摘要
目的分析脑出血后并发睡眠障碍的影响因素,建立出血后并发睡眠障碍的预测模型。方法回顾性选取宁乡市人民医院2022年6月~2024年5月收治的173例脑出血患者,使用中文版匹兹堡睡眠量表(PSQI)评估所有患者发病2周内睡眠障碍发生情况,并按照患者是否发生睡眠障碍,分别纳入发生组、未发生组,对比两组患者临床资料,使用logistic多因素回归模型,归纳影响脑出血后并发睡眠障碍的相关因素,并基于相关因素构建列线图预测模型、评估模型预测效能。结果173例脑出血患者中,91例发生睡眠障碍,发生率为52.60%。logistic多因素回归分析示,年龄≥60岁、血肿破入脑室、收缩压≥140 mmHg、美国国立卫生院卒中量表(National institute of health stroke scale,NIHSS)≥15分、焦虑、抑郁均为影响脑出血后并发睡眠障碍的独立危险因素,出血部位为顶枕叶为保护性因素(P<0.05)。脑出血后并发睡眠障碍的列线图一致性系数C-index为0.779,准确度较高;校准曲线接近标准曲线,预测发生率和实际发生率间符合度的平均绝对误差为0.052,符合度良好。结论脑出血患者睡眠障碍发生率较高,且与患者年龄、血肿破入脑室、收缩压、神经损伤程度、心理状态等多种因素有关,基于上述因素建立的列线图预测模型能够为患者睡眠障碍的预测提供参考。
Objective To analyze the influencing factors of sleep disorder after cerebral hemorrhage and establish a prediction model of sleep disorder after hemorrhage.Methods 173 patients with cerebral hemorrhage admitted to our hospital from June 2022 to May 2024 were included.The Chinese version of Pittsburgh sleep quality index(PSQI)was used to evaluate the occurrence of sleep disorder within two weeks after onset,and according to whether the patients had sleep disorder,they were divided into the occurrence group and the non-occurrence group respectively.The clinical data of the two groups were compared,and the logistic multivariate regression model was used to summarize the related factors affecting the sleep disorder after cerebral hemorrhage.Based on the related factors,a nomogram prediction model was constructed.Results Among 173 cases of cerebral hemorrhage,91 cases had sleep disorder,the incidence rate was 52.60%.Logistic regression analysis showed that age≥60 years old,ventricular rupture,systolic blood pressure≥140 mmHg,NIHSS score≥15,anxiety and depression were all independent risk factors for sleep disorder after cerebral hemorrhage,and parietal occipital lobe was the protective factor(P<0.05).The nomogram C-index of sleep disorder after cerebral hemorrhage is 0.779,with high accuracy.The calibration curve is close to the standard curve,and the average absolute error of the coincidence between the predicted incidence rate and the actual incidence rate is 0.052,and the coincidence degree is good.Conclusion The incidence of sleep disorder in patients with cerebral hemorrhage is high,which is related to many factors,such as age,hematoma breaking into ventricle,systolic blood pressure,degree of nerve injury,psychological state and so on.The nomogram prediction model based on the above factors can provide reliable reference for the prediction of sleep disorder in patients.
作者
任发
刘霞
张继辉
Ren Fa;Liu Xia;Zhang Jihui(Department of Neurosurgery,Ningxiang People's Hospital,Changsha 410200,China)
出处
《中华保健医学杂志》
2025年第3期442-445,共4页
Chinese Journal of Health Care and Medicine
基金
长沙市自然科学基金项目(kq2202499)。
关键词
脑出血
睡眠障碍
影响因素
列线图
Cerebral hemorrhage
Sleep disorder
Influencing factors
Nomogram model
