基于胱抑素C水平构建急性缺血性脑卒中后抑郁的风险模型及验证  

Development and Validation of a Risk Model for Post-Stroke Depression after Acute Ischemic Stroke Based on Cystatin C Level

作　　者：连浩军 LIAN Haojun(Department of Neurology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450000)

机构地区：[1]郑州大学第二附属医院神经内科,河南郑州450000

出　　处：《医学临床研究》2025年第4期608-611,共4页Journal of Clinical Research

摘　　要：【目的】构建并验证基于胱抑素C(cys C)水平的急性缺血性脑卒中(AIS)后抑郁风险模型。【方法】收集102例AIS患者的临床数据,统计患者住院期间抑郁发生情况,分析患者抑郁的影响因素,构建AIS后患者抑郁风险列线图模型并验证其效能。【结果】102例患者中,30例出现抑郁。Logistic多因素回归分析显示,左侧病灶、美国国立卫生研究员卒中量表(NIHSS)评分>4分、同型半胱氨酸(Hcy)≥15μmoL/L、cys C≥1.09 mg/L是影响AIS治疗后患者抑郁的危险因素(P<0.05)。以上述危险因素作为预测变量,建立列线图预测模型,各因素总分为87~372分,对应风险率0.05~0.81。列线图模型验证结果显示,C-index指数为0.811(95%CI:0.774~0.849),预测AIS后患者抑郁的校正曲线趋近于理想曲线(P>0.05)。【结论】病灶侧别、NIHSS评分、Hcy及cys C水平与AIS后患者抑郁有关,依此建立的列线图模型评估患者抑郁的效能良好。【Objective】To construct and validate a risk model for post-stroke depression after acute ischemic stroke(AIS)based on cystatin C(cys C)level.【Methods】Clinical data of 102 AIS patients were collected,and the occurrence of depression during hospitalization was recorded.Factors influencing the development of depression in these patients were analyzed,and a risk nomogram for depression in AIS patients was developed and validated.【Results】Among the 102 patients,30 developed depression.Logistic multivariate regression analysis identified left-sided lesions,NIHSS score>4,homocysteine(Hcy)≥15μmol/L,and cys C≥1.09 mg/L as factors influencing post-AIS depression(P<0.05).Using these risk factors as predictive variables,a nomogram model was established with a total score range(including each factor)of 87 to 372 points,which were corresponding to a risk rate of 0.05 to 0.81.The validation of the nomogram model showed that a C-index was 0.811(95%CI:0.774-0.849),and the calibration curve for predicting depression after AIS was close to the ideal curve(P>0.05).【Conclusion】Lesion side,NIHSS score,Hcy levels,and cys C levels are associated with post-stroke depression after AIS.The nomogram model developed based on these factors has good predictive efficacy for assessing post-stroke depression in AIS patients.

关 键 词：脑缺血 卒中 急性病 半胱氨酸蛋白酶抑制物C 

分 类 号：R743.3[医药卫生—神经病学与精神病学]