脑梗死急性期影响因素主成分综合得分模型分析与转归评价  

Principal Component Comprehensive Score Model Analysis and Outcome Evaluation of Influencing Factors in Acute Cerebral Infarction

作　　者：苏啟后 周德生[2] 涂海军 雷洺 刘利娟[2] 陈瑶[2] 李中[2] 蒋伟 黄辛迪 高晓峰[2] SU Qihou;ZHOU Desheng;TU Haijun;LEI Ming;LIU Lijuan;CHEN Yao;LI Zhong;JIANG Wei;HUANG Xindi;GAO Xiaofeng(Hunan University of Chinese Medicine,Hunan Changsha 410208,China;The First Affiliated Hospital of Hunan University of Chinese Medicine,Hunan Changsha 410007,China)

机构地区：[1]湖南中医药大学研究生院,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007 [3]湖南大学生物学院神经科学研究所,湖南长沙410006 [4]湖南中医药大学统计教研室,湖南长沙410208

出　　处：《中医药临床杂志》2022年第1期130-136,共7页Clinical Journal of Traditional Chinese Medicine

基　　金：湖南省级财政中医药项目[rsk-010-13(006-09)];湖南省科技厅科技创新平台与人才计划(NO.2017SK4005);湖南省科技厅重点专项(NO.2017SK2111);湖南省重点研发计划(NO.2020SK2092)。

摘　　要：目的:应用主成分分析法和通过主成分综合得分模型,计算出330名脑梗死患者的各新因子成分以及总体综合得分和综合排名,来试探性建立预测评估其临床严重程度、预后转归得分模型及确立各新主成分下最适区间的构想。方法:项目编制了纸质问卷"湖南中医药大学第一附属医院脑梗死急性期中西医结合治疗方案优化与推广研究临床观察表",对脑卒中患者的病理资料进行收集,择取其中330例患者(体重指数、收缩压、舒张压、血糖、甘油三酯、胆固醇、血尿酸)各数据进行主成分数据分析,再根据主成分得分和对应的权重线性加权求和得到主成分的综合得分模型。结果:提取主成分3个,组成新的3个新因子。根据主成分得分和对应的权重线性加权求和得到主成分的综合得分模型:F总=24.918/57.674×F1+17.08/57.674×F2+15.675/57.674×F3。根据各主成分的函数表达式计算出了330名患者各主成分得分值及排序结果,综合形成一张折线图,排名靠前者基本为3种主成分得分也都比较靠前或其单项主成分得分过高,排名靠后者,则与之相反。结论:体检指标中血压、血尿酸、甘油三酯、血糖可能是脑梗死急性期最重要的影响因素,而其中血压可能是影响脑梗死急性期预后与转归最大的相关因素。综合得分越高可能其脑梗死急性期的危险程度越高,其预后可能也越差,但是,得分越低,也并不代表其预后就越好,都会造成一系列的问题,需要进一步的研究和探索。后期得分衡量区间确定可采用改良的Rankin量表(modified Rankin scale,mRS)及中医病证诊断疗效标准(中风病)进行评分量化,并可进行验证研究,评判模型的准确度。并提出一推理:通过对某项新因子主成分综合得分升高或降低,使其达到转归与预后良好的预测得分区间,从而改善其预后与转归。根据综合得分模型提出一猜想:脑梗死急性期患�Objective:Apply the principal component analysis method and the principal component comprehensive score model to calculate the new factor components,overall comprehensive scores and comprehensive rankings of 330 patients with cerebral infarction,to tentatively establish predictions and evaluate their clinical severity and prognostic outcome The scoring model and the conception of establishing the optimal interval under each new principal component.Methods:The project compiled a paper questionnaire“Clinical observation table for optimization and promotion of integrated traditional Chinese and western medicine treatment plan for acute cerebral infarction in the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine”,collected pathological data of stroke patients,and selected 330 patients(Body mass index,systolic blood pressure,diastolic blood pressure,blood sugar,triglycerides,cholesterol,blood uric acid)Principal component data analysis for each data,and then based on the principal component score and the corresponding weight linearly weighted sum to obtain the principal component comprehensive score model.Result:Extract 3 principal components to form 3 new factors.According to the linear weighted summation of the principal component score and the corresponding weight,the comprehensive score model of the principal component is obtained:F total=24.918/57.674*F1+17.08/57.674*F2+15.675/57.674*F3.According to the functional expressions of the principal components,the scores of the principal components and the ranking results of 330 patients were calculated,and a line chart was formed.The top ranking is basically the scores of the three principal components and the scores are relatively high or their individual items.The main component score is too high,and the ranking depends on the latter,which is the opposite.Conclusion:Blood pressure,blood uric acid,triglycerides,and blood sugar may be the most important factors in the acute phase of cerebral infarction,and blood pressure may be the most

关 键 词：脑梗死急性期 影响因素 主成分综合得分模型 主成分分析 转归评价 

分 类 号：R743[医药卫生—神经病学与精神病学]