550747365, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2023, volume=48, issue=5, pageStart=615, pageEnd=620, url=null, language=null, rfNumber=[26], rfOrder=25, authorNames=许呢妹, 张爽, 刘志锋, journalName=解放军医学杂志, refType=null, unstructuredReference=许呢妹, 张爽, 刘志锋. 急性呼吸窘迫综合征的分型及个体化治疗研究进展[J]. 解放军医学杂志, 2023, 48(5): 615-620., articleTitle=急性呼吸窘迫综合征的分型及个体化治疗研究进展, refAbstract=null), Reference(id=1190669343626244838, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2024, volume=49, issue=9, pageStart=1004, pageEnd=1010, url=null, language=null, rfNumber=[27], rfOrder=26, authorNames=任江珊, 贾军梅, 孙萍, journalName=解放军医学杂志, refType=null, unstructuredReference=任江珊, 贾军梅, 孙萍, 等. 高能量代谢肺癌患者临床特征分析及其预测模型建立[J]. 解放军医学杂志, 2024, 49(9): 1004-1010., articleTitle=高能量代谢肺癌患者临床特征分析及其预测模型建立, refAbstract=null), Reference(id=1190669343701742311, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2013, volume=16, issue=19, pageStart=8, pageEnd=9, url=null, language=null, rfNumber=[28], rfOrder=27, authorNames=王加充, 赵建农, 王鹏程, journalName=中国实用神经疾病杂志, refType=null, unstructuredReference=王加充, 赵建农, 王鹏程, 等. 良性脑膜瘤患者术后短期预后的相关因素分析[J]. 中国实用神经疾病杂志, 2013, 16(19): 8-9., articleTitle=良性脑膜瘤患者术后短期预后的相关因素分析, refAbstract=null), Reference(id=1190669343768851176, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2011, volume=91, issue=15, pageStart=1051, pageEnd=1054, url=null, language=null, rfNumber=[29], rfOrder=28, authorNames=武宏杰, 车彦军, 鞠东辉, journalName=中华医学杂志, refType=null, unstructuredReference=武宏杰, 车彦军, 鞠东辉, 等. 脑膜瘤术后近期预后影响因素分析[J]. 中华医学杂志, 2011, 91(15): 1051-1054., articleTitle=脑膜瘤术后近期预后影响因素分析, refAbstract=null), Reference(id=1190669343877903081, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2019, volume=133, issue=2, pageStart=486, pageEnd=495, url=null, language=null, rfNumber=[30], rfOrder=29, authorNames=Scotti P, Séguin C, Lo BWY, journalName=J Neurosurg, refType=null, unstructuredReference=Scotti P, Séguin C, Lo BWY, et al. Antithrombotic agents and traumatic brain injury in the elderly population: hemorrhage patterns and outcomes[J]. J Neurosurg, 2019, 133(2): 486-495., articleTitle=Antithrombotic agents and traumatic brain injury in the elderly population: hemorrhage patterns and outcomes, refAbstract=null), Reference(id=1190669343940817642, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=9, issue=4, pageStart=294, pageEnd=297, url=null, language=null, rfNumber=[31], rfOrder=30, authorNames=孙士梅, 曲虹, 蒋金, journalName=创伤与急危重病医学, refType=null, unstructuredReference=孙士梅, 曲虹, 蒋金. 盐酸右美托咪定在颅脑损伤患者术后镇静中疗效及安全性[J]. 创伤与急危重病医学, 2021, 9(4): 294-297., articleTitle=盐酸右美托咪定在颅脑损伤患者术后镇静中疗效及安全性, refAbstract=null), Reference(id=1190669344003732203, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=67, issue=2, pageStart=119, pageEnd=124, url=null, language=null, rfNumber=[32], rfOrder=31, authorNames=Salami AA, Okunlola AI, Ajani MA, journalName=Neurochirurgie, refType=null, unstructuredReference=Salami AA, Okunlola AI, Ajani MA, et al. WHO classification of meningiomas-a single institutional experience[J]. Neurochirurgie, 2021, 67(2): 119-124., articleTitle=WHO classification of meningiomas-a single institutional experience, refAbstract=null), Reference(id=1190669344070841068, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2021, volume=9, issue=3, pageStart=319, pageEnd=null, url=null, language=null, rfNumber=[33], rfOrder=32, authorNames=Ogasawara C, Philbrick BD, Adamson DC, journalName=Biomedicines, refType=null, unstructuredReference=Ogasawara C, Philbrick BD, Adamson DC. Meningioma: a review of epidemiology, pathology, diagnosis, treatment, and future directions[J]. Biomedicines, 2021, 9(3): 319., articleTitle=Meningioma: a review of epidemiology, pathology, diagnosis, treatment, and future directions, refAbstract=null), Reference(id=1190669344129561325, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2022, volume=35, issue=4, pageStart=221, pageEnd=225, url=null, language=null, rfNumber=[34], rfOrder=33, authorNames=韩世文, 洪文明, 宣浩, journalName=立体定向和功能性神经外科杂志, refType=null, unstructuredReference=韩世文, 洪文明, 宣浩. 85例脑膜瘤患者术后临床结局和复发情况及其影响因素的分析[J]. 立体定向和功能性神经外科杂志, 2022, 35(4): 221-225., articleTitle=85例脑膜瘤患者术后临床结局和复发情况及其影响因素的分析, refAbstract=null), Reference(id=1190669344221836014, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2020, volume=29, issue=10, pageStart=827, pageEnd=831, url=null, language=null, rfNumber=[35], rfOrder=34, authorNames=杨长志, 马媛媛, 杨云云, journalName=局解手术学杂志, refType=null, unstructuredReference=杨长志, 马媛媛, 杨云云, 等. 良性脑膜瘤术后复发的相关因素及预后分析[J]. 局解手术学杂志, 2020, 29(10): 827-831., articleTitle=良性脑膜瘤术后复发的相关因素及预后分析, refAbstract=null), Reference(id=1190669344347665135, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2016, volume=131, issue=6, pageStart=803, pageEnd=820, url=null, language=null, rfNumber=[36], rfOrder=35, authorNames=Louis DN, Perry A, Reifenberger G, journalName=Acta Neuropathol, refType=null, unstructuredReference=Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary[J]. Acta Neuropathol, 2016, 131(6): 803-820., articleTitle=The 2016 World Health Organization classification of tumors of the central nervous system: a summary, refAbstract=null), Reference(id=1190669344427356912, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2019, volume=32, issue=2, pageStart=85, pageEnd=88, url=null, language=null, rfNumber=[37], rfOrder=36, authorNames=陈阿静, 隋玉明, 勾荣彬, journalName=立体定向和功能性神经外科杂志, refType=null, unstructuredReference=陈阿静, 隋玉明, 勾荣彬. 单中心107例脑膜瘤临床病理分析[J]. 立体定向和功能性神经外科杂志, 2019, 32(2): 85-88., articleTitle=单中心107例脑膜瘤临床病理分析, refAbstract=null), Reference(id=1190669344511242993, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2023, volume=65, issue=5, pageStart=458, pageEnd=472, url=null, language=null, rfNumber=[38], rfOrder=37, authorNames=Navarro-Ballester A, Aleixandre-Barrachina M, Marco-Doménech SF, journalName=Radiologia (Engl Ed), refType=null, unstructuredReference=Navarro-Ballester A, Aleixandre-Barrachina M, Marco-Doménech SF. Update on meningioma: clinical-radiological and radio-pathological correlation[J]. Radiologia (Engl Ed), 2023, 65(5): 458-472., articleTitle=Update on meningioma: clinical-radiological and radio-pathological correlation, refAbstract=null), Reference(id=1190669344574157554, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2022, volume=22, issue=11, pageStart=993, pageEnd=999, url=null, language=null, rfNumber=[39], rfOrder=38, authorNames=黄冠又, 郝淑煜, 王亮, journalName=中国现代神经疾病杂志, refType=null, unstructuredReference=黄冠又, 郝淑煜, 王亮, 等. 