脑卒中患者继发血管认知功能损害的风险预警模型构建及验证  

Construction and verification of risk warning model for secondary vascular cognitive impairment in stroke patients

作　　者：杭代 刘才荣 吴正超 蔡志敏[1] Hang Dai;Liu Cairong;Wu Zhengchao;Cai Zhimin(General Medicine Department of Gulou Hospital Affiliated to Nanjing University School of Medicine,Jiangsu 210000,China)

机构地区：[1]南京大学医学院附属鼓楼医院全科医学科,江苏210000

出　　处：《脑与神经疾病杂志》2025年第1期29-33,共5页Journal of Brain and Nervous Diseases

基　　金：南京鼓楼医院临床研究及横向科研项目(2023-H398)。

摘　　要：目的构建脑卒中患者继发血管认知功能损害(VCI)的风险预警模型,并验证该模型的预测效果。方法选取2023年1月至2024年2月南京大学医学院附属鼓楼医院全科医学科374例脑卒中患者为研究对象,其中262例患者进行模型构建,采用Logistic回归分析模型构建,采用受试者工作特征曲线(ROC)曲线下面积AVC和Hosmer-Lemeshow检验评估模型的预测能力和拟合度;再通过112例脑卒中患者进行模型的验证。结果脑卒中患者继发VCI发生率为48.7%,脑卒中患者继发VCI的影响因素包括年龄、高血压、糖尿病、脑血管狭窄、卒中次数,Hosmer-Lemeshow检验P=0.683,AVC为0.860,约登指数最大值为0.647,最佳临界值为0.460,灵敏度为0.800,特异度为0.760。结论本研究构建的脑卒中患者继发VCI的风险预警模型预测效果良好,可广泛应用于脑卒中患者继发VCI的筛查。Objective To establish a risk early warning model for secondary vascular cognitive impairment(VCI)in stroke patients,and to verify the predictive effect of this model.Methods A total of 374 stroke patients from General Medicine Department of Gulou Hospital Affiliated to Nanjing University School of Medicine were selected as the study objects,and 262 of them were model constructed by Logistic regression analysis.The predictive ability and fit of the model were evaluated by area under ROC curve and Hosmer-Lemeshow test.The model was verified by 112 stroke patients.Results The incidence of secondary VCI in stroke patients was 48.7%.The influencing factors of secondary VCI in stroke patients included age,hypertension,diabetes,cerebrovascular stenosis and stroke frequency.P=0.683 in Hosmer-Lemeshow test,the area under ROC curve was 0.860,and the maximum of Yoden index was 0.647.The optimal critical value was 0.460,the sensitivity was 0.800,and the specificity was 0.760.Conclusion The risk warning model of secondary VCI in stroke patients established in this study has good predictive effect,and can be widely used in the screening of secondary VCI in stroke patients.

关 键 词：脑卒中 血管认知功能损害 预警模型 

分 类 号：R743.32[医药卫生—神经病学与精神病学]