卵圆孔未闭并发偏头痛患者的血清学高危因素分析及诊断模型构建OA

Objective To investigate the high-risk factors of patients with patent foramen ovale(PFO)complicated with mi-graine(MA),and to establish and validate a risk diagnostic model based on clinical and laboratory indicators.Methods A retrospec-tive study was conducted on the clinical data of PFO patients admitted to the Sixth Medical Center of Chinese PLA General Hospital from January 1 2021,to December 31 2024.The patients were stratified into groups based on the presence or absence of migraine,and demographic characteristics along with laboratory parameter data were collected.LASSO regression was utilized for feature selection,with selected variables subsequently incorporated into multivariable logistic regression analysis.Odds ratios(OR)and 95%confidence intervals(CI)were reported.Discriminative performance was evaluated by the area under the receiver operating characteristic curve(AUC),calibration performance was assessed through calibration curves and Brier scores,and 10-fold cross-validation was implemen-ted to evaluate the stability of the model.Results A total of 346 patients aged 18-65 years were included.In univariable analyses,age,sex,WBC,gammaglutamyl transferase(GGT),serum creatinine(SCr),homocysteine(HCY),erythrocyte sedimentation rate(ESR),and fibrinogen(FIB)were associated with the outcome of migraine(P<0.05).Multivariable analysis identified elevated HCY as an independent risk factor(OR=1.341,95%CI:1.241-1.463,P<0.001),while lower ESR(OR=0.817,95%CI:0.764-0.867,P<0.001)and age 51-65 years(OR=0.270,95%CI:0.113-0.626,P=0.003)were protective factors.The construc-ted model demonstrated excellent discrimination and calibration(AUC=0.914,95%CI:0.883-0.944),with consistent perform-ance on internal cross-validation.Conclusions Elevated homocysteine(HCY)concentration is a high-risk factor for migraine in pa-tients with PFO,while a lower ESR level and the age range of 51-65 years are protective factors.The multivariable model established based on the screened features exhibits good predictive efficacy and can provide guidance for the risk assessment and personalized man-agement of PFO patients with migraine.