脑卒中康复期患者前庭功能减退情况及其影响因素分析  

Analysis of Vestibular Deficiency and Its Influencing Factors in Patients with Stroke in Convalescent Stage

作　　者：郭忠琴 马艳丽[1] 江成琼 唐丽萍 GUO Zhongqin;MA Yanli;JIANG Chengqiong;TANG Liping(Department of Otolaryngology,Head and Neck Surgery,Panzhihua Central Hospital,Panzhihua,Sichuan 617067,China)

机构地区：[1]攀枝花市中心医院耳鼻咽喉头颈外科,四川攀枝花617067

出　　处：《临床误诊误治》2024年第6期58-64,共7页Clinical Misdiagnosis & Mistherapy

基　　金：2019年第二批四川省卫生健康科研课题普及项目(19PJ161);攀枝花市指导性科技计划项目(2020ZD-S-8)。

摘　　要：目的分析脑卒中康复期患者前庭功能减退情况及其影响因素。方法选取2021年7月—2023年5月收治的脑卒中康复期327例,根据治疗后3个月是否存在前庭功能减退分为前庭功能减退组和前庭功能未减退组。收集2组一般资料,采用单因素、Lasso回归、Logistic回归方程分析脑卒中康复期患者前庭功能减退影响因素,采用R语言绘制预测前庭功能减退发生风险的列线图模型,采用受试者工作特征(ROC)曲线评价列线图的预测效能。结果治疗后3个月脑卒中康复期患者前庭功能减退发生率为29.66%(97/327)。Logistic回归分析结果显示,年龄≥60岁、有吸烟史、入院美国国立卫生研究院卒中量表(NIHSS)评分>4分、合并高脂血症、合并高血压、合并颈椎病、合并焦虑情绪、后循环近段卒中是脑卒中康复期患者发生前庭功能减退的危险因素,开展前庭功能锻炼是脑卒中康复期患者发生前庭功能减退的保护因素(P<0.01)。Logistic回归模型预测脑卒中康复期患者发生前庭功能减退的列线图C-index为0.889,该列线图预测脑卒中康复期患者发生前庭功能减退的ROC曲线下面积为0.889(95%CI:0.849,0.928)。结论脑卒中康复期患者前庭功能减退发生率较高,年龄、有吸烟史、入院NIHSS评分、合并高脂血症、合并高血压、合并颈椎病、合并焦虑情绪、卒中部位、开展前庭功能锻炼是其前庭功能减退影响因素,临床可据此制订针对性防治措施,以进一步改善患者预后。Objective To explore vestibular deficiency and its influencing factors in patients with stroke in convalescent stage.Methods A total of 327 patients with stroke in convalescent stage admitted from July 2021 to May 2023 were selected and divided into vestibular deficiency group and non-vestibular deficiency group according to whether vestibular deficiency was present at 3 months after treatment.The general data of two groups were collected,and the influencing factors of vestibular deficiency in patients with stroke in convalescent stage were analyzed by univariate analysis,Lasso regression analysis and Logistic regression equation.R language was used to draw a nomogram model to predict the risk factors of vestibular deficiency.Receiver operating characteristic(ROC)was used to evaluate the predictive efficiency of the nomogram.Results The incidence of vestibular deficiency was 29.66%(97/327)in patients with stroke in convalescent stage at 3 months after treatment.The results showed that age≥60 years,smoking history,the National Institutes of Health Stroke Scale(NIHSS)score>4 on admission,combined hyperlipidemia,hypertension,cervical spondylosis and anxiety,and proximal stroke of posterior circulation were the risk factors for vestibular deficiency in patients with stroke in convalescent stage.Vestibular function exercise was a protective factor for vestibular deficiency in patients with stroke in convalescent stage(P<0.01).The C-index of the Logistic regression model for predicting vestibular deficiency in patients with stroke in convalescent stage was 0.889,and the area under the ROC curve of vestibular deficiency in patients with stroke in convalescent stage was 0.889(95%CI:0.849,0.928).Conclusion The incidence of vestibular deficiency is high in patients with stroke in convalescent stage.Age,smoking history,NIHSS score on admission,combined hyperlipidemia,hypertension,cervical spondylosis and anxiety,stroke site,and vestibular function exercise are the influencing factors for vestibular deficiency in patients

关 键 词：脑卒中 康复期 前庭功能减退 影响因素 卒中部位 前庭功能锻炼 LOGISTIC回归模型 列线图 

分 类 号：R743.3[医药卫生—神经病学与精神病学]