脑膜瘤术后复发生存分析: 附176例报告[J]. 中国现代神经疾病杂志, 2022, 22(11): 993-999., articleTitle=脑膜瘤术后复发生存分析: 附176例报告, refAbstract=null), Reference(id=1190669344637072115, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2012, volume=15, issue=16, pageStart=59, pageEnd=60, url=null, language=null, rfNumber=[40], rfOrder=39, authorNames=魏少伟, journalName=中国实用神经疾病杂志, refType=null, unstructuredReference=魏少伟. 蝶骨嵴脑膜瘤的手术治疗及预后分析[J]. 中国实用神经疾病杂志, 2012, 15(16): 59-60., articleTitle=蝶骨嵴脑膜瘤的手术治疗及预后分析, refAbstract=null), Reference(id=1190669344695792372, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2024, volume=47, issue=3, pageStart=1366, pageEnd=1377, url=null, language=null, rfNumber=[41], rfOrder=40, authorNames=He W, Liu Z, Zheng D, journalName=Asian J Surg, refType=null, unstructuredReference=He W, Liu Z, Zheng D, et al. Management of cavernous sinus meningiomas: clinical features, treatment strategies, and long-term outcomes[J]. Asian J Surg, 2024, 47(3): 1366-1377., articleTitle=Management of cavernous sinus meningiomas: clinical features, treatment strategies, and long-term outcomes, refAbstract=null), Reference(id=1190669344758706933, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, doi=null, pmid=null, pmcid=null, year=2023, volume=180, issue=null, pageStart=e281, pageEnd=e287, url=null, language=null, rfNumber=[42], rfOrder=41, authorNames=AlKhoshi AM, AlZahrani AA, Shawli FS, journalName=World Neurosurg, refType=null, unstructuredReference=AlKhoshi AM, AlZahrani AA, Shawli FS, et al. Prognostic factors affecting postsurgical outcomes of adult patients with intracranial meningioma: a retrospective study[J]. World Neurosurg, 2023, 180: e281-e287., articleTitle=Prognostic factors affecting postsurgical outcomes of adult patients with intracranial meningioma: a retrospective study, refAbstract=null)], funds=[Fund(id=1190669341654921928, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, awardId=2021JH2/10300116, language=EN, fundingSource=Science and Technology Plan of Liaoning Province(2021JH2/10300116), fundOrder=null, country=null), Fund(id=1190669341726225097, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, awardId=2021JH2/10300116, language=CN, fundingSource=辽宁省科技计划(2021JH2/10300116), fundOrder=null, country=null), Fund(id=1190669341789139658, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, awardId=2022JH2/101500037, language=EN, fundingSource=Science and Technology Plan of Liaoning Province(2022JH2/101500037), fundOrder=null, country=null), 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figs=[ArticleFig(id=1190669339352249013, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=EN, label=Fig.1, caption=ROC curves of postoperative albumin, hemoglobin (A) and multifactorial modeling (B) for predicting prognosis in elderly postoperative patients with meningiomas, figureFileSmall=FyLqEtzGMu5d2cMSKk5uMg==, figureFileBig=LgIyOiesaM9QQXGD3t2/Gg==, tableContent=null), ArticleFig(id=1190669339419357878, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=CN, label=图1, caption=术后白蛋白、血红蛋白(A)与多因素模型(B)预测老年脑膜瘤患者术后预后不良的ROC曲线, figureFileSmall=FyLqEtzGMu5d2cMSKk5uMg==, figureFileBig=LgIyOiesaM9QQXGD3t2/Gg==, tableContent=null), ArticleFig(id=1190669339595518647, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=EN, label=Fig.2, caption=Calibration curves for internal validation of modeling sets, figureFileSmall=U9OytUfRW+24ZmCKSfc0jw==, figureFileBig=QdieFBQTydRKdCTlXWdWdQ==, tableContent=null), ArticleFig(id=1190669339662627512, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=CN, label=图2, caption=采用建模集对预测模型进行内部验证的校准曲线, figureFileSmall=U9OytUfRW+24ZmCKSfc0jw==, figureFileBig=QdieFBQTydRKdCTlXWdWdQ==, tableContent=null), ArticleFig(id=1190669339721347769, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=EN, label=Fig.3, caption=Dose-response relationship between postoperative albumin (A), postoperative hemoglobin (B), and poor postoperative prognosis based on a restricted cubic spline model, figureFileSmall=dcoCzUQyjtUZ6zdb+2e3Nw==, figureFileBig=rvVeK4nlEjUr7RobasDihg==, tableContent=null), ArticleFig(id=1190669339784262330, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=CN, label=图3, caption=基于RCS模型分析术后白蛋白(A)、术后血红蛋白(B)与术后预后不良的剂量反应关系, figureFileSmall=dcoCzUQyjtUZ6zdb+2e3Nw==, figureFileBig=rvVeK4nlEjUr7RobasDihg==, tableContent=null), ArticleFig(id=1190669339842982587, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=EN, label=Fig.4, caption=Decision curves of postoperative albumin and hemoglobin levels and the multifactor model, figureFileSmall=DQPzn9o9iednc7VCuMReIg==, figureFileBig=pJdIiqactmbEJKiKIn4/aw==, tableContent=null), ArticleFig(id=1190669339893314236, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=CN, label=图4, caption=术后白蛋白、血红蛋白水平与多因素模型的决策曲线, figureFileSmall=DQPzn9o9iednc7VCuMReIg==, figureFileBig=pJdIiqactmbEJKiKIn4/aw==, tableContent=null), ArticleFig(id=1190669339952034493, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=EN, label=Fig.5, caption=ROC curve and calibration curve for validation set multifactorial model to predict prognosis of elderly postoperative patients with meningiomas, figureFileSmall=zbJ/sbZLUBoXlkv7RHzLOg==, figureFileBig=jtCVSFKpcn6mzV+5n9UPlA==, tableContent=null), ArticleFig(id=1190669340014949054, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=CN, label=图5, caption=验证集中多因素模型预测老年脑膜瘤患者术后预后不良的ROC曲线(A)和校准曲线(B), figureFileSmall=zbJ/sbZLUBoXlkv7RHzLOg==, figureFileBig=jtCVSFKpcn6mzV+5n9UPlA==, tableContent=null), ArticleFig(id=1190669340090446527, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=EN, label=Tab.1, caption=

