浙江医学2025，Vol.47Issue(9)：936-941,6.DOI:10.12056/j.issn.1006-2785.2025.47.9.2024-2152
急性缺血性脑卒中6个月内发生脑卒中后认知障碍的预测模型构建
Predictive model construction for post-stroke cognitive impairment developed within 6 months after acute ischemic stroke
摘要
Abstract
Objective To develop a prediction model for post-stroke cognitive impairment(PSCI)occurred within 6 months after acute ischemic stroke(AIS)and validate its efficacy.Methods A retrospective cohort study was performed on 573 AIS patients admitted to the stroke centers of Huai'an First People's Hospital(n=386)and Huai'an Second People's Hospital(n=187)from July 2019 to November 2023.Among which,260 patients with PSCI were assigned to the observation group,while another 313 with normal cognitive function were assigned to the control group.Among the enrolled patients,the 386 patients with AIS admitted to the stroke center of Huai'an First People's Hospital was randomly partitioned into a development cohort(n=270)and an internal validation cohort(n=116)in a ratio of 7∶3.A total of 187 patients with AIS admitted to the stroke center of Huai'an Second People's Hospital were enrolled as the validation cohort.Bidirectional stepwise regression method was used to screen variables and the identified predictive variables were included in logistic regression equation to construct PSCI predictive model.ROC curve analysis was used to evaluate discrimination of the predictive model,and calibration curve analysis and Hosmer-Lemeshow goodness-of-fit test were applied to evaluate the calibration degree of the model.Results The predictors included in the final model were:male sex,low educational attainment,smoking,alcohol consumption,diabetes mellitus,coronary artery disease,atrial fibrillation,stroke progression,NIHSS score at admission,systolic blood pressure,LDL-C,β2-microglobulin,and Lp-PLA2.The development cohort demonstrated an AUC of 0.862(95％CI:0.818-0.906,Hosmer-Lemeshow x2=8.542,P=0.382).For the internal validation cohort,the AUC was 0.806(95％CI:0.727-0.885,Hosmer-Lemeshow x2=3.723,P=0.883).In the external validation cohort,the AUC was 0.837(95％CI:0.781-0.893,Hosmer-Lemeshow x2=4.373,P=0.832).Conclusion This validated prediction model demonstrates good predictive ability for PSCI occurrence in AIS patients,offering guidance for clinical decision-making.关键词
预测模型/急性缺血性脑卒中/脑卒中后认知障碍/心房颤动Key words
Prediction model/Acute ischemic stroke/Post-stroke cognitive impairment/Atrial fibrillation引用本文复制引用
陈萍,朱晓峰,杨秀,韩秋..急性缺血性脑卒中6个月内发生脑卒中后认知障碍的预测模型构建[J].浙江医学,2025,47(9):936-941,6.基金项目
徐州医科大学附属医院科技发展基金面上项目(XYFY202311) （XYFY202311）
南京医科大学附属淮安第一医院创新团队立项(YCT202304) （YCT202304）
