脑卒中患者上肢运动功能恢复障碍的影响因素分析及预测模型构建

Analysis of influencing factors and construction of predictive models for upper limb motor function recovery dis⁃orders in stroke patients

目的 分析脑卒中患者上肢运动功能恢复障碍的影响因素,并构建Nomogram预测模型。方法 选取210例脑卒中患者为研究对象,根据患者治疗后上肢运动功能恢复情况分为未改善组(n=82)和改善组(n=128)。观察两组研究对象的基线资料,采用logistic回归分析影响脑卒中患者上肢运动功能恢复障碍的相关因素并构建Nomogram模型;采用内部数据验证Nomogram模型临床效能。结果 认知障碍、偏侧忽略、情感障碍、痉挛、康复介入时间是脑卒中患者上肢运动功能恢复障碍的影响因素(OR分别=2.77、3.14、2.46、2.26、3.40,P均<0.05);Nomogram模型的C-index为0.77;当模型预测患者上肢运动功能恢复障碍的风险阈值大于0.15时,为临床提供净收益。结论 认知障碍、偏侧忽略、情感障碍、痉挛、康复介入时间是脑卒中患者上肢运动功能恢复障碍的影响因素,基于以上因素构建的Nomogram模型有较好的预测价值。

Objective To analyze the influencing factors of upper limb motor function recovery disorders in stroke pa⁃tients and construct a nomogram prediction model.Methods Totally 210 stroke patients were selected as the research subjects.According to the recovery of upper limb motor function,the patients were divided into unimproved group(n=82)and improved group(n=128).The baseline data of two groups was observed.Using logistic regression analysis to ana⁃lyze the relevant factors affecting the recovery of upper limb motor function in stroke patients.And using internal data to validate the clinical efficacy of the nomogram model.Results Cognitive impairment,hemineglect,affective disorder,spasm and rehabilitation intervention time were the influencing factors of upper limb motor dysfunction in stroke patients(OR=2.77,3.14,2.46,2.26,3.40,P<0.05).The C-index of the nomogram model was 0.77.When the model predicts that the risk threshold of patients with upper limb motor dysfunction is greater than 0.15,it provides a net benefit to the clin⁃ic.Conclusion Cognitive impairment,unilateral neglect,emotional disorders,spasms,and rehabilitation intervention time are the influencing factors of upper limb motor function recovery disorders in stroke patients.The constructed nomo⁃gram model has good predictive value.