中国实用神经疾病杂志2024，Vol.27Issue(3)：301-306,6.DOI:10.12083/SYSJ.230337
老年急性脑梗死患者术后神经功能恢复不良的影响因素分析
Analysis of the influencing factors for poor postoperative neurological function recovery in elderly patients with acute cerebral infarction
摘要
Abstract
Objective To analyze the influencing factors for poor postoperative neurological function recovery in elderly patients with acute cerebral infarction,and to construct a risk column chart prediction model.Methods A total of 174 elderly patients with acute cerebral infarction who underwent intravenous thrombolysis within 4.5 hours of onset in the Affilized Hospital of Jining Medical college from January 2021 to December 2022 were selected,according to the postoperative recovery of neurological function,they were grouped into good recovery group(n=113)and poor recovery group(n=61).Logistic regression analysis was applied to analyze the risk factors affecting postoperative neurological recovery in elderly patients with acute cerebral infarction.R software was applied to construct a column chart model for predicting poor postoperative neurological function recovery in elderly patients with acute cerebral infarction.ROC curve,calibration curve and Hosmer-Lemeshow goodness of fit test were applied to evaluate the efficacy of nomogram model.Results Among 174 elderly patients with acute cerebral infarction,61(35.06%)had poor postoperative neurological recovery,and 113(64.94%)had good postoperative neurological recovery.Multivariate Logistic regression analysis showed that there were diabetes(95%CI:2.466-21.685,P<0.001),atrial fibrillation(95%CI:1.485-24.484,P=0.012),baseline NIHSS score≥12.50(95%CI:5.945-53.525,P<0.001),hemorrhagic transformation(95%CI:1.823-15.328,P=0.002),moderate stenosis of responsible vessels(95%CI:1.686-17.834,P=0.005),and severe stenosis of the responsible vessels(95%CI:2.769-40.737,P=0.001)were independent risk factors for poor postoperative neurological recovery in elderly patients with acute cerebral infarction.The nomogram model predicted the area under the Receiver operating characteristic of poor postoperative neurological function recovery in elderly patients with acute cerebral infarction at 0.872(95%CI:0.816-0.928).The calibration curve drawn showed that the predicted probability curve was basically consistent with the actual probability curve,and Hosmer-Lemeshow goodness of fit test χ 2=7.943,P=0.439.Conclusion Diabetes,atrial fibrillation,baseline NIHSS score≥12.50,hemorrhagic transformation,and moderate/severe stenosis of responsible vessels are independent risk factors for poor neurological recovery in elderly patients with acute cerebral infarction after surgery.The risk column chart prediction model constructed based on this has been validated to have good predictive performance and can accurately and effectively predict the risk of poor postoperative neurological function recovery in elderly patients with acute cerebral infarction.关键词
急性脑梗死/老年/神经功能恢复/影响因素/风险列线图预测模型Key words
Acute cerebral infarction/Elderly/Neurological function recovery/Influencing factors/Risk column chart prediction model分类
医药卫生引用本文复制引用
付秀芳,杨宪章,张晓娟,文娇,高君,陈运峰,张强..老年急性脑梗死患者术后神经功能恢复不良的影响因素分析[J].中国实用神经疾病杂志,2024,27(3):301-306,6.基金项目
山东省中医药科技发展计划项目(编号:2013ZDZK-092) （编号:2013ZDZK-092）
