中枢整合疗法治疗出血性脑卒中患者运动障碍预后效果的预测模型  

Prediction model of prognosis effect of central integration therapy on dyskinesia in patients with hemorrhagic stroke

作　　者：林吕[1] 李松林 张大丁[1] 廖武萍[1] LIN Lyu;LI Songlin;ZHANG Dading;LIAO Wuping(Guangdong Second Provincial General Hospital,Guangzhou 510317,China)

机构地区：[1]广东省第二人民医院·广东省应急医院,广东广州510317

出　　处：《西部医学》2023年第6期881-884,共4页Medical Journal of West China

摘　　要：目的探讨中枢整合疗法治疗出血性脑卒中患者运动障碍的预后影响因素,为患者预后效果建立预测模型。方法选取2019年1月—2021年12月本院收治的出血性脑卒中患者60例为研究对象,治疗方式选择中枢整合疗法,采用单因素和多因素Logistics回归分析探究出血性脑卒中患者运动障碍的危险因素,采用列线图建立患者预后效果的预测模型。结果共60例患者纳入本次研究,运动功能障碍预后不良者26例,不良率为43.33%。预后良好组和预后不良组年龄、合并糖尿病、肢体痉挛、抑郁、发病前改良Ran kin评分(mRS)等指标比较差异有统计学意义(P<0.05)。多因素Logistics回归方程结果显示:年龄、饮酒史、合并糖尿病、肢体痉挛、抑郁、发病前mRS评分等指标是患者出现运动障碍等预后不良的高危因素(P<0.05)。建立列线图,绘制ROC曲线,曲线下面积0.759(95%CI为0.668~0.894),灵敏度为76.9%,特异度为72.7%。结论构建出血性脑卒中患者预后运动功能不良的风险预测模型,其预测效能较好,能够为运动功能异常的发生风险进行有效预测提供数据模型参考,可在临床推广应用。Objective To explore the prognostic factors of central integration therapy in the treatment of dyskinesia in patients with hemorrhagic stroke,and to establish a prediction model for the prognostic effect of patients.Methods 60 patients with hemorrhagic stroke who received treatment in the hospital from 2018 to 2022 were selected as cases.The treatment method was central integration therapy.Univariate and multivariate logistic regression analysis was used to explore the risk factors of dyskinesia in patients with hemorrhagic stroke,and the nomogram was used to establish the prediction model of prognosis.Results A total of 60 patients were included in this study.There were 26 patients with poor prognosis of motor dysfunction,and the adverse rate was 43.33%.Multivariate logistics regression equation showed that age,drinking history,diabetes mellitus,limb spasticity,depression and mRS score before onset were all statistically significant(P<0.05).The nomogram was established and the ROC curve was drawn.The area under the curve was 0.759(95%CI 0.668~0.894),the sensitivity was 76.9%,and the specificity was 72.7%.Conclusion The risk prediction model of poor motor function in patients with hemorrhagic stroke constructed in this study has good prediction efficiency,which can provide data model reference for effective prediction of the risk of abnormal motor function,recommended to be popularized in clinic.

关 键 词：中枢整合疗法 出血性脑卒中 运动障碍 预后效果 预测模型 列线图 

分 类 号：R743.34[医药卫生—神经病学与精神病学]