基于倾向性评分匹配法评估急性缺血性脑卒中神经功能改善的影响因素分析

目的 探讨急性缺血性脑卒中(AIS)患者神经功能改善的影响因素.方法 选取上海市第十人民医院2019年6月—2020年6月首次缺血性卒中的247例患者为研究对象,根据出院时患者美国国立卫生研究院卒中量表(NIHSS)减少的百分率分为非显著提高组(＜46％)和显著提高组(≥46％);使用1∶1倾向性评分匹配方法控制一般资...

Analysis of the influencing factors of neurological improvement in acute ischemic stroke on the basis of propensity score matching

Objective To explore the factors influencing the improvement of neurological function in patients with acute ischemic stroke(AIS).Methods A total of 247 patients with first ischemic stroke from June 2019 to June 2020 in Shanghai Tenth People's Hospital were selected as the research objects,and the patients were divided into the non-significantly improved group(<46%)and significantly improved group(≥46%)according to the percentage reduction in National Institutes of Health Stroke Scale(NIHSS)at discharge.The 1∶1 propensity score matching method was used to control the general data of patients the admission NIHSS score,and logistic regression was used for matched patients to analyse the influencing factors of neurological function improvement.Results Before matching,MBI(Z=2.030,P=0.042),mRs(Z=2.996,P=0.003),admission NIHSS score(Z=2.501,P=0.012),sleep duration(χ²=9.486,P=0.009)and cognitive impairment(χ²=31.598,P<0.001)showed a statistically significant difference between both groups.After matching,sleep duration(χ²=8.161,P=0.017),diabetes(χ²=6.092,P=0.014)and cognitive impairment(χ²=21.066,P<0.001)showed a statistically significant difference between both groups.After matching,the variables(diabetes,sleep duration,cognitive impairment)with P<0.1 in the comparison between both groups were entered into logistic regression analysis.Results showed that sleep duration(OR=1.667,95%CI:1.043-2.664,P=0.033)and MoCA(OR=4.697,95%CI:1.973-11.185,P<0.001)were risk factors affecting the improvement of neurological function.Conclusion Shorter sleep duration and early cognitive dysfunction after stroke have an adverse effect on the short-term prognosis of AIS.