Unifactorial analysis of poor prognosis in elderly postoperative patients with meningiomas

, figureFileSmall=null, figureFileBig=null, tableContent=
因素

预后良好组

(n=161)

预后不良组

(n=92)

χ2/tP
年龄(岁, $\bar{x}±s$)68.8±2.868.9±3.10.3890.698
男[例(%)]43(26.7)41(44.6)8.4180.004
低蛋白血症[例(%)]85(52.8)67(72.8)9.7940.002
贫血[例(%)]45(28.0)51(55.4)18.782<0.0001
NICU留置时间(d, $\bar{x}±s$)5.13±2.605.69±2.231.7460.082
术后继发性癫痫[例(%)]8(5.0)11(12.0)4.1150.042
肿瘤部位[例(%)]12.1810.032
大脑凸面62(38.5)33(35.9)
鞍区64(39.8)28(30.4)
小脑18(11.2)9(9.8)
脑室4(2.5)6(6.5)
脑干1(0.6)6(6.5)
其他12(7.5)10(10.9)
肾损伤[例(%)]31(19.3)25(27.2)2.1300.144
肝损伤[例(%)]60(37.3)42(45.7)1.7110.191
超敏C反应蛋白升高[例(%)]82(50.9)66(71.7)10.4400.001
WHO分级[例(%)]39.066<0.0001
Ⅰ级140(87.0)47(51.1)
Ⅱ、Ⅲ级21(13.0)45(48.9)
切除程度[例(%)]13.676<0.0001
大体全切除141(87.6)63(68.5)
次全切除20(12.4)29(31.5)
使用镇痛/镇静药物[例(%)]5.3900.020
50(31.1)42(45.7)
111(68.9)50(54.3)
吸烟史[例(%)]59(36.6)34(37.0)0.0020.961
饮酒史[例(%)]56(34.8)34(37.0)0.1210.728
高血压[例(%)]62(38.5)39(42.4)0.3680.544
糖尿病[例(%)]26(16.1)13(14.1)0.1830.669
冠心病[例(%)]15(9.3)12(13.0)0.8530.356
使用激素[例(%)]43(26.7)27(29.3)0.2040.652
BMI[例(%)]5.2510.154
<18.5 kg/m27(4.3)2(2.2)
18.5~23.9 kg/m269(42.9)35(38.0)
24.0~27.9 kg/m263(39.1)48(52.2)
), ArticleFig(id=1190669340216275648, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=CN, label=表1, caption=

老年脑膜瘤患者术后预后不良的单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素

预后良好组

(n=161)

预后不良组

(n=92)

χ2/tP
年龄(岁, $\bar{x}±s$)68.8±2.868.9±3.10.3890.698
男[例(%)]43(26.7)41(44.6)8.4180.004
低蛋白血症[例(%)]85(52.8)67(72.8)9.7940.002
贫血[例(%)]45(28.0)51(55.4)18.782<0.0001
NICU留置时间(d, $\bar{x}±s$)5.13±2.605.69±2.231.7460.082
术后继发性癫痫[例(%)]8(5.0)11(12.0)4.1150.042
肿瘤部位[例(%)]12.1810.032
大脑凸面62(38.5)33(35.9)
鞍区64(39.8)28(30.4)
小脑18(11.2)9(9.8)
脑室4(2.5)6(6.5)
脑干1(0.6)6(6.5)
其他12(7.5)10(10.9)
肾损伤[例(%)]31(19.3)25(27.2)2.1300.144
肝损伤[例(%)]60(37.3)42(45.7)1.7110.191
超敏C反应蛋白升高[例(%)]82(50.9)66(71.7)10.4400.001
WHO分级[例(%)]39.066<0.0001
Ⅰ级140(87.0)47(51.1)
Ⅱ、Ⅲ级21(13.0)45(48.9)
切除程度[例(%)]13.676<0.0001
大体全切除141(87.6)63(68.5)
次全切除20(12.4)29(31.5)
使用镇痛/镇静药物[例(%)]5.3900.020
50(31.1)42(45.7)
111(68.9)50(54.3)
吸烟史[例(%)]59(36.6)34(37.0)0.0020.961
饮酒史[例(%)]56(34.8)34(37.0)0.1210.728
高血压[例(%)]62(38.5)39(42.4)0.3680.544
糖尿病[例(%)]26(16.1)13(14.1)0.1830.669
冠心病[例(%)]15(9.3)12(13.0)0.8530.356
使用激素[例(%)]43(26.7)27(29.3)0.2040.652
BMI[例(%)]5.2510.154
<18.5 kg/m27(4.3)2(2.2)
18.5~23.9 kg/m269(42.9)35(38.0)
24.0~27.9 kg/m263(39.1)48(52.2)
), ArticleFig(id=1190669340291773121, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=EN, label=Tab.2, caption=

Multifactor logistic regression analysis assignment table

, figureFileSmall=null, figureFileBig=null, tableContent=
因素赋值
性别女=0,男=1
术后低蛋白血症无=0,有=1
术后贫血无=0,有=1
术后继发性癫痫无=0,有=1
肿瘤部位其他=0,大脑凸面=1,鞍区=2,小脑=3,脑室=4,脑干=5
超敏C反应蛋白升高无=0,有1
WHO分级Ⅰ级=0,Ⅱ级和Ⅲ级=1
肿瘤切除程度次全切除=0,大体全切除=1
镇静/镇痛药物不使用=0,使用=1
预后情况良好=0,不良=1
), ArticleFig(id=1190669340354687682, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=CN, label=表2, caption=

多因素logistic回归分析各变量赋值表

, figureFileSmall=null, figureFileBig=null, tableContent=
因素赋值
性别女=0,男=1
术后低蛋白血症无=0,有=1
术后贫血无=0,有=1
术后继发性癫痫无=0,有=1
肿瘤部位其他=0,大脑凸面=1,鞍区=2,小脑=3,脑室=4,脑干=5
超敏C反应蛋白升高无=0,有1
WHO分级Ⅰ级=0,Ⅱ级和Ⅲ级=1
肿瘤切除程度次全切除=0,大体全切除=1
镇静/镇痛药物不使用=0,使用=1
预后情况良好=0,不良=1
), ArticleFig(id=1190669340413407939, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=EN, label=Tab.3, caption=

Multifactorial logistic regression analysis of poor prognosis in elderly postoperative patients with meningiomas

, figureFileSmall=null, figureFileBig=null, tableContent=
因素偏回归系数标准误Wald χ2POR95%CI
术后低蛋白血症0.7860.3624.7040.0302.1941.079~4.462
术后贫血0.7500.3364.9890.0262.1171.096~4.089
WHO分级(Ⅱ、Ⅲ级)1.3850.36214.597<0.00013.9941.963~8.126
使用镇痛/镇静药物-0.9470.3358.0020.0050.3880.201~0.748
常量-2.9830.88311.4160.0010.051-
), ArticleFig(id=1190669340476322500, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=CN, label=表3, caption=

老年脑膜瘤患者术后预后不良的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素偏回归系数标准误Wald χ2POR95%CI
术后低蛋白血症0.7860.3624.7040.0302.1941.079~4.462
术后贫血0.7500.3364.9890.0262.1171.096~4.089
WHO分级(Ⅱ、Ⅲ级)1.3850.36214.597<0.00013.9941.963~8.126
使用镇痛/镇静药物-0.9470.3358.0020.0050.3880.201~0.748
常量-2.9830.88311.4160.0010.051-
), ArticleFig(id=1190669340568597189, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=EN, label=Tab.4, caption=

Comparison of independent predictors and the predictive effect of multifactorial models in elderly patients with postoperative meningiomas

, figureFileSmall=null, figureFileBig=null, tableContent=
指标AUC95%CI最佳截断值敏感度(%)特异度(%)P
多因素模型0.8100.754~0.8670.55386.366.30.001
术后血红蛋白0.6320.561~0.702118.5 g/L59.663.00.001
术后白蛋白0.5450.472~0.61735.1 g/L46.068.50.237
), ArticleFig(id=1190669341575230150, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669165867446504, language=CN, label=表4, caption=

