脑卒中住院期间ASD的个体化Nomogram预警工具评估  

Study on the individualized Nomogram early warning tool for assessing ASD during stroke hospitalization

作　　者：曹丽[1] 马华[1] 王运锋[1] 袁映红[1] 宋慧敏[1] 袁春艳[1] CAO Li;MA Hua;WANY Yunfeng;YUAN Yinghong;SONG Huimin;YUAN Chunyan(Department of Neurology,The Second Clinical Medical College of North Sichuan Medical College,Nanchong Central Hospital,Nanchong Sichuan 637000,China)

机构地区：[1]川北医学院第二临床医学院、南充市中心医院神经内科,四川南充637000

出　　处：《蚌埠医学院学报》2024年第11期1518-1522,共5页Journal of Bengbu Medical College

基　　金：四川省基层卫生事业发展研究中心资助项目(SWFZ19-C-71)。

摘　　要：目的:分析脑卒中住院期间发生急性应激障碍(ASD)的危险因素,并建立Nomogram模型进行个体化预警。方法:纳入脑卒中病人182例为模型组,根据是否发生ASD将其分为ASD组80例和非ASD组102例。同时选择住院脑卒中病人134例作为验证组。采用logistic回归分析模型组脑卒中病人并发ASD的独立危险因素,并采用R软件建立评估脑卒中病人ASD发生的Nomogram模型并进行验证,采用ROC曲线评价该模型评估价值。结果:ASD组和非ASD组病人的年龄、性格、吞咽功能障碍以及偏瘫差异均有统计学意义(P<0.05~P<0.01),其中ASD组性格以内向为主,年龄>60岁,且吞咽功能障碍、偏瘫比例较高(P<0.05~P<0.01)。logistic回归分析显示年龄(OR=1.527,95%CI:1.072~2.268)、性格(OR=1.619,95%CI:1.060~2.473)、吞咽功能障碍(OR=1.696,95%CI:1.128~2.549)、偏瘫(OR=1.250,95%CI:1.250~2.472)均是ASD的独立影响因素(P<0.05~P<0.01)。Nomogram模型预测建模组、验证组的C-index分别为0.822和0.803。ROC曲线分析显示,Nomogram模型预测建模组、验证组发生ASD的AUC分别为0.822(95%CI:0.757~0.888)、0.809(95%CI:0.748~0.870)。结论:年龄、性格、吞咽功能障碍以及偏瘫是影响脑卒中住院病人发生ASD的独立危险因素,以上述指标建立的Nomogram模型具有良好预测效能。Objective:To analyze the risk factors of acute stress disorder(ASD)during stroke hospitalization,and establish a Nomogram model for individualized early warning.Methods:One hundred and eighty-two stroke patients were selected as the as model group,and subdivided into the ASD group(80 cases)and non-ASD group(102 cases)according to whether the ASD occurred.At the same time,134 stroke patients with hospitalization were selected as the validation group.The logistic regression andlysis was used to analyze the independent risk factors of ASD in stroke patients in the model group.The nomogram model for evaluating the occurrence of ASD in stroke patients was established and verified by R software,and the evaluation value of model was evaluated by ROC curve.Results:There were statistically significant in the age,personality,swallowing dysfunction and hemiplegia between the ASD group and non-ASD group(P<0.05).For the ASD group,the patients were mainly introverted,and more than 60 years old,and the proportion of swallowing dysfunction and hemiplegia were higher(P<0.05 to P<0.01).The results of logistic regression analysis showed that the age(OR=1.527,95%CI:1.072-2.268),personality(OR=1.619,95%CI:1.060-2.473),swallowing dysfunction(OR=1.696,95%CI:1.128-2.549)and hemiplegia(OR=1.250,95%CI:1.250-2.472)were the independent influencing factors of ASD(P<0.05 to P<0.01).The Nomogram model predicted that the C-index of the model group and validation group were 0.822 and 0.803,respectively.The results of ROC curve showed that the AUC value of the Nomogram model for predicting ASD in the model group and validation group were 0.822(95%CI:0.757-0.888)and 0.809(95%CI:0.748-0.870),respectively.Conclusions:The age,personality,swallowing dysfunction and hemiplegia are the independent risk factors of ASD in hospitalized stroke patients,and the Nomogram model established with the above indicators has good predictive performance.

关 键 词：脑卒中 急性应激障碍 Nomogram模型 个性化评估 

分 类 号：R743.3[医药卫生—神经病学与精神病学]