Zhu Chuanxi, Li Lingxu, Qiu Long, Ji Guangcheng
Department of Rehabilitation Medicine, Changchun University of Chinese Medicine, Changchun, Jilin, China.
Tongliao City Hospital, Tongliao, Inner Mongolia, China.
Front Neurol. 2024 Dec 17;15:1478206. doi: 10.3389/fneur.2024.1478206. eCollection 2024.
Post-stroke spasticity (PSS) is a common complication after stroke and is an important cause of high rates of disability after stroke. At present, modern medicine has made great progress in the treatment of PSS, 'early detection, early treatment' has become a general consensus for the treatment of PSS in the clinic. Clarifying the risk factors of PSS can help to detect and treat the functional disorders caused by PSS at an earlier stage.
This is a retrospective study. 436 stroke patients who visited the Neurology Department of the Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine from June 2020 to November 2020 were selected as study subjects, and finally 257 patients were included in the final analysis, and divided into 101 cases with spasticity and 156 cases without spasticity, depending on whether or not the stroke victim had a spasm at the time of admission.
The multivariate regression analysis showed that basal ganglia as the cerebral hemorrhage or infarction site (OR = 4.930, 95%CI = 2.743-8.86, = 0.000), cerebral hemorrhage or infarction volume (OR = 1.087, 95%CI = 1.016-1.164, = 0.016) and NIHSS scores (OR = 1.232, 95%CI = 1.089-1.393, = 0.001) are independent influencing factors and independent risk factors for spasticity ( < 0.05). A risk prediction model for spasticity in stroke patients is derived with the multivariate logistic regression analysis Logit (P) = 1.595 * Basal ganglia +0.084 * infarct volume + 0.208 * NIHSS scores - 2.092. An evaluation of the goodness of fit using the ROC curve showed AUC (95% CI) = 0.786 (0.730-0.843), an indication of a high degree of model fit.
Independent risk factors for Post-stroke spasticity include basal ganglia as the cerebral hemorrhage or infarction site, cerebral hemorrhage or infarction volume and NIHSS scores.
中风后痉挛（PSS）是中风后常见的并发症，是中风后致残率高的重要原因。目前，现代医学在PSS的治疗方面取得了很大进展，“早发现、早治疗”已成为临床上治疗PSS的普遍共识。明确PSS的危险因素有助于更早地发现和治疗由PSS引起的功能障碍。
这是一项回顾性研究。选取2020年6月至2020年11月在长春中医药大学附属第三临床医院神经内科就诊的436例中风患者作为研究对象，最终257例患者纳入最终分析，根据中风患者入院时是否有痉挛分为痉挛组101例和无痉挛组156例。
多因素回归分析显示，基底节作为脑出血或梗死部位（OR = 4.930，95%CI = 2.743 - 8.86， = 0.000）、脑出血或梗死体积（OR = 1.087，95%CI = 1.016 - 1.164， = 0.016）和美国国立卫生研究院卒中量表（NIHSS）评分（OR = 1.232，95%CI = 1.089 - 1.393， = 0.001）是痉挛的独立影响因素和独立危险因素（ < 0.05）。通过多因素logistic回归分析得出中风患者痉挛的风险预测模型Logit（P） = 1.595 * 基底节 +0.084 * 梗死体积 + 0.208 * NIHSS评分 - 2.092。使用ROC曲线对拟合优度进行评估，结果显示AUC（95%CI） = 0.786（0.730 - 0.843），表明模型拟合度较高。
中风后痉挛的独立危险因素包括基底节作为脑出血或梗死部位、脑出血或梗死体积和NIHSS评分。
