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目的 分析急性脑梗死(acute cerebral infarction,ACI)患者颈动脉易损斑块的独立危险因素,建立并验证个体化预测颈动脉易损斑块的列线图模型.方法 纳入2014年1月—2017年6月于河北北方学院附属第一医院神经内科诊治的ACI患者128例,收集临床资料.应用单因素及多因素Logistic回归模型,分析ACI患者颈动脉易损斑块的独立危险因素.应用R软件构建预测颈动脉易损斑块的列线图模型,并进行验证.结果 多因素Lo?gistic回归分析显示,高血压病(OR=2.966,95%CI:1.267~6.945)、2型糖尿病(OR=3.701,95CI%:1.555~8.813)、LDL(OR=1.006,95CI% :1.001~1.011)、TNF-α(OR=1.281,95CI% :1.066~1.540)及 MMP-9(OR=2.320,95CI% :1.322~4.070)均为颈动脉易损斑块的独立危险因素(P<0.05).对列线图模型进行验证,ROC曲线显示该模型预测颈动脉易损斑块的曲线下面积为0.804(95%CI:0.724~0.884);校准曲线图形为斜率接近于1的直线,Hosmer-Lemeshow拟合优度检验(c2=7.560,P=0.478)均显示该模型预测颈动脉易损斑块具有良好准确度.结论 本研究基于高血压病、2型糖尿病、LDL、TNF-α及MMP-9这5项ACI患者颈动脉易损斑块的独立危险因素,构建的预测颈动脉易损斑块的列线图模型,具有良好的区分度与准确度,可为临床个体化防治ACI提供科学指导.“,”Objective To determine risk factors of carotid vulnerable plaque in patients with acute cerebral infraction (ACI), and develop a nomogram model to predict the risk of carotid vulnerable plaque. Method A total of 128 ACI pa?tients hospitalized at the department of neurology at the First Affiliated Hospital of Hebei North University from January 2014 to June 2017 were included. Uni-and multivariate logistic regression analyses were performed to identify inde?pendent risk factors of carotid vulnerable plaque in ACI patients. A nomogram was developed by R software and validat?ed to predict the risk of carotid vulnerable plaque. Results Multivariate logistic regression analysis revealed that hyper?tension (OR=2.966, 95%CI: 1.267-6.945), type 2 diabetes (OR=3.701, 95CI%: 1.555-8.813), LDL (OR=1.006, 95CI%:1.001-1.011), TNF-α (OR=1.281, 95CI%: 1.066-1.540) and MMP-9 (OR=2.320, 95CI%: 1.322-4.070) were indepen?dent risk factors of carotid vulnerable plaque (P<0.05). Validation of the nomogram: ROC curve revealed that the model predicting carotid vulnerable plaque was with an area under the curve 0.804 (95%CI: 0.724-0.884); the slope of the cali?bration plot was almost one and the model passed Hosmer-Lemeshow goodness of fit test (c2=7.560,P=0.478) which demonstrated that the model was with good accuracy. Conclusions The nomogram predicting carotid vulnerable plaque constructed based on hypertension, type 2 diabetes, LDL, TNF-α, and MMP-9 was with good discrimination and accura?cy, which could provide scientific guidance for individualized prevention and treatment of ACI in clinical practice.