老年脑膜瘤患者术后的独立预测指标及多因素模型的预测效果比较

, figureFileSmall=null, figureFileBig=null, tableContent=
指标AUC95%CI最佳截断值敏感度(%)特异度(%)P
多因素模型0.8100.754~0.8670.55386.366.30.001
术后血红蛋白0.6320.561~0.702118.5 g/L59.663.00.001
术后白蛋白0.5450.472~0.61735.1 g/L46.068.50.237
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白蛋白、血红蛋白及多因素模型对老年脑膜瘤患者术后预后不良的预测价值
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拱艳羽 1 , 曲虹 2, * , 冯思哲 2 , 于春泳 2 , 杜金伟 1 , 蒋金 2
解放军医学杂志 | 临床研究 2025,50(4): 418-426
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解放军医学杂志 | 临床研究 2025, 50(4): 418-426
白蛋白、血红蛋白及多因素模型对老年脑膜瘤患者术后预后不良的预测价值
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拱艳羽1, 曲虹2, * , 冯思哲2, 于春泳2, 杜金伟1, 蒋金2
作者信息
  • 1中国医科大学北部战区总医院研究生培养基地,辽宁沈阳 110016
  • 2北部战区总医院神经外科,辽宁沈阳 110016
  • 拱艳羽,硕士研究生,主要从事神经重症基础与临床方面的研究

通讯作者:

曲虹,E-mail:
Predictive value of albumin, hemoglobin, and multifactorial model for poor postoperative prognosis in elderly patients with meningiomas
Yan-Yu Gong1, Hong Qu2, * , Si-Zhe Feng2, Chun-Yong Yu2, Jin-Wei Du1, Jin Jiang2
Affiliations
  • 1Training Base for Graduate, General Hospital of Northern Theater Command, China Medical University, Shenyang, Liaoning 110016, China
  • 2Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, Liaoning 110016, China
出版时间: 2025-04-28 doi: 10.11855/j.issn.0577-7402.0115.2024.0929
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目的 探讨白蛋白、血红蛋白及多因素模型对老年脑膜瘤患者术后预后不良的预测价值。方法 回顾性纳入北部战区总医院2019年1月-2021年9月收治的253例老年脑膜瘤术后转入神经外科重症监护病房(NICU)治疗的患者作为建模集,2021年11月-2023年6月收治的227例老年脑膜瘤术后转入NICU治疗的患者作为验证集。根据格拉斯哥昏迷评分(GCS)将建模集患者分为预后良好组(GCS评分>7分,n=161)与预后不良组(GCS评分≤7分,n=92)。使用建模集进行单因素和多因素logistic回归分析以确定独立危险因素,并据此构建预测老年脑膜瘤患者术后预后不良的多因素模型。通过受试者操作特征(ROC)曲线下面积(AUC)、敏感度、特异度、Hosmer-Lemeshow拟合优度检验以及校准曲线评价模型的预测效能和准确度。通过限制性立方样条模型(RCS)、决策曲线(DCA)评估术后白蛋白、血红蛋白及多因素模型对老年脑膜瘤患者术后预后的预测价值,使用验证集进行验证以评估模型的稳定性。结果 脑膜瘤WHO Ⅱ级和Ⅲ级(OR=3.994,95%CI 1.963~8.126)、术后低蛋白血症(OR=2.194,95%CI 1.079~4.462)、术后贫血(OR=2.117,95%CI 1.096~4.089)是老年脑膜瘤患者术后预后不良的独立危险因素(P<0.05),而使用镇痛/镇静药物是其保护因素(OR=0.388,95%CI 0.201~0.748,P<0.05)。Hosmer-Lemeshow检验显示,所构建的多因素模型拟合准确度良好(P=0.161)。术后白蛋白、血红蛋白预测老年脑膜瘤患者术后预后不良的AUC分别为0.545(95%CI 0.472~0.617)、0.632(95%CI 0.561~0.702),且与预后不良呈非线性剂量反应关系(P<0.01)。DCA分析结果显示,阈值概率为0.10~0.90时,多因素模型较术后白蛋白、血红蛋白的净获益率高。该模型在建模集和验证集中预测老年脑膜瘤患者术后预后的AUC分别为0.810和0.819,其校准曲线提示区分度、准确度较好。结论 脑膜瘤WHO Ⅱ级和Ⅲ级、术后贫血及低蛋白血症是老年脑膜瘤患者术后预后不良的独立危险因素,而使用镇痛/镇静药物为其保护因素;基于此构建的多因素模型具有良好的预测效能,可信度较高,可用于临床决策的参考。

血红蛋白  /  多因素模型  /  老年  /  脑膜瘤  /  预后

Objective To explore the predictive value of albumin, hemoglobin and multifactorial model for poor postoperative prognosis in elderly patients with meningioma. Methods A retrospective analysis was conducted on 253 elderly patients who underwent meningioma surgery and were transferred to the neurosurgical intensive care unit (NICU) at General Hospital of Northern Theater Command from January 2019 to September 2021, serving as the modeling cohort. Another 227 elderly patients who were treated in NICU after meningioma surgery from November 2021 to June 2023 were used as the validation cohort. Patients in the modeling cohort were categorized into good prognosis group [Glasgow Coma Scale (GCS) score>7, n=161] and poor prognosis group (GCS≤7, n=92) based on the GCS. Univariate and multifactorial logistic regression analyses were performed on the modeling cohort to identify independent risk factors, and a multifactorial model for predicting poor postoperative prognosis in elderly patients with meningioma was constructed based on these factors. The predictive efficacy and accuracy of the model were evaluated using the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, Hosmer-Lemeshow goodness-of-fit test, and calibration curves. The predictive value of postoperative albumin, hemoglobin, and the multifactorial models for postoperative prognosis in elderly meningioma patients was assessed using restricted cubic spline modeling (RCS), decision curves (DCA), and validated using an external validation cohort to assess the stability of the model. Results Meningioma WHO grade Ⅱ and Ⅲ (OR=3.994, 95%CI 1.963-8.126), postoperative hypoalbuminemia (OR=2.194, 95%CI 1.079-4.462), and postoperative anemia (OR=2.117, 95%CI 1.096-4.089) were identified as independent risk factors for poor postoperative prognosis in elderly meningioma patients (P<0.05), while the use of analgesic/sedative medications was a protective factor (OR=0.388, 95%CI 0.201-0.748, P<0.05). The Hosmer-Lemeshow test indicated that the constructed multifactorial model had a good fit accuracy (P=0.161). The AUC for predicting poor postoperative prognosis in elderly meningioma patients for postoperative albumin and hemoglobin were 0.545 (95%CI 0.472-0.617) and 0.632 (95%CI 0.561-0.702), respectively, and showed a nonlinear dose-response relationship with prognosis (P<0.01). DCA analysis results showed that the net benefit rate of multifactorial model was higher than that of postoperative albumin and hemoglobin when the threshold probabilities were between 0.10 and 0.90. The AUC for predicting postoperative prognosis in the elderly meningioma patients in the modeling and validation cohorts were 0.810 and 0.819, respectively, and their calibration curves suggested good discrimination and accuracy. Conclusions Meningioma WHO grades Ⅱ and Ⅲ, postoperative anemia and hypoalbuminemia are independent risk factors for poor postoperative prognosis in elderly meningioma patients, while the use of analgesic/sedative drugs is a protective factor. The multifactorial model constructed based on these factors has a good predictive efficacy and credibility, and can be used as a reference for clinical decision-making.

