| 郭莞莹,舒 可,王若怡,亚金蓉,杨鹤云.血清IL-6联合MoCA评分、CHANGE风险评分对急性脑卒中后认知障碍的多维度预测模型研究[J].,2025,(18):2981-2987 |
| 血清IL-6联合MoCA评分、CHANGE风险评分对急性脑卒中后认知障碍的多维度预测模型研究 |
| Study on the Multidimensional Predictive Model of Serum IL-6 Combined with MoCA Score and CHANGE Risk Score for Post-Stroke Cognitive Impairment |
| 投稿时间：2025-04-15 |
| DOI：10.13241/j.cnki.pmb.2025.18.014 |
| 中文关键词: 急性脑卒中 卒中后认知障碍 白细胞介素-6 蒙特利尔认知评估量表 CHANGE风险评分 |
| 英文关键词: Acute stroke Post-stroke cognitive impairment Interleukin-6 Montreal Cognitive Assessment CHANGE risk score |
| 基金项目:昆明市卫生健康委员会卫生科研课题项目（2023-03-07-009） |
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| 中文摘要: |
| 摘要 目的：探讨血清白细胞介素-6（interleukin-6, IL-6）联合蒙特利尔认知评估量表（Montreal Cognitive Assessment, MoCA）评分、CHANGE风险评分在急性脑卒中后认知障碍（post-stroke cognitive impairment, PSCI）的预测价值，为高风险患者早期识别及干预提供依据。方法：回顾性分析2022年10月至2024年9月我院收治的200例急性脑卒中患者的一般资料，根据急性脑卒中后3个月是否发生PSCI分为PSCI组（49例）和非PSCI组（151例）。对比两组的一般资料，采用多因素Logistic回归分析PSCI影响因素，并使用受试者工作特征（receiver operating characteristic, ROC）曲线评估血清IL-6、MoCA评分及CHANGE风险评分对PSCI发生的预测效能。结果：两组年龄、受教育程度比较差异有统计学意义（P<0.05）。PSCI组血清IL-6水平及CHANGE风险评分高于非PSCI组，MoCA评分低于非PSCI组（P<0.05）。多因素Logistic回归显示IL-6水平升高（OR=1.851，P=0.001）、CHANGE风险评分升高（OR=1.076，P=0.016）是PSCI发生的独立危险因素，MoCA评分升高（OR=0.806，P=0.001）是保护因素（P<0.05）。IL-6水平、MoCA评分及CHANGE风险评分均对预测PSCI发生有较高的效能，三者单独预测PSCI发生的曲线下面积（area under the curve, AUC）分别为0.783、0.825、0.857，三者联合检测AUC为0.912，显著高于各指标单独检测。结论：血清IL-6升高、MoCA评分降低及CHANGE风险评分升高是PSCI的危险因素，三者联合检测模型对PSCI发生的预测效能最高，可为临床早期干预提供科学依据。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the predictive value of serum interleukin-6 (IL-6) combined with Montreal Cognitive Assessment (MoCA) score and CHANGE risk score for post-stroke cognitive impairment (PSCI), and to provide a basis for early identification and intervention of high-risk patients. Methods: The general data of 200 patients with acute stroke who were admitted to our hospital from October 2022 to September 2024 were retrospectively analyzed, they were divided into PSCI group (49 cases) and non PSCI group (151 cases) based on whether PSCI occurred 3 months after acute stroke. The general data of two groups were compared, multiple logistic regression was used to analyze the influencing factors of PSCI, and receiver operating characteristic (ROC) curves were used to evaluate predictive efficiency of serum IL-6, MoCA score and CHANGE risk score for of PSCI. Results: There was a statistically significant difference in age and education level between the two groups (P<0.05). The serum IL-6 level and CHANGE risk score in the PSCI group were higher than those in the non PSCI group, while the MoCA score was lower than that in the non PSCI group (P<0.05). Multivariate logistic regression showed that elevated IL-6 levels (OR=1.851, P=0.001) and elevated CHANGE risk scores (OR=1.076, P=0.016) were independent risk factors of the occurrence of PSCI, while elevated in MoCA score (OR=0.806, P=0.001) was a protective factor (P<0.05). IL-6 levels, MoCA scores and CHANGE risk scores have high predictive efficiency for the occurrence of PSCI, the area under the curve (AUC) for predicting occurrence of PSCI by the three alone were 0.783, 0.825 and 0.857 respectively, the AUC for the combined detection of the three indicators was 0.912, significantly higher than that of each indicator detected separately. Conclusion: Elevated serum IL-6, decreased MoCA score and increased CHANGE risk score are risk factors for PSCI, the combined detection model of the three has the highest predictive efficiency for occurrence of PSCI and can provide scientific basis for early clinical intervention. |
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