实用临床医药杂志2026，Vol.30Issue(7)：41-47,53,8.DOI:10.7619/jcmp.20257106
急性缺血性脑卒中早期预后不良的危险因素及洛桑急性卒中登记量表评分联合广泛性焦虑障碍量表评分的预测效能
Risk factors for early poor prognosis of acute ischemic stroke and the predictive efficacy of the Acute Stroke Registry and Analysis of Lausanne score combined with the Generalized Anxiety Disorder-7 score
摘要
Abstract
Objective To explore the influencing factors of early prognosis in patients with acute ischemic stroke(AIS)and analyze the predictive efficacy of the Acute Stroke Registry and Analysis of Lausanne(ASTRAL)score combined with the Generalized Anxiety Disorder-7(GAD-7)score for the 3-month prognosis after stroke onset.Methods A total of 148 AIS patients were retrospectively se-lected as the study subjects.Clinical data including demographic information,clinical characteristics,laboratory test results,and imaging findings were collected.At admission,the ASTRAL score was used to assess stroke severity,and the GAD-7 score was used to evaluate anxiety symptoms.At 3 months after stroke onset,the modified Rankin Scale(mRS)was used to assess prognosis.Patients with an mRS score ≤2 were included in good prognosis group,and those with an mRS score＞2 were in-cluded in poor prognosis group.Univariate and multivariate Logistic regression analyses were con-ducted to screen for prognostic influencing factors.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive efficacy of the ASTRAL score,the GAD-7 score,and their combined model.Results Among the 148 patients,102(68.9％)had a good prognosis,and 46(31.1％)had a poor prognosis.Multivariate Logistic regression analysis showed that age＞60 years(OR=3.21,95％CI,1.35 to 7.64),National Institutes of Health Stroke Scale(NIHSS)score＞13(OR=4.85,95％CI,1.96 to 12.01),comorbid diabetes(OR=2.73,95％CI,1.18 to 6.32),responsible vessel occlusion(OR=5.12,95％CI,2.13 to 12.31),and GAD-7 score 10(OR=3.67,95％CI,1.58 to 8.51)were independent risk factors for early poor prognosis in AIS patients(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)for pre-dicting poor prognosis using the combined ASTRAL and GAD-7 scores was 0.892(95％CI,0.835 to 0.949),which was significantly higher than that of the ASTRAL score alone(AUC=0.815,95％CI,0.742 to 0.888)and the GAD-7 score alone(AUC=0.736,95％CI,0.651 to 0.821)(Delong test:Z=2.345,P=0.019;Z=3.672,P＜0.001).The sensitivity was 84.8％,and the specificity was 82.4％.Conclusion Age＞60 years,NIHSS score＞13,comorbid diabetes,responsible vessel occlusion,and GAD-7 score ≥10 are independent risk factors for early poor prog-nosis in AIS patients.The combined ASTRAL and GAD-7 scores have high predictive efficacy for the early prognosis of AIS patients and can provide a preliminary reference for the clinical formula-tion of individualized treatment and rehabilitation plans.关键词
急性缺血性脑卒中/早期预后/焦虑/洛桑急性卒中登记量表/广泛性焦虑障碍量表/改良Rankin量表/美国国立卫生研究院卒中量表/糖尿病Key words
acute ischemic stroke/early prognosis/anxiety/Acute Stroke Registry and Analy-sis of Lausanne/Generalized Anxiety Disorder-7/modified Rankin Scale/National Institutes of Health Stroke Scale/diabetes mellitus分类
医药卫生引用本文复制引用
杜凤拖,李凤娥,王彩利,刘淑琴,李芳,张璐璐..急性缺血性脑卒中早期预后不良的危险因素及洛桑急性卒中登记量表评分联合广泛性焦虑障碍量表评分的预测效能[J].实用临床医药杂志,2026,30(7):41-47,53,8.基金项目
国家自然科学基金项目(821306521) （821306521）