hemoglobin  /  multifactorial model  /  elderly  /  meningioma  /  prognosis
拱艳羽, 曲虹, 冯思哲, 于春泳, 杜金伟, 蒋金. 白蛋白、血红蛋白及多因素模型对老年脑膜瘤患者术后预后不良的预测价值. 解放军医学杂志, 2025 , 50 (4) : 418 -426 . DOI: 10.11855/j.issn.0577-7402.0115.2024.0929
Yan-Yu Gong, Hong Qu, Si-Zhe Feng, Chun-Yong Yu, Jin-Wei Du, Jin Jiang. Predictive value of albumin, hemoglobin, and multifactorial model for poor postoperative prognosis in elderly patients with meningiomas[J]. Medical Journal of Chinese People’s Liberation Army, 2025 , 50 (4) : 418 -426 . DOI: 10.11855/j.issn.0577-7402.0115.2024.0929
脑膜瘤是常见的中枢神经系统肿瘤和原发性颅内肿瘤,起源于硬脑膜内表面的蛛网膜细胞,约占中枢神经系统肿瘤的37.6%[1-3],发病率约为8.58/10万,且随着年龄的增长而增高[4-5]。随着中国老龄化加剧,截至2022年末,全国65岁及以上老年人口为20 978万,占总人口的14.9%[6];肿瘤学界认为脑肿瘤患者诊断的中位年龄为65岁,65岁及以上的脑膜瘤患者显著增多[7]。目前,手术切除是脑膜瘤的常规治疗方法[8]。而脑膜瘤本身产生的重要结构受累、占位效应、高级别组织学等均会引发诸多严重并发症(癫痫、意识障碍、感染、瘫痪等)[9]。因此,脑膜瘤患者术后常需转入神经外科重症监护病房(neurological intensive care unit,NICU)进一步治疗。老年患者因患有多种慢性疾病且术前功能状态较差,故对手术耐受性差,术后并发症发生率高等[10-11],常导致术后康复不能达到预期效果。目前尚无统一且有效的指标可预测老年脑膜瘤术后患者的预后,因此,建立预后不良发生风险的预测模型对于提高我国脑膜瘤的诊断与治疗水平具有重要意义。本研究旨在探究老年脑膜瘤患者术后预后不良的独立危险因素,构建预测模型并进行验证,以期早期识别预后不良的高危患者并对其进行临床干预,缩短此类患者的住院时间,减轻其经济负担,改善其生活质量。
回顾性纳入2019年1月-2021年9月北部战区总医院收治的253例老年脑膜瘤术后转入NICU治疗的患者作为建模集,2021年11月-2023年6月收治的227例老年脑膜瘤术后转入NICU治疗的患者作为验证集。建模集中男84例,女169例,年龄(68.8±2.9)岁,随访期间死亡5例(2.0%),复发17例(6.7%);验证集中男78例,女149例,年龄(69.2±2.9)岁,随访期间死亡3例(1.3%),复发14例(6.2%)。纳入标准:(1)年龄≥65岁;(2)首次发现并经手术病理确诊为脑膜瘤;(3)接受手术治疗,术前意识清楚,术后安返NICU进行监护。排除标准:(1)存在急性脑血管疾病;(2)既往有脑部手术史;(3)主动放弃治疗;(4)资料不全或缺失;(5)合并其他肿瘤。从NICU转出后通过定期随访或复查,对建模集患者进行格拉斯哥昏迷评分法(Glasgow coma scale,GCS)评估。根据患者转出6个月时的GCS评分结果将其分为预后良好组(GCS评分>7分,n=161)与预后不良组(GCS评分≤7分,n=92)。本研究符合《赫尔辛基宣言》中的伦理要求,并通过北部战区总医院医学伦理委员会审批[伦审Y(2024)084号]。
所有患者手术均在全身麻醉下进行。麻醉诱导:术前静注东莨菪碱注射液和盐酸吗啡注射液,麻醉医师完成气管插管。麻醉维持:持续泵入枸橼酸芬太尼注射液、丙泊酚注射液并吸入七氟醚,间断静注罗库溴铵注射液。手术时用头架固定头部,肿瘤部位朝上。麻醉生效后,常规切开头皮,头皮夹止血,用铣刀或线锯开颅,切开硬脑膜后暴露肿瘤,较小的肿瘤从周边逐渐分离,而较大的肿瘤需进行瘤内切除,减少对周围脑组织的牵拉。观察患者生命体征及血气指标,对纱布器械进行清点,双人确认无误后关颅。待患者指标平稳后安返NICU进行监护观察。
生命体征较平稳、脱离呼吸机、血流动力学基本稳定、不需要使用特殊生理检测仪、并发症已稳定控制、已脱离急性期。具体指征:自主呼吸<30次/min,脉搏血氧饱和度≥95%,氧分压≥60 mmHg,二氧化碳分压≤45 mmHg,50 mmHg<收缩压<140 mmHg,有创颅内压(intracranial pressure,ICP)[12]≤180 mmH2O,血红蛋白≥110 g/L,头颅CT示水肿消退且无新发出血。
收集患者的临床资料,包括年龄、性别、NICU留置时间、饮酒史、吸烟史、高血压、体重指数(body mass index,BMI)、冠心病、脑膜瘤世界卫生组织(WHO)分级、肿瘤部位、糖尿病、手术切除程度,术后留置NICU期间是否出现贫血、低蛋白血症和继发性癫痫,超敏C反应蛋白是否升高,是否有肾损伤、肝损伤,以及是否使用糖皮质激素和镇痛/镇静药物等。
血清白蛋白<35 g/L认定为低蛋白血症;男性血红蛋白<120 g/L,女性血红蛋白<110 g/L认定为贫血;超敏C反应蛋白增高>3 mg/L认定为升高;谷丙转氨酶>40 U/L认定为肝损伤;肌酐>110 μmol/L和尿素氮>7.1 mmol/L认定为肾损伤[13]。脑膜瘤常见部位为大脑凸面、鞍区、小脑、脑室、脑干和其他。WHO根据脑膜瘤的病理特征将其分为三级[14],良性脑膜瘤(WHO Ⅰ级)可以采取单独手术的方法进行治疗,非典型脑膜瘤(WHO Ⅱ级)和间变性脑膜瘤(WHO Ⅲ级)除手术治疗外还需要辅助放疗或化疗。参考Simpson分级,脑膜瘤手术切除分为Ⅰ-Ⅴ级,欧洲神经肿瘤学协会(European Association of Neuro-Oncology,EANO)指南指出,手术切除程度分为大体全切除术(GTR,Simpson Ⅰ-Ⅲ级)和次全切除术(STR,Simpson Ⅳ-Ⅴ级)[8]
采用SPSS 26.0及R 4.3.2软件进行统计分析。符合正态分布的计量资料以$\bar{x}±s$表示,组间比较采用t检验;计数资料以例(%)表示,组间比较采用χ2检验;采用多因素logistic回归模型分析老年脑膜瘤患者术后预后不良的独立危险因素,建立多因素模型,使用Hosmer-Lemeshow检验对模型进行拟合优度检验。将独立危险因素作为预测指标绘制受试者操作特征(receiver operator characteristic,ROC)曲线,使用约登(Youden)指数得出最佳截断值。通过R程序4.3.2版本,采用限制性立方样条(restricted cubic spline,RCS)法分析独立危险因素与老年脑膜瘤患者术后预后不良发生风险的关系。采用决策曲线(decision curve analysis,DCA)评估独立危险因素及多因素风险预测模型对老年脑膜瘤患者术后预后的预测价值。在训练集与验证集中,分别绘制ROC曲线评估模型的区分度,通过Bootstrap法重抽样1000次进行验证,分别绘制校准曲线评估模型的校准度。P<0.05为差异有统计学意义。
建模集中共253例患者,其中男84例,女169例;预后良好组161例,预后不良组92例。两组性别、肿瘤部位、WHO分级、手术切除程度,术后留置NICU期间是否出现贫血和低蛋白血症、是否发生继发性癫痫、超敏C反应蛋白是否升高、镇痛/镇静药使用情况等差异均有统计学意义(P<0.05);两组年龄、NICU留置时间、饮酒史、吸烟史、高血压、BMI、冠心病、糖尿病,术后留置NICU期间是否有肾损伤和肝损伤、是否使用激素等差异均无统计学意义(P>0.05,表1)。
将单因素分析筛选出的9个因素纳入多因素logistic回归模型中(各变量赋值如表2所示),结果显示,脑膜瘤WHO Ⅱ级和Ⅲ级、术后留置NICU期间贫血及低蛋白血症是老年脑膜瘤患者术后预后不良的独立危险因素(P<0.05),使用镇痛/镇静药物为其保护因素(P<0.05,表3)。
