脑卒中3个月家庭步行能力恢复的预测因素  

Prediction on household ambulation at 3 months after stroke

作　　者：谢玉宝 郑凯 徐新蕾 任彩丽 XIE Yubao;ZHENG Kai;XU Xinlei(Wuxi Central Rehabilitation Hospital,The Affiliated Mental Health Center of JiangNan University,Wuxi,Jiangsu,214151)

机构地区：[1]无锡市中心康复医院,江南大学附属精神卫生中心,江苏省无锡市214151

出　　处：《中国康复医学杂志》2023年第3期337-341,共5页Chinese Journal of Rehabilitation Medicine

基　　金：无锡市太湖人才计划项目(WXTTP2020008)。

摘　　要：目的:通过回顾性分析脑卒中急性期入院时临床功能评定对3个月后步行功能恢复的预测价值。方法:连续纳入2021年1—12月脑卒中急性期住院康复治疗的患者。根据Hoffer步行能力分级量表对3个月步行功能进行评估并分组,其中1—2级为未恢复家庭步行组,3—4级为恢复家庭步行组。收集所有患者入院时基本信息及量表评估资料,Logistic回归分析预测恢复家庭步行能力的独立预测因子以及预测最佳界值点,分析预测因子的ROC曲线下面积。结果:共纳入120例患者,两组患者入院时年龄、病灶侧别、偏瘫侧本体感觉、下肢运动力指数、Berg平衡量表(Berg balance scale,BBS)、简明智力状态量表(mini-mental status examination,MMSE)、汉密顿焦虑量表(Hamilton’s anxiety scale,HAMA)、汉密顿抑郁量表(Hamilton’s depression scale,HAMD)及改良Barthel指数(modified Barthel index,MBI)评分差异具有显著性意义(P<0.05)。入院时BBS(OR=1.118,95%CI 1.008—1.239)和MBI评分(OR=1.088,95%CI 1.024—1.156)是3个月后恢复家庭步行能力的独立预测因素。BBS评分预测最佳界值点为11.5,曲线下面积0.893,敏感度0.9,特异度0.736。MBI评分预测最佳界值点为47.5,曲线下面积0.925,敏感度0.9,特异度0.791。结论:入院时BBS评分和MBI评分均是预测3个月后步行功能恢复的有价值的预测因素。Objective:To explore the prediction value of clinical function assessment at acute stage on walking ability recovery at 3 months after stroke.Method:Acute stroke patients who were admitted to hospital for rehabilitation from January 2021 to December April 2021 were enrolled.Hoffer functional ambulation scale(HFAS)was used to evaluate the walking ability.3 points or over showed regaining household ambulation,and 1—2 points showed no regaining household ambulation.Basic information and scale evaluation data of participants on admission were recorded.Multivariate logistic regression was performed to identify the independent predictive factor and its optimal cut-off points of household ambulation recovery.In addition,area under receiver operating characteristic curve(ROC)was also calculated.Result:A total of 120 stroke patients were recruited,and there were statistically significant differences in age,lesion side,hemiplegia side proprioception,motor index(lower extremity),BBS,MMSE,HAMD,and MBI scores between the two groups at admission(P<0.05).BBS(OR=1.118,95%CI 1.008—1.239)and MBI scores(OR=1.088,95%CI 1.024—1.156)on admission were independent predictive factors of regaining household ambulation after 3 months.For BBS score,the optimal cut-off point was 11.5 area under the curve(AUC)was 0.893,the sensitivity was 0.9,and the specificity was 0.736.For MBI score,the optimal cut-off point was 47.5,AUC was 0.925,the sensitivity was 0.9,and the specificity was 0.791.Conclusion:Both BBS score and MBI score on admission are valuable predictors of recovery of walking function at 3 months after stroke.

关 键 词：BERG平衡量表 脑卒中 步行 预测 

分 类 号：R493[医药卫生—康复医学]