急性脑卒中患者发生认知功能障碍的危险因素分析及风险列线图模型的建立

Risk factors analysis of cognitive dysfunction in patients with acute stroke and establishment of risk nomogram model

目的探讨急性脑卒中(Acute stroke,AI)患者发生认知功能障碍(Post-stroke cognitive dysfunction,PSCD)的危险因素并风险列线图模型。方法将260例AI患者根据是否发生PSCD分为发生PSCD组和未发生PSCD组,采用Logistic二元回归分析筛选出影响AI患者发生PSCD的独立危险因素,利用R软件对筛选出的独立危险因素建立列线图风险预测模型,并对模型的预测性与准确度进行验证。结果Logistic回归分析发现,年龄、文化程度、高血压、糖尿病、体育锻炼、脑血管狭窄等为AI患者发生PSCD的独立危险因素(P<0.05),均与PSCD高度相关;基于上述6项影响因素建立预测AI患者发生PSCD的列线图模型;验证结果显示,该模型具有较高的预测性能,C-index为0.808(95%CI 0.747~0.869)。结论对于AI患者应及时考虑年龄、文化程度、高血压、糖尿病、体育锻炼、脑血管狭窄等综合因素,并通过列线图模型个体化预测AI患者发生PSCD的概率,并尽早做好干预措施,改善患者预后。

Objective To explore the risk factors and risk mapping model of post-stroke cognitive dysfunction(PSCD)in patients with Acute stroke(AI).Methods Two hundred and sixty cases of AI patients were divided into PSCD group and PSCD group according to whether the patients had PSCD.Independent risk factors affecting the occurrence of PSCD in AI patients were screened by Logistic regression analysis.R software was used to establish a risk prediction model for the screened independent risk factors,and the predictive and accuracy of the model were verified.Results Logistic regression analysis showed that age,education level,hypertension,diabetes,physical exercise and cerebrovascular stenosis were independent risk factors for PSCD in AI patients(P<0.05),which were all highly correlated with PSCD.Based on the above 6 influencing factors,a nomogram model was established to predict PSCD in AI patients.The verification results show that the model has a high predictive performance with a C-index of 0.808(95%CI 0.747~0.869).Conclusion Comprehensive factors such as age,education level,hypertension,diabetes,physical exercise and cerebral vascular stenosis should be taken into account in time for AI patients,and the probability of PSCD occurrence in AI patients should be predicted through the individual line map model,and intervention measures should be taken as soon as possible to improve the prognosis of the patients.