老年脑膜瘤患者术后预后不良的预测方程为Logit(P)=0.786(术后低蛋白血症)+0.750(术后贫血)+1.385(脑膜瘤WHO分级Ⅱ、Ⅲ级)-0.947(使用镇痛/镇静药物)-2.983。Hosmer-Lemeshow拟合度检验显示,χ2=11.779,P=0.161,表明模型的准确度良好。绘制ROC曲线评估术后白蛋白、血红蛋白及多因素模型对术后预后不良的预测价值(图1),通过计算Youden指数,获得最佳截断值分别为35.10 g/L、118.5 g/L、0.553,敏感度分别为46.0%、59.6%、86.3%,特异度分别为68.5%、63.0%、66.3%(表4)。校准曲线分析结果显示,预测概率与实际概率接近,提示该模型具有良好的区分度、校准和预测能力(图2)。
使用RCS函数分析术后白蛋白、血红蛋白与老年脑膜瘤患者术后预后不良的剂量反应关系,以术后白蛋白、血红蛋白连续变化为横坐标,以OR值为纵坐标,95%CI由阴影部分所表示,将术后白蛋白34.15 g/L、术后血红蛋白120.05 g/L设定为参考值(图3)。术后白蛋白、术后血红蛋白的连续变化与老年脑膜瘤患者术后预后不良的关联强度均为非线性剂量反应关系,呈负相关(P<0.01)。当术后白蛋白<34.15 g/L时,随着其水平升高,老年脑膜瘤患者术后预后不良的发生风险明显下降;当术后血红蛋白<120.05 g/L时,随着其水平升高,老年脑膜瘤患者术后预后不良的发生风险也明显下降。
DCA分析结果如图4所示,多因素模型的净受益率随高风险阈值增加而逐渐下降,下降速度逐渐加快。高风险阈值越小,多因素模型净获益率越高。高风险阈值在0.10~0.90范围时,多因素模型净获益率高于术后白蛋白、血红蛋白。
使用验证集对老年脑膜瘤患者术后预后不良的多因素模型进行验证,绘制ROC曲线,其AUC为0.819(95%CI 0.760~0.878),约登指数为0.553(P<0.05),敏感度为84.9%,特异度为70.4%(图5A)。校准曲线分析结果显示,该模型具有良好的区分度与精准度(图5B)。
脑膜瘤是一种常见的脑部肿瘤,年龄是该病患者预后不良的危险因素[15-16]。目前,随着人口老龄化进程的加快,老年人口的健康问题越来越受到关注。老年患者常伴有健康状况不佳、手术耐受性低、术后并发症发生率高等情况,术后预后不佳。传统的神经外科评分标准如GCS评分、肌力分级、格拉斯哥预后评分(GOS)、远期生活质量评估(Karnofsky performance scale)等无法充分利用多层次、多维度的数据准确反映老年脑膜瘤患者的不良预后,难以准确评估老年脑膜瘤患者术后的身体状况。如何对老年脑膜瘤患者术后进行快速、准确地评估,预测不良预后的发生,及早干预,改善患者的临床预后是目前神经重症领域研究的重点和难点。
校准曲线是评价logistic回归模型效能的重要工具之一,可反映模型的预测概率与实际概率之间的关系[17],以及模型估计事件的概率是否准确。Hosmer-Lemeshow拟合优度检验可用于评估模型的校准性。ROC曲线常被用来比较不同模型的效能以及评判预测模型的优劣,主要是利用AUC衡量模型预测的准确性,AUC越接近于1,表示模型的效能越良好。但AUC并未综合考虑特定模型的临床诊断效果,而DCA充分考虑了临床实用性,是一种新兴的、越来越流行的以预期受益高于预期损失为理论基础的决策分析方法,可用于评估预测模型对医疗决策的价值[18-19],更倾向于将临床决策与“净益处”联系起来,直观地比较不同决策方法的优劣。但目前临床上对于阈值概率的选择问题尚未达成一致,因此DCA在医学领域中未被普遍应用。本研究使用校准曲线及ROC曲线判断术后白蛋白、血红蛋白及多因素模型预测老年脑膜瘤患者术后发生预后不良的准确性,通过DCA量化分析且直观展示在给定阈值范围内的临床效益。本研究中,在阈值概率>0.10时,多因素模型较术后白蛋白、血红蛋白预测老年脑膜瘤患者术后预后不良的发生有更高的净获益率。同时选择RCS对术后白蛋白、血红蛋白与老年脑膜瘤患者术后预后不良进行拟合和建模,显示二者呈非线性剂量反应关系。通过验证集进行模型验证,其校准曲线及ROC曲线提示该模型具有良好的准确度和区分度。
研究显示,白蛋白、血红蛋白是预测多种实体瘤患者预后的生物标志物[20-23],但特异性不强,仅可作为预测患者病情严重程度和预后的参考依据。血红蛋白可以反映机体的贫血程度。当血红蛋白低于正常范围时,易发生低氧血症,影响脑组织的氧合[24-26];还可导致外周动脉收缩,心脏后负荷明显增加,心室每搏输出量减少,脑部小动脉痉挛,脑组织低灌注,增加脑组织缺氧等,与预后不良紧密相关。白蛋白是人体血浆中的主要蛋白质,可反映机体的营养状态[27],白蛋白低于正常范围表明患者营养状态差,会影响脑部的血液循环,使大脑供氧不足,导致神经递质不能正常分泌,易诱发认知障碍,与预后不良相关。老年患者由于胃肠功能减弱、应激性溃疡出血常出现营养不良和慢性失血,在NICU期间引发低蛋白血症和贫血的概率较高。Guo等[15]发现,脑膜瘤患者血清白蛋白水平降低与不良预后相关。王加充等[28]发现,良性脑膜瘤患者术中出血量过多或发生失血性休克可影响术后预后。本研究中,低蛋白血症与贫血可显著影响老年脑膜瘤患者住NICU期间的预后。术后血红蛋白水平低于正常范围引发的贫血是老年脑膜瘤患者术后预后不良的独立危险因素,其AUC为0.632,以118.5 g/L为最佳截断值时,预测老年脑膜瘤患者术后预后不良的敏感度为59.6%、特异度为63.0%。从AUC、敏感度及特异度可知,术后血红蛋白较术后白蛋白的预测效能更高。老年患者的脑血管硬化常较严重,血管壁弹性较差,存在不同程度的脑组织萎缩[29]。而血管弹性的变化和服用抗血小板或抗凝药物可能增加术中出血量,增加止血难度[30],易导致术后出现贫血、血红蛋白水平低等情况。
超敏C反应蛋白是与炎症反应相关的标志物。本研究中,老年脑膜瘤患者术后NICU治疗期间,超敏C反应蛋白水平升高,预后不良发生率明显增高。由此可见,颅内出现炎症反应可增加术后并发症的发生风险,导致术后恢复延迟,影响预后。侵入性手术可对脑组织造成严重损伤,术后炎性因子的大量释放还可导致严重的脑组织水肿,增加肿瘤床再次出血的风险。脑膜瘤患者术后可能并发癫痫,导致脑组织缺血、缺氧加重,引起脑积水、脑出血等并发症。本研究中术后发生继发性癫痫19例,约占7.5%(19/253);多因素logistic回归分析显示,术后继发性癫痫与老年脑膜瘤患者术后预后相关,但并非独立危险因素,归因于术后给予患者镇痛/镇静药物;本研究中使用镇痛/镇静药物的患者共161例,约占63.6%(161/253)。研究发现,应用镇痛/镇静药物可降低患者术后不良反应的发生率[31],预防术后癫痫的发生,减少躁动,保持血压平稳,降低颅内再出血和水肿加重的风险,缓解疼痛。本研究多因素logistic分析结果显示,使用镇痛/镇静药物可影响老年脑膜瘤患者术后的预后,为其保护因素。
肿瘤部位、WHO分级、手术切除程度均可影响老年脑膜瘤患者术后的预后情况[32-33],是预后不良的影响因素;本研究多因素logistic回归分析进一步显示,WHO Ⅱ级和Ⅲ级是老年脑膜瘤患者术后预后不良的独立危险因素(P<0.05),但肿瘤部位、手术切除程度与术后预后不良相关性不明显(P>0.05)。另有研究发现,脑膜瘤的肿瘤部位与术后预后相关,但不是老年脑膜瘤患者术后预后不良的独立危险因素[34-36]。脑膜瘤分级对于评估脑膜瘤的预后具有重要意义[37],非典型脑膜瘤(WHO Ⅱ级)和间变性脑膜瘤(WHO Ⅲ级)的治疗通常采取手术与放疗或化疗相结合[38];黄冠又等[39]对176例脑膜瘤患者进行分析发现,WHO Ⅱ级和Ⅲ级可增加脑膜瘤患者术后预后不良的发生风险。本研究结果显示,WHO Ⅱ级和Ⅲ级是老年脑膜瘤患者术后预后不良的独立危险因素。
目前,手术切除程度对患者预后的影响仍存在较多争议。王加充等[28]的研究显示,肿瘤切除级别低即GTR是脑膜瘤患者术后预后不良的独立危险因素。魏少伟[40]认为,最大程度地切除可导致围手术期死亡率和并发症发生率增高。而Guo等[15]分析了1443例脑膜瘤患者的临床资料后认为,接受GTR治疗的患者预后优于接受STR的患者,STR是术后严重并发症的独立危险因素。本研究结果显示,老年脑膜瘤患者的预后与切除程度有关,但不是其独立危险因素。多数患者接受GTR治疗可降低复发率,但由于老年患者基础条件较差,对开颅手术的耐受性较差,完全切除瘤体与其附着的硬脑膜、颅骨及受累的组织,可能会出现正常组织牵拉严重等情况,导致预后不良[41]。此外,部分肿瘤所在的部位解剖结构复杂,周围附着重要的血管及神经,在开颅后仅能行颅内减压,此时,对高龄患者采用STR可获得更好的临床收益。从外科手术和颅内解剖的角度来看,肿瘤的位置越浅,越容易切除,预后越好[42];而肿瘤靠近颅底生长并包绕重要神经和大血管时,剥离全部肿瘤组织并最大限度保持神经功能完整的手术难度极高,术后发生不良事件的风险同样增加。所以在手术过程中,应将术中的实际情况与患者的具体情况相结合,权衡利弊,慎重决定切除范围,以降低手术风险,改善患者预后,提高患者生存质量,降低复发率。
