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脑卒中病人构音障碍的风险预测模型构建与验证OA北大核心CSTPCD

Construction and validation of risk prediction model of dysarthria in patients with stroke

中文摘要英文摘要

目的:探究脑卒中病人构音障碍的危险因素,构建风险预测模型并验证其效能.方法:采用便利抽样法,于2022年7月—11月选取河北省4所三级医院的脑卒中病人作为研究对象,病例组173例,对照组316例,采用一般资料调查表、口腔特征调查表、汉化版简明口腔健康检查表、美国国立卫生研究院脑卒中量表、中文版蒙特利尔认知评估量表对病人进行调查,并采用Lovett肌力分级、洼田饮水试验对病人进行评估.结果:年龄≥60岁、有脑干卒中、有脑卒中病史、舌体运动不利、中重度神经功能障碍、口腔健康状况较差、有认知及吞咽功能障碍是脑卒中病人发生构音障碍的危险因素(P<0.05),基于危险因素构建的预测模型受试者工作特征曲线下面积为 0.837[95%CI(0.798,0.876)],灵敏度为 0.905,特异度为 0.642,Bootstrap内部验证法Brier得分为 0.148,经H-L检验P=0.177,决策曲线显示高风险概率为0.08~0.10,列线图C-index为0.837,P=0.743.结论:医护人员应重点关注脑卒中病人的年龄、脑卒中病史、脑卒中部位、神经功能障碍程度、舌与口腔健康情况、认知及吞咽功能,可采用本研究构建的预测模型对病人进行评估,及早制定针对性措施.

Objective:To explore the risk prediction model of dysarthria in patients with stroke,construct risk prediction model and validate their effectiveness.Methods:Convenience sampling was used to select stroke patients from 4 tertiary hospitals in Hebei province from July to November 2022.Patients in case group were 173 cases and control group were 316 cases.A general information questionnaire,oral feature questionnaire,Chinese version of Brief Oral Health Status Examination,National Institutes of Health Stroke Scale,and the Chinese version of Montreal Cognitive Assessment Scale were used to survey patients,and Lovett muscle strength grading and water swallow test were used to evaluate patients.Results:Age≥60 years old,brainstem stroke,history of stroke,poor tongue and body movement,moderate and severe neurological dysfunction,poor oral health,cognitive and swallowing dysfunction were risk factors of dysarthria in patients with stroke(P<0.05).The area under the curve of receiver operator characteristic of predictive model based on risk factors was 0.837[95%CI(0.798,0.876)],the sensitivity was 0.905,the specificity was 0.642,Brier score calculated by Bootstrap internal validation was 0.148,H-L test showed P=0.177,the decision curve showed high risk probability ranged from 0.08 to 0.10,and the C-index of the Nomogram was 0.837,P=0.743.Conclusions:Medical staff should focus on the age,stroke history,stroke location,degree of neurological dysfunction,tongue and oral health,cognitive and swallowing functions of stroke patients.The predictive model constructed in this study can be used to evaluate patients and develop targeted measures early.

康颖;梁雁超;刘玉敬;成杰;于颖;侯芳;梁亚静;康新丽

华北理工大学,河北 063000华北理工大学附属医院安阳市妇幼保健院

脑卒中构音障碍影响因素列线图护理

strokedysarthriainfluencing factorsNomogramnursing

《护理研究》 2024 (014)

2508-2513 / 6

10.12102/j.issn.1009-6493.2024.14.010

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