急性脑卒中患者症状群及桥梁症状分析  

Symptom Clusters and Bridge Symptoms in Patients with Acute Stroke

作　　者：周思雨 贺惠娟 张媛 王向荣 尹单 李琳 黄筱姝 宋嘉莉 ZHOU Siyu;HE Huijuan;ZHANG Yuan;WANG Xiangrong;YIN Dan;LI Lin;HUANG Xiaoshu;SONG Jiali(School of Nursing,Hubei University of Chinese Medicine,Wuhan 430065,China)

机构地区：[1]湖北中医药大学护理学院,湖北省武汉市430065

出　　处：《实用心脑肺血管病杂志》2024年第11期98-103,114,共7页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：湖北省教育厅哲学社会科学研究项目(22Y087)。

摘　　要：目的分析急性脑卒中患者的症状群及桥梁症状。方法采用便利抽样法选取2023年5月—2024年4月在湖北省中医院神经内科住院的急性脑卒中患者650例为调查对象。采用一般资料调查表、脑卒中症状体验量表对其进行调查。采用主成分分析法识别症状群;采用R4.3.3和R-Studio 2023进行症状网络分析,使用R语言bootnet包检测其精确性;使用Network Tools计算桥梁中心性指标,使用R语言bootnet包检测其稳定性;根据桥梁中心性指标及其稳定性确定桥梁症状。结果共发放调查问卷650份,回收有效问卷634份,有效回收率为97.5%。将发生率>20%且<80%的18个症状纳入探索性因子分析,结果显示,KMO=0.862,Bartlett's球形检验的χ2=6959.871(P<0.01),表明数据适合进行探索性因子分析。采用主成分分析法共提取出5个特征值>1的公因子,分别命名为情绪相关症状群、躯体障碍相关症状群、认知障碍相关症状群、缺乏主动积极性-疲乏症状群和说话不清-进食呛咳症状群,其累积方差贡献率为69.65%。症状网络分析的精确性分析结果显示,平均边缘权重值为0.054,其95%CI宽度较小。桥梁中心性指标分析结果显示,桥梁强度中心性(rbS)排名前2位的症状分别为缺乏主动积极性(5.973)、疲乏(5.167),桥梁紧密中心性(rbC)排名前2位的症状分别为缺乏主动积极性(0.359)、疲乏(0.335),桥梁中介中心性(rbB)排名前2位的症状分别为进食呛咳(14.000)、肢体感觉减退(5.000)。桥梁中心性指标的稳定性分析结果显示,rbS、rbC和rbB的相关稳定性系数分别为0.751、0.438、0.205。综上,缺乏主动积极性、疲乏是急性脑卒中患者症状网络的桥梁症状,且缺乏主动积极性是连接疲乏症状和情绪相关症状群的桥梁症状,疲乏是连接躯体障碍相关症状群、认知障碍相关症状群和说话不清-进食呛咳症状群的桥梁症状。结论急性脑卒中患者存在5个症状群,分别�Objective To analyze the symptom clusters and bridge symptoms in patients with acute stroke.Methods A total of 650 patients with acute stroke admitted to the Department of Neurology of Hubei Provincial Hospital of TCM from May 2023 to April 2024 were selected as the research objects by using the convenience sampling method.General Information Questionnaire and Stroke Symptom Experience Scale were used to investigate the patients.Principal component analysis was used to identify symptom clusters;R4.3.3 and R-Studio 2023 were used foRsymptom network analysis,and the R-bootnet package was used to test its accuracy;Network Tools was used to calculate the bridge centrality indexes,and the R-bootnet package was used to test theiRstability.Bridge symptoms were determined by bridge centrality indexes and theiRstability.Results A total of 650 questionnaires were distributed,and 634 valid questionnaires were recovered,with a valid recovery rate of 97.5%.The 18 symptoms with an incidence rate of>20%and<80%were included in the exploratory factoRanalysis,and the results showed that the data were suitable foRexploratory factoRanalysis,with KMO of 0.862 andχ2 of 6959.871 foRBartlett's spherical test(P<0.01).A total of five symptom clusters with eigenvalues>1 were extracted by principal component analysis,which were named as mood-related symptom cluster,limb dysfunction-related symptom cluster,cognitive disorder-related symptom cluster,lack of initiative-fatigue symptom cluster,and slurred speech-coughing afteReating symptom cluster,with a cumulative variance contribution of 69.65%.The accuracy analysis results of the bridge centrality analysis showed that the mean edge weight value was 0.054 and its 95%CI width was small.Bridge centrality indexes analysis showed that lack of initiative(5.973)and fatigue(5.167)were the top 2 symptoms ranked by bridge strength(rbS),lack of initiative(0.359)and fatigue(0.335)were the top 2 symptoms ranked by bridge closeness(rbC),and coughing afteReating(14.000)and hypomesthesia(5.000)were the to

关 键 词：卒中 症状网络 桥梁症状 

分 类 号：R743[医药卫生—神经病学与精神病学]