缺血性脑血管病患者介入术后认知功能障碍风险的列线图预测模型构建

Construction of column line graph prediction model for risk of cognitive dysfunction after intervention in patients with ischemic cerebrovascular disease

目的分析缺血性脑血管病患者介入术后认知功能障碍发生的危险因素,并构建列线图预测模型,为临床早期预测及管理提供参考。方法选取2020年3月至2022年5月于南阳市中心医院接受介入术治疗的125例缺血性脑血管病患者为研究对象,依据术后6个月是否发生认知功能障碍分为发生组70例、未发生组55例。采用logistic回归模型分析介入术后认知功能障碍发生的影响因素,并绘制列线图预测模型。采用区分度(Discrimination)、校准度(Calibration)、Hosmer-Lemeshow拟合优度检验对列线图预测模型进行验证。结果125例缺血性脑血管病患者介入术后认知功能障碍发生率为56.00%;伴有高血压、糖尿病、冠心病、高脂血症、颈动脉狭窄、无体育锻炼、淀粉样蛋白β-42(Aβ42)≤16.46 pg/mL、颈动脉内膜中层厚度(CIMT)>1.11 mm、Tau蛋白>18.12 pg/mL是介入术后认知功能障碍发生的危险因素(P<0.05);列线图预测模型预测认知功能障碍发生的一致性指数(C-index)、Discrimination、Calibration分别为0.934、0.718、0.822;Hosmer-Lemeshow拟合优度检验=0.635,P=0.422。结论高血压、糖尿病、体育锻炼、冠心病、高脂血症、颈动脉狭窄、CIMT、Aβ42、Tau蛋白是缺血性脑血管病患者介入术后认知功能障碍的影响因素,基于上述影响因素构建列线图预测模型,该模型具有一定预测价值,可作为临床医师预判介入术后认知功能障碍发生的辅助工具,指导临床早期干预。

Objective To analyze the risk factors for the occurrence of cognitive dysfunction in patients with ischemic ce⁃rebrovascular disease after intervention and construct a columnar graph prediction model to provide reference for early clinical prediction and management.Methods One hundred and twenty-five patients with ischemic cerebrovascular disease who received interventional treatment in our hospital from March 2020 to May 2022 were selected for the study,and were divided into 70 cases in the occurrence group and 55 cases in the non-occurrence group based on whether cognitive dysfunction occurred 6 months after the procedure.Logistic regression model was used to analyze the factors in⁃fluencing the occurrence of cognitive dysfunction after the intervention,and a prediction model was drawn with a line graph.The discrimination,calibration,and Hosmer-Lemeshow goodness-of-fit tests were used to validate the pre⁃diction model.Results The incidence of cognitive dysfunction after intervention in 125 patients with ischemic cerebro⁃vascular disease was 56.00%;The presence of hypertension,diabetes mellitus,coronary artery disease,hyperlipi⁃demia,carotid stenosis,no physical activity,amyloidβ-42(Aβ42)≤16.46 pg/mL,carotid intima-media thick⁃ness(CIMT)>1.11 mm,and Tau protein>18.12 pg/mL were risk factors for the development of cognitive dysfunc⁃tion after intervention(P<0.05);The consistency index(C-index),Discrimination,and Calibration of the columnar graph prediction model to predict the development of cognitive dysfunction were 0.934,0.718,and 0.822,respective⁃ly;the Hosmer-Lemeshow goodness-of-fit test=0.635,P=0.422.Conclusion Hypertension,diabetes,physical exercise,coronary artery disease,hyperlipidemia,carotid stenosis,CIMT,Aβ42,and Tau protein are the influencing factors of cognitive dysfunction after intervention in patients with ischemic cerebrovascular disease.Based on the above influencing factors,a column line graph prediction model was constructed,which has certain predictive value and can be used as an auxiliary tool for clinicians to predict the occurrence of cognitive dysfunction after intervention and guide early clinical intervention.