综上所述,本研究结果表明,脑膜瘤WHO Ⅱ级和Ⅲ级、术后贫血及低蛋白血症是老年脑膜瘤患者术后预后不良的独立危险因素,而使用镇痛/镇静药物为其保护因素。联合多种因素建立的预测模型可较好地预测老年脑膜瘤患者术后预后不良的发生,验证结果显示该模型具有较好的准确度和较高的预测价值,临床应用价值较高。医护人员在临床决策中应用DCA可帮助患者提高净获益率。对于老年脑膜瘤患者术后应关注脑膜瘤分级,避免术后出现营养不良及贫血,谨慎选择手术方案,以期改善预后,减轻经济负担,使其受益最大化。本研究仍存在一定的局限性,如为单中心回顾性研究,病例来源局限,样本量有限。未来可针对性地开展多中心前瞻性队列研究,得到更加准确的结果,以全面分析老年脑膜瘤患者术后的转归及影响因素。
  • 辽宁省科技计划(2021JH2/10300116)
  • 辽宁省科技计划(2022JH2/101500037)
参考文献 引证文献
排序方式:
[1]
Ostrom QT, Price M, Neff C, et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the united states in 2016-2020[J]. Neuro Oncol, 2023, 25(12 Suppl 2): iv1-iv99.
[2]
Walsh KM. Epidemiology of meningiomas[J]. Handb Clin Neurol, 2020, 169: 3-15.
[3]
黄冠又, 郝淑煜, 冯洁, 等. NF2基因多态性与脑膜瘤预后的相关性[J]. 解放军医学杂志, 2023, 48(9): 1061-1068.
[4]
Nakasu S, Notsu A, Nakasu Y. Prevalence of incidental meningiomas and gliomas on MRI: a meta-analysis and meta-regression analysis[J]. Acta Neurochir (Wien), 2021, 163(12): 3401-3415.
[5]
Withrow DR, Devesa SS, Deapen D, et al. Nonmalignant meningioma and vestibular schwannoma incidence trends in the United States, 2004-2017[J]. Cancer, 2021, 127(19): 3579-3590.
[6]
安娜. 《2022年度国家老龄事业发展公报》发布[J]. 社会与公益, 2023, (12): 7.
[7]
Preusser M, Brastianos PK, Mawrin C. Advances in meningioma genetics: novel therapeutic opportunities[J]. Nat Rev Neurol, 2018, 14(2): 106-115.
[8]
Goldbrunner R, Stavrinou P, Jenkinson MD, et al. EANO guideline on the diagnosis and management of meningiomas[J]. Neuro Oncol, 2021, 23(11): 1821-1834.
[9]
Akimoto T, Yoshikawa H, Fushimi S, et al. Surgical complications and recurrence factors for asymptomatic meningiomas: a single-center retrospective study[J]. Acta Neurochir (Wien), 2023, 165(5): 1345-1353.
[10]
Rafiq R, Katiyar V, Garg K, et al. Comparison of outcomes of surgery for intracranial meningioma in elderly and young patients-a systematic review and meta-analysis[J]. Clin Neurol Neurosurg, 2021, 207: 106772.
[11]
Li Y, Lu D, Feng D, et al. Management of incidental anterior skull base large and giant meningiomas in elderly patients[J]. J Neurooncol, 2020, 148(3): 481-488.
[12]
中国医师协会心脏重症专业委员会, 中国医药教育协会重症医学专业委员会, 中国研究型医院学会神经再生与修复专业委员会心脏重症脑保护学组, 等. 心脏重症围手术期脑损伤中西医结合诊治专家共识[J]. 解放军医学杂志, 2023, 48(5): 489-500.
[13]
万学红, 卢雪峰. 诊断学[M]. 9版. 北京: 人民卫生出版社, 2018: 238-441.
[14]
Wen PY, Packer RJ. The 2021 WHO classification of tumors of the central nervous system: clinical implications[J]. Neuro Oncol, 2021, 23(8): 1215-1217.
[15]
Guo ZQ, Xia XY, Cao D, et al. A nomogram for predicting the risk of major postoperative complications for patients with meningioma[J]. Neurosurg Rev, 2023, 46(1): 288.
[16]
王壮壮, 刘彦廷, 艾文兵, 等. 脑膜瘤临床特点和预后影响因素分析[J]. 中国现代医药杂志, 2022, 24(7): 1-6.
[17]
卢珮宇, 杨艳, 周华, 等. 接受PD-1抑制剂治疗的肿瘤患者发生肾损伤的风险预测模型构建与评价[J]. 解放军医学杂志, 2023, 48(11): 1328-1337.
[18]
Mijderwijk HJ, Nieboer D. Is my clinical prediction model clinically useful? A primer on decision curve analysis[J]. Acta Neurochir Suppl, 2022, 134: 115-118.
[19]
Vickers AJ, Holland F. Decision curve analysis to evaluate the clinical benefit of prediction models[J]. Spine J, 2021, 21(10): 1643-1648.
[20]
徐天波, 刘德国, 顾增辉, 等. 衰老基因在骨肉瘤治疗、预后及肿瘤微环境中的作用研究[J]. 解放军医学杂志, 2024, 49(5): 557-569.
[21]
Qi C, Wang L, Duan G. Nutritional and inflammatory immune-based hemoglobin, albumin, lymphocyte, and platelet (HALP) score as a prognostic biomarker in patients with high-risk neuroblastoma[J]. Asian J Surg, 2023, 46(9): 4068-4069.
