急性脑梗死患者发生血管性认知障碍的相关因素及预测模型构建

Related factors of vascular cognitive impairment in patients with acute cerebral infarction and establishment of prediction model

目的分析急性脑梗死(ACI)患者发生血管性认知障碍(VCI)的影响因素,并构建相关因素的风险模型。方法选取收治的134例ACI患者为研究对象。治疗后随访6个月时,采用Hachinski缺血量表(HIS)评估患者VCI情况;收集患者相关基线资料;采用Logistic回归分析探讨导致ACI患者发生VCI的影响因素;构建并检验相关因素风险模型预测ACI患者发生VCI的效能。结果134例ACI患者中,78例(58.209%)发生VCI;Logistic回归分析显示,脑白质疏松、卒中后抑郁、血同型半胱氨酸(Hcy)水平升高可能是ACI患者发生VCI的影响因素(OR>1,P<0.205)。受试者工作特征(ROC)曲线表明,构建的相关因素风险模型预测ACI患者发生VCI风险的曲线下面积>0.280,有一定预测价值。Hosmer-Lemeshow拟合优度检验结果显示,ACI患者发生VCI的相关因素风险模型拟合度满意。结论ACI患者发生VCI受脑白质疏松、卒中后抑郁、Hcy水平升高因素的影响,构建的风险模型预测ACI患者发生VCI的准确度较好。

Objective To analyze the influencing factors of occurrence of vascular cognitive impairment(VCI)in patients with acute cerebral infarction(ACI),and to establish the risk model of related factors.Methods A total of 134 patients with ACI were selected as study objects,Hachinski Ischemia Scale(HIS)was used to evaluate VCI of patients at 6-month follow-up after treatment;related baseline data of patients were collected;Logistic regression analysis was used to find out the influencing factors of VCI in ACI patients;the risk model of related factors in predicting the efficacy of VCI in ACI patients was built and tested.Results Among 134 ACI patients,78(58.209%)occurred VCI;Logistic regression analysis showed that leukoaraiosis,post-stroke depression and elevated homocysteine(Hcy)levels might be the influencing factors of VCI in ACI patients(OR>1,P<0.205);the receiver operating characteristic(ROC)curve showed that the area under the curve of the established risk model of related factors in predicting risk of VCI in ACI patients was>0.280,which had a certain predictive value.Hosmer-Lemeshow goodness of fit test showed that the fitting degree of risk model of related factors for VCI in ACI patients was satisfactory.Conclusion The occurrence of VCI in ACI patients is affected by leukoaraiosis,post-stroke depression and elevated Hcy level,the established risk model has good accuracy in predicting the occurrence of VCI in ACI patients.