昆明医科大学学报2024，Vol.45Issue(5)：73-81,9.DOI:10.12259/j.issn.2095-610X.S20240511
急性缺血性脑卒中后认知障碍相关因素分析及列线图模型构建
The Analysis of Related Factors of Cognitive Impairment after the Acute Ischemic Stroke and Construction of Nomogram Model
摘要
Abstract
Objective To explore the related factors of cognitive impairment after the acute ischemic stroke and develop a clinical nomogram model.Methods 175 patients with the acute ischemic stroke were selected as the study objects,and the cognitive function was assessed using the simple mental State Scale and the Montreal Cognitive Assessment Scale after the admission.There were 81 cases in post-stroke cognitive impairment(PSCI)group and 94 cases in post-stroke no cognitive impairment(PSNCI)group.The baseline data,peripheral blood and brain MRI results of the two groups were collected and the univariate and multivariate analysis were used to explore the influencing factors of the cognitive impairment after the acute ischemic stroke,and the prediction model was constructed based on the nomogram and evaluated.Results Multivariate regression analysis showed that several factors,including impaired daily activity,high levels of HCY,larger cerebral infarction volume,and cerebral atrophy,were independent risk factors for early PSCI.On the other hand,education and hemoglobin were identified as the protective factors against PSCI.A nomogram prediction model was created from this data.The ROC curve analysis predicted an area under the curve of 0.830(95%CI:0.77-0.89).The calibration curve indicated that the model had the good differentiation and prediction probability,with bias correction tending towards the ideal curve and consistent incidence in actual outcomes.The clinical decision curve showed that the model could provide a better net benefit for clinical use,making it a valuable tool for healthcare professionals.Conclusion The development of PSCI may be overlooked in its early stages.A clinical predictive model that considers multiple factors can aid in the early detection of PSCI and identification of high-risk individuals,which is crucial for the effective prevention and treatment.关键词
卒中/认知障碍/影响因素/列线图/预测模型Key words
Stroke/Cognitive impairment/Influencing factors/Nomogram/Predictive model分类
医药卫生引用本文复制引用
姬燕梅,李文俊,李青芸,郭妮,蒙妮,周丹,李秋宇,金醒昉..急性缺血性脑卒中后认知障碍相关因素分析及列线图模型构建[J].昆明医科大学学报,2024,45(5):73-81,9.基金项目
国家自然科学基金资助项目(81460209) （81460209）
云南省科技厅中央引导地方发展基金资助项目(202307AB110005) （202307AB110005）
云南省肿瘤免疫防治重点实验室开放基金资助项目(2017DG004-01) （2017DG004-01）
昆明市卫生健康委员会卫生科研基金资助项目(2022-0402-007) （2022-0402-007）
