中青年轻型脑梗死患者急性期认知功能障碍危险因素分析及风险预测模型建立OA

Objective To explore the risk factors of acute cognitive dysfunction in young and middle-aged patients with mild cerebral infarction,and to construct a risk prediction model to improve the accuracy of early diagnosis and intervention.Methods A total of 60 young and middle-aged patients with mild cerebral infarction admitted to Pingxiang Second People's Hospital from January 2023 to January 2025 were selected.According to MoCA score,the patients were divided into cognitive impairment group(n=17)and cognitive normal group(n=43).The risk factors of acute cognitive dysfunction in young and middle-aged patients with mild cerebral infarction were analyzed.Logistic regression model was used to construct risk prediction model,and Bootstrap method was used to verify its efficacy.Results Among the 60 patients included in the study,17(28.33％)patients had acute cognitive dysfunction.Univariate analysis showed that there were significant differences in education level,CRP level,Hcy level and stenosis degree of responsible vessels between the two groups(P<0.05).Logistic regression analysis showed that low education level,CRP≥3.035 mg/L,Hcy≥18.30 μmol/L,and responsible vascular stenosis≥50％were independent risk factors for acute cognitive dysfunction in young and middle-aged patients with mild cerebral infarction.The nomogram model based on these factors was validated by Bootstrap,with C-index of 0.825 and AUC of 0.827(95％CI:0.774-0.879,P<0.001),showing good discrimination and goodness of fit(Hosmer-Lemeshow test:x2=3.001,P=0.934).Conclusion Cognitive dysfunction in young and middle-aged patients with acute mild cerebral infarction is closely related to education level,CRP,Hcy level and degree of responsible vascular stenosis,and the risk prediction model has good predictive efficacy,which can provide strong support for early clinical identification of high-risk patients,help timely intervention,and improve the prognosis of patients.