基于体质的缺血性中风病复发风险评估模型建立研究

Construct a risk assessment model for ischemic stroke recurrence based on constitution

目的:构建基于体质的缺血性中风病复发风险评估模型。方法:采用注册登记研究,共纳入1384例首发动脉粥样硬化性缺血性中风病患者的一般信息及发病时的症状和体征等多维度信息,采用Grouplasso Logistic模型辨识缺血性中风病复发的核心危险因素,运用多因素Logistic模型构建基于体质的缺血性中风病复发风险评估模型。结果:痰湿质患者复发风险是2.133倍,95%CI[1.049,4.340];血瘀质患者复发风险是2.585倍,95%CI[1.288,5.188]。基于体质的缺血性中风病复发风险评估模型AUC值为0.766,西医危险因素缺血性中风病复发风险评估模型的AUC值0.718。结论:基于体质的缺血性中风病复发风险评估模型其预测效能更佳,根据数据来源,该模型可能更适用于缺血性中风病中经络和发病时就诊于三级医院的缺血性中风病复发的风险评估。

To construct a risk assessment model for the recurrent ischemic stroke.Registration study was used in this research.The general information of 1 384 patients with first onset atherosclerotic ischemic stroke and the multidimensional information of symptoms and signs were included.The group lasso Logistic model was used to identify the core risk factors for the recurrence of ischemic stroke,and the multiple factor Logistic model was used to construct a risk assessment model for ischemic stroke recurrence based on constitution.The relative risk of recurrence in patients with phlegm dampness constitution is 2.133 times than patients without phlegm dampness constitution patients,95%CI(1.049,4.340)The relative risk of recurrence in patients with blood stasis constitution is 2.585 times than patients without stasis constitution patients,95%CI(1.288,5.188)The prediction ability of the risk assessment model was evaluated.First,based on constitution the risk assessment model recurrent ischemic stroke was 0.766;Second,the calculation only included the risk assessment model of conventional western medicine risk factors.The AUC value was 0.718.Conclusion:The risk assessment model of the recurrent ischemic stroke based on the constitution is more suitable for the national use.This model may be more suitable for the risk assessment of ischemic stroke recurrence in the three level hospital and belong to middle meridian and collaterals of ischemic stroke.