Logistic regression analysis on the influencing factors of cognitive dysfunction in elderly patients with acute ischemic stroke
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摘要: 目的 了解高龄急性缺血性脑卒中患者(acute ischemic stroke,AIS)认知功能障碍的发生率及影响因素。方法 选取2013年1月~2016年9月海口市第三人民医院收治的AIS患者725例,最终纳入患者426例。根据患者病情稳定即将出院时采用简易精神状态量表(mini mental state examination,MMSE)评估其是否存在认知功能障碍,分为认知功能障碍组201例和认知功能正常组225例。应用单因素及多元Logistic回归分析急性缺血性脑卒中患者认知功能障碍的影响因素,并绘制受试者工作特征曲线来评估Logistic回归模型的效果。结果 单因素及多元Logistic回归分析显示,高血压史、高脂血症、高同型半胱氨酸血症、体育锻炼、交流频率、日常生活能力是脑卒中患者发生认知功能障碍的独立影响因素(均有P<0.05)。受试者工作特征曲线评价Logistic回归模型效果的曲线下面积为0.853(95%CI:0.781~0.926)。>3个独立危险因素组MMSE评分低于≤ 3个独立危险因素组MMSE评分(t=4.183,P=0.016)。结论 高龄急性缺血性脑卒中患者认知功能障碍的发生率较高,影响认知功能障碍的危险因素较多,需采取预防措施,以减少或延缓认知障碍的发生。
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关键词:
- 卒中 /
- 认知障碍 /
- Logistic模型
Abstract: Objective To investigate the incidence and influencing factors of cognitive dysfunction in elderly patients with acute ischemic stroke(AIS). Methods From January 2013 to September 2016, 725 patients with AIS in the third people's Hospital of Haikou were selected and 426 patients were included in the analysis of cognitive dysfunction using mini mental state examination (MMSE). Accordingly, the total 426 cases were divided into cognitive dysfunction group with 201 cases and normal cognitive function group with 225 cases. The influencing factors of cognitive impairment in patients with acute ischemic stroke were analyzed by single factor and multiple Logistic regression analysis. Receiver operating characteristic(ROC)curve was used to evaluate the effect of the logistic regression model. Results Single factor and multivariate Logistic regression analysis showed that history of hypertension, hyperlipidemia, hyperhomocystinemia, physical exercise, exchange frequency and ability of daily life were independent influencing factors for stroke patients with cognitive dysfunction (all P<0.05). The area under the curve(AUC) was 0.853(95% CI:0.781-0.926) under the effect of the logistic regression model by the ROC curve. MMSE score of groups with more than three independent risk factors was significantly lower than that of groups with less than three independent risk factors (t=4.183,P=0.016). Conclusions The incidence of cognitive dysfunction in elderly patients with acute ischemic stroke is high. There are a large number of risk factors for cognitive dysfunction. Preventive measures should be taken to reduce or delay the occurrence of cognitive impairment.
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