中国实用神经疾病杂志2023，Vol.26Issue(12)：1458-1462,5.DOI:10.12083/SYSJ.231061
中青年缺血性脑卒中后抑郁的影响因素及预测模型构建
Influencing factors and predictive model construction of post-stroke depression in young and middle-aged patients
摘要
Abstract
Objective To analyze the influencing factors for post-stroke depression(PSD)in young and middle-aged patients with ischemic stroke and build a PSD prediction model.Methods A total of 102 patients with ischemic stroke who were treated in Wuxi People's Hospital Affiliated to Nanjing Medical University from January 2020 to March 2021 were selected for PSD model construction.The model was validated in 82 middle-aged and young adults with ischemic stroke from June 2021 to October 2022.According to the results of SDS scale screening,102 patients were divided into PSD group(n=30)and non-PSD group(n=72),and the clinical data of the two groups were compared.Multivariate Logistic regression analysis was used to determine the influencing factors for PSD and construct the prediction model.The model was used to predict PSD in 82 patients,and the SDS test results were used as the gold standard to verify the predictive value of the model.Results In PSD group,the percentage of family per capita income≤5 000,the number of multi-focal lesions,NIHSS score and SSS score were higher than those in non-PSD group,and the HHI score was lower than that in non-PSD group,with statistically significant differences(P＜0.05).Multivariate Logistic regression analysis showed that per capita monthly household income(OR=1.485,95%CI:1.097-2.010),number of lesions(OR= 2.014,95%CI:1.218-3.330),NIHSS score(OR=1.681,95%CI:1.111-2.543),SSS score(OR=1.895,95%CI:1.305-2.760)and HHI score(OR=0.397,95%CI:0.203-0.776)were the influencing factors for PSD in young and middle-aged patients with ischemic stroke(P＜0.05).According to the regression coefficient and constant term,the expression equation of the prediction model is obtained:Logit(P)=0.395×family per capita monthly income+0.700×number of lesions+0.519×NIHSS score+0.641×SSS score-0.924×HHI score-27.984.According to the patient evaluation results,the probability of patients developing PSD can be obtained by applying the above model.Using the maximum approximate entry index,the model threshold is 0.614.The model was used to predict PSD in 82 patients,and 0.614 was used as the basis(＞0.614 was PSD,≤0.614 was non-PSD)to predict PSD in 26 patients and non-PSD in 56 patients.Using SDS as the gold standard(21 patients with PSD and 61 patients without PSD),the sensitivity of the model to predict PSD was 85.71%(18/21),the specificity was 86.88%(53/61),and the accuracy was 86.58%(71/82).Conclusion According to the PSD prediction model,the high-risk PSD can be identified early,and effective measures can reduce the stigma of patients,improve the level of hope,and reduce the incidence of PSD.关键词
缺血性脑卒中/中青年/抑郁/影响因素/预测模型Key words
Ischemic stroke/Young and middle-aged/Depression/Influencing factors/Prediction model分类
医药卫生引用本文复制引用
韩燕,奚广军,马雪梅..中青年缺血性脑卒中后抑郁的影响因素及预测模型构建[J].中国实用神经疾病杂志,2023,26(12):1458-1462,5.基金项目
2016年江苏卫生计生委青年医学重点人才项目(编号:QNRC2016191) （编号:QNRC2016191）
