《中国康复理论与实践》

《中国康复理论与实践》 ›› 2013, Vol. 19 ›› Issue (3): 210-213.

• 论文 • 上一篇    下一篇

缺血性脑卒中复发预测模型的构建

安雅臣，王玉浔，张江，赵晓晶，高素玲，王艳，刘国荣   

  1. 河北联合大学附属医院神经内科，河北唐山市063000。
  • 收稿日期:2012-12-30 修回日期:2013-03-05 出版日期:2013-03-25 发布日期:2013-03-25
  • 通讯作者: 王玉浔

Establishment of Prediction Model for Ischemic Stroke Recurrence

AN Ya-chen, WANG Yu-xun, ZHANG Jiang, et al.   

  1. Department of Neurology, Hospital Affiliated to Hebei United University, Tangshan 063000, Hebei, China
  • Received:2012-12-30 Revised:2013-03-05 Published:2013-03-25 Online:2013-03-25

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摘要：

目的应用Cox 比例风险回归模型构建缺血性脑卒中复发的预测模型。方法调查2008 年1 月1 日~2009 年12 月31 日确诊的连续性初发缺血性脑卒中患者资料，并随访患者的复发情况，于2010 年6 月30 日完成随访工作。应用Kaplan-Meier 法进行复发率分析，应用Cox 比例风险回归模型对影响患者复发的危险因素进行单因素和多因素分析，建立复发模型及个体预后指数。结果随访结束共有79 例患者复发。年龄(X1)、高血压史(X2)、家族卒中史(X3)、总胆固醇(X4)、病情进展(X5)、Essen 卒中风险量表(ESRS)评分(X6)是影响患者复发的独立危险因素。据此建立的复发模型的个体预后指数(PI)为：PI=0.025X1+0.681X2+0.973X3+0.395X4+0.636X5+0.283X6。应用受试者工作特征(ROC)曲线分析，得到以2.289 为截断点，此时模型的灵敏度为0.731，特异度为0.795。结论应用Cox 比例风险回归模型成功建立复发模型及个体预后指数方程。

关键词: 缺血性脑卒中, 复发, Cox 回归模型, 预后指数

Abstract: Objective To establish the prediction model for ischemic stroke recurrence. Methods Consecutive patients with ischemic stroke from January 1st, 2008 to December 31st, 2009 were followed up until June 30th, 2010. The rate of recurrence were described with Kaplan-Meier curve, and the factors associated with recurrence were analyzed with monovariant and multivariate Cox's proportional hazard regression. Results There were 79 cases relapsed during the follow-up. The independent risk factors associated with recurrence were age(X),history of hypertension (X2), family stroke history (X3), total cholesterol (X4), disease progression (X5), total scores of Essen stroke risk score (X6). The personal prognosis index (PI) for predicting recurrence was as: PI=0.025X1+0.681X2+0.973X3+0.395X4+0.636X5+0.283X6. As the receiver operating characteristic (ROC) curve showed, when the cut-off point of PI was 2.289, the sensitivity of the model was 0.731 and specificity was 0.795. Conclusion The model for predicting recurrence of ischemic stroke was established.

Key words: ischemic stroke, recurrence, Cox's regression model, prognosis index