[22]
Kaya C, Caliskan S, Sungur M, et al. HALP score and albumin levels in men with prostate cancer and benign prostate hyperplasia[J]. Int J Clin Pract, 2021, 75(3): e13766.
[23]
Yalav O, Topal U, Unal AG, et al. Prognostic significance of preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) in patients undergoing curative resection for colorectal cancer[J]. Ann Ital Chir, 2021, 92: 283-292.
[24]
Kurtz P, Helbok R, Claassen J, et al. The effect of packed red blood cell transfusion on cerebral oxygenation and metabolism after subarachnoid hemorrhage[J]. Neurocrit Care, 2016, 24(1): 118-121.
[25]
孙彪, 李保银, 韩宏光, 等. 寒区非体外循环下冠状动脉旁路移植术后低氧血症危险因素分析[J]. 临床军医杂志, 2021, 49(3): 254-256, 260.
[26]
许呢妹, 张爽, 刘志锋. 急性呼吸窘迫综合征的分型及个体化治疗研究进展[J]. 解放军医学杂志, 2023, 48(5): 615-620.
[27]
任江珊, 贾军梅, 孙萍, 等. 高能量代谢肺癌患者临床特征分析及其预测模型建立[J]. 解放军医学杂志, 2024, 49(9): 1004-1010.
[28]
王加充, 赵建农, 王鹏程, 等. 良性脑膜瘤患者术后短期预后的相关因素分析[J]. 中国实用神经疾病杂志, 2013, 16(19): 8-9.
[29]
武宏杰, 车彦军, 鞠东辉, 等. 脑膜瘤术后近期预后影响因素分析[J]. 中华医学杂志, 2011, 91(15): 1051-1054.
[30]
Scotti P, Séguin C, Lo BWY, et al. Antithrombotic agents and traumatic brain injury in the elderly population: hemorrhage patterns and outcomes[J]. J Neurosurg, 2019, 133(2): 486-495.
[31]
孙士梅, 曲虹, 蒋金. 盐酸右美托咪定在颅脑损伤患者术后镇静中疗效及安全性[J]. 创伤与急危重病医学, 2021, 9(4): 294-297.
[32]
Salami AA, Okunlola AI, Ajani MA, et al. WHO classification of meningiomas-a single institutional experience[J]. Neurochirurgie, 2021, 67(2): 119-124.
[33]
Ogasawara C, Philbrick BD, Adamson DC. Meningioma: a review of epidemiology, pathology, diagnosis, treatment, and future directions[J]. Biomedicines, 2021, 9(3): 319.
[34]
韩世文, 洪文明, 宣浩. 85例脑膜瘤患者术后临床结局和复发情况及其影响因素的分析[J]. 立体定向和功能性神经外科杂志, 2022, 35(4): 221-225.
[35]
杨长志, 马媛媛, 杨云云, 等. 良性脑膜瘤术后复发的相关因素及预后分析[J]. 局解手术学杂志, 2020, 29(10): 827-831.
[36]
Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary[J]. Acta Neuropathol, 2016, 131(6): 803-820.
[37]
陈阿静, 隋玉明, 勾荣彬. 单中心107例脑膜瘤临床病理分析[J]. 立体定向和功能性神经外科杂志, 2019, 32(2): 85-88.
[38]
Navarro-Ballester A, Aleixandre-Barrachina M, Marco-Doménech SF. Update on meningioma: clinical-radiological and radio-pathological correlation[J]. Radiologia (Engl Ed), 2023, 65(5): 458-472.
[39]
黄冠又, 郝淑煜, 王亮, 等. 脑膜瘤术后复发生存分析: 附176例报告[J]. 中国现代神经疾病杂志, 2022, 22(11): 993-999.
[40]
魏少伟. 蝶骨嵴脑膜瘤的手术治疗及预后分析[J]. 中国实用神经疾病杂志, 2012, 15(16): 59-60.
[41]
He W, Liu Z, Zheng D, et al. Management of cavernous sinus meningiomas: clinical features, treatment strategies, and long-term outcomes[J]. Asian J Surg, 2024, 47(3): 1366-1377.
[42]
AlKhoshi AM, AlZahrani AA, Shawli FS, et al. Prognostic factors affecting postsurgical outcomes of adult patients with intracranial meningioma: a retrospective study[J]. World Neurosurg, 2023, 180: e281-e287.
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doi: 10.11855/j.issn.0577-7402.0115.2024.0929
  • 接收时间:2024-01-25
  • 首发时间:2025-10-30
  • 出版时间:2025-04-28
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  • 收稿日期:2024-01-25
  • 录用日期:2024-03-22
基金
Science and Technology Plan of Liaoning Province(2021JH2/10300116)
辽宁省科技计划(2021JH2/10300116)
Science and Technology Plan of Liaoning Province(2022JH2/101500037)
辽宁省科技计划(2022JH2/101500037)
作者信息
    1中国医科大学北部战区总医院研究生培养基地,辽宁沈阳 110016
    2北部战区总医院神经外科,辽宁沈阳 110016

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参考文献
分享链接
https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/10.11855/j.issn.0577-7402.0115.2024.0929
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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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