老年缺血性脑卒中后精神行为症状发生率及其风险预测模型构建

doi:10.3969/j.issn.1003-9198.2025.02.009

摘要/Abstract

摘要： 目的本研究旨在调查老年急性缺血性脑卒中(AIS)病人精神行为症状(BPS)的发生率,并构建BPS的风险预测模型。方法选取2021年1月至2023年8月西京医院诊治的174例老年AIS病人,根据精神行为问卷(NPI)评估结果分为BPS组和非BPS组。比较2组间一般资料、实验室指标及影像学指标,并通过logistic回归分析筛选BPS的独立影响因素,构建其风险预测模型。结果 174例病人中,94例(54.02%)病人在卒中后1个月内出现BPS,不同梗死部位病人BPS类型表现各异。单因素分析显示,教育年限、血小板-淋巴细胞比值(PLR)、中性粒细胞-淋巴细胞比值(NLR)、MoCA评分和生活自理能力(ADL)评分与BPS发生相关(P＜0.05)。多因素logistic回归分析结果显示,PLR、NLR、MoCA评分和ADL评分为BPS的独立影响因素(P＜0.05)。ROC曲线分析显示,风险预测模型的AUC为0.899(95%CI: 0.855~0.944),敏感度为89.40%,特异度为76.20%。结论老年AIS病人BPS发生率较高,本研究构建的风险预测模型可为临床提供有效的BPS风险评估结果,有助于早期识别和预防BPS。

关键词: 缺血性脑卒中, 精神行为症状, 老年人, 发生率, 风险预测模型

Abstract: Objective To investigate the incidence of behavioral and psychiatric symptoms (BPS) in the elderly patients with acute ischemic stroke (AIS), and to establish a reliable risk prediction model. Methods A total of 174 elderly patients with AIS treated in Xijing Hospital from January 2021 to August 2023 were enrolled in this study and divided into BPS group and non-BPS group according to the results of neuropsychiatric inventory (NPI). Univariate analysis was used to compare the general data, laboratory indicators and imaging indexes between the two groups, and logistic regression analysis was used to screen the independent influencing factors of BPS and to establish a risk prediction model. Results Among the 174 patients, 94 (54.02%) cases presented with BPS within 1 month after stroke, and the types of BPS were different in the patients with different infarction sites. Univariate analysis showed that years of education, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR),Montreal Cognitive Assessment Scale(MoCA) score and activities of daily living(ADL) score showed significant differences between the two groups (P<0.05). Multivariate logistic regression analysis showed that PLR, NLR, MoCA score and ADL score were independent influencing factors of BPS (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of the model was 0.899 (95%CI: 0.855-0.944). Conclusions The incidence of BPS in the elderly patients with AIS is relatively high, and the constructed risk prediction model can provide an effective risk assessment result for clinical practice, which is helpful for early identification and prevention of BPS.

Key words: acute ischemic stroke, behavioral and psychological symptoms, aged, incidence rate, risk prediction model

中图分类号:

朱英华, 周淑玲, 闫明珠, 施艳. 老年缺血性脑卒中后精神行为症状发生率及其风险预测模型构建[J]. 实用老年医学, 2025, 39(2): 148-152.

ZHU Yinghua, ZHOU Shuling, YAN Mingzhu, SHI Yan. Establishment of prediction model for behavioral and psychiatric symptoms in elderly patients with ischemic stroke[J]. Practical Geriatrics, 2025, 39(2): 148-152.

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