基于主成分分析法的脑卒中后轻度认知障碍风险预测模型研究-现代医学

基于主成分分析法的脑卒中后轻度认知障碍风险预测模型研究

单位：1. 东南大学附属中大医院护理部, 江苏南京 210009;
2. 东南大学附属中大医院神经内科, 江苏南京 210009;
3. 东南大学医学院护理系, 江苏南京 210009

分类号：R743.3

出版年·卷·期（页码）：2023·51·第十期（1386-1391）

摘要：

目的：构建脑卒中后轻度认知障碍（PSMCI）预测模型，精准评估患者轻度认知障碍风险程度，为临床识别高危风险人群提供依据。方法：选择2020年1月至2022年6月在东南大学附属中大医院神经内科住院的脑卒中患者，采用听觉词语学习测验、逻辑记忆测验、Rey复杂图形测验、言语流畅性测验、图片命名测验、数字广度测验、数字符号转换测验、连线测验、Stroop色词测验、词语流畅测验等16个指标进行调查，采用主成分分析法对数据进行统计分析，确定脑卒中患者存在的认知障碍风险所包涵维度，形成风险预测模型。结果：脑卒中患者认知障碍风险存在3个维度，对总方差的累积贡献率是59.227%，分别为记忆功能和注意水平、记忆功能和执行能力、患者抑郁状态和日常生活自理能力，并形成基于3个维度在原变量中所占的百分比认知障碍风险的评价计算公式。结论：本研究构建的PSMCI患者风险预测模型，能客观评价患者存在的认知障碍风险并进行分级，有助于临床早期识别不同程度风险人群，针对性地提供预防与干预措施。

Objective: This study aims to construct a risk prediction model for post-stroke mild cognitive impairment(PSMCI) patients, to accurately assess the degree of risk of mild cognitive impairment, and to provide a basis for clinical identification of high-risk groups. Methods: Stroke patients admitted to the Department of Neurology, Zhongda Hospital Affiliated to Southeast University, from January 2020 to June 2022 were recruited. 16 indicators such as the Auditory-Verbal Learning Test(AVLT), Logical Memory Test(LMT), Rey-Osterrieth Complex Figure Test(ROCF), Verbal Fluency Test(VFT), Picture-Naming Test, Digit Span Test(DST), Symbol Digit Modalities Test(SDMT), Trail Making Test(TMT), Stroop Color Word Test(SCWT) and Word Fluency Test were used to investigate patients. Principal component analysis method was used to determine the dimensions of risk for PSMCI patients and to develop a risk prediction model. Results: Three dimensions of risk for PSMCI patients were identified, with a cumulative contribution of 59.227% to the total variance:memory function and attention level, memory function and executive ability, and depressive state and activities of daily living. The evaluation formula of cognitive impairment risk was formed based on the percentage of the three dimensions in the original variable. Conclusion: The risk prediction model for PSMCI patients constructed in this study can objectively evaluate and grade the risk of cognitive impairment. This is helpful for the early clinical identification of stroke people with different levels of risk, and the targeted provision of preventive measures and intervention.

参考文献：

[1] GBD 2016 Causes of Death Collaborators.Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016:a systematic analysis for the Global Burden of Disease Study 2016[J].Lancet, 2017, 390(10100):1151-1210.
[2] ZHOU M, WANG H, ZHU J, et al.Cause-specific mortality for 240 causes in China during 1990-2013:a systematic subnational analysis for the Global Burden of Disease Study 2013[J].Lancet, 2016, 387(10015):251-272.
[3] 国家卫生健康委员会编.2018中国卫生健康统计提要[M].北京:中国协和医科大学出版社, 2018.
[4] KIM A S, CAHILL E, CHENG N T.Global stroke belt:geographic variation in stroke burden worldwide[J].Stroke, 2015, 46(12):3564-3570.
[5] 王陇德, 刘建民, 杨弋, 等.我国脑卒中防治仍面临巨大挑战:《中国脑卒中防治报告2018》概要[J].中国循环杂志, 2019, 34(2):105-119.
[6] BROSSERON F, KRAUTHAUSEN M, KUMMER M, et al.Body fluid cytokine levels in mild cognitive impairment and Alzheimer's disease:a comparative overview[J].Mol Neurobiol, 2014, 50(2):534-544.
[7] VASSALLO M, POYNTER L, KWAN J, et al.A prospective observational study of outcomes from rehabilitation of elderly patients with moderate to severe cognitive impairment[J].Clin Rehabil, 2016, 30(9):901-908.
[8] GUAN T, MA J, LI M, et al.Rapid transitions in the epidemiology of stroke and its risk factors in China from 2002 to 2013[J].Neurology, 2017, 89(1):53-61.
[9] WANG W, JIANG B, SUN H, et al.Prevalence, incidence, and mortality of stroke in China:results from a nationwide population-based survey of 480687 adults[J].Circulation, 2017, 135(8):759-771.
[10] 中国卒中学会, 卒中后认知障碍管理专家委员会.卒中后认知障碍管理专家共识[J].中国卒中杂志, 2017, 12(6):519-531.
[11] 健康之路栏目丛书编委会编.脑血管病[M].北京:北京出版社, 2007.
[12] 张磊, 刘建民.改良Rankin量表[J].中华神经外科杂志, 2012, 28(5):512.
[13] 李会, 张振香, 梅永霞, 等.脑卒中后认知障碍风险预测模型研究进展[J].护理研究, 2022, 36(20):3645-3649.
[14] BALTHAZAR M L, YASUDA C L, CENDES F, et al.Learning, retrieval, and recognition are compromised in aMCI and mild AD:are distinct episodic memory processes mediated by the same anatomical structures?[J].J Int Neuropsychol Soc, 2010, 16(1):205-209.
[15] 张晓玲.轻度认知障碍向AD转化的Landmark模型动态风险预测[D].太原:山西医科大学, 2020.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录