| 焦爱菊,朱若兰,张春花,李文瑞,孙霞,赵玮婧,任宝龙.脑小血管病患者MRI总负荷联合认知障碍对跌倒风险的预测价值[J].中国康复,2026,41(1):22-26 |
| 脑小血管病患者MRI总负荷联合认知障碍对跌倒风险的预测价值 |
| Predictive value of the total burden of MRI combined with cognitive impairment in risk of falls in patients with cerebral small vessel disease |
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| DOI：10.3870/zgkf.2026.01.004 |
| 中文关键词: 脑小血管病 认知障碍 跌倒风险 MRI总负荷 |
| 英文关键词: cerebral small vessel disease cognitive impairment risk of falls total burden of MRI |
| 基金项目:甘肃省重点研发项目（21YF5FH212）；武威市科技计划B类项目（WW23B02SF042） |
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| 中文摘要: |
| 目的：探讨脑小血管病（CSVD）患者MRI总负荷、认知障碍与跌倒风险的相关性，以及MRI总负荷联合认知障碍对CSVD患者跌倒风险的预测价值。方法：选取200例CSVD患者根据计时“起立-行走”测试（TUG）时间分为低跌倒风险（LRF，TUG时间＜15s）组113例和高跌倒风险（HRF，TUG时间≥15s）组87例。采用3.0T MRI评价CSVD患者MRI总负荷评分，蒙特利尔认知评估量表（MoCA）评估患者认知功能，比较2组临床资料。Spearman分析CSVD患者MRI总负荷、MoCA评分与跌倒风险相关性。以Logistic回归分析评估CSVD患者跌倒风险的影响因素，受试者工作特征（ROC）曲线评估MRI总负荷、MoCA评分对CSVD患者跌倒风险的预测价值，并进行外部验证。结果：与LRF组相比，HRF组患者存在明显的跌倒史，MRI总负荷评分升高，MoCA评分降低（均P＜0.05）。CSVD患者跌倒风险与MRI总负荷呈正相关，与MoCA评分呈负相关（均P＜0.05）。多因素Logistic回归分析显示，MRI总负荷增高、MoCA评分降低为CSVD患者跌倒的危险因素（均P＜0.05），有一定的预测价值，但其联合预测的曲线下面积（AUC）为96.8%，外部验证的AUC为87.3%，预测价值更高。结论：CSVD患者MRI总负荷、认知功能障碍与跌倒风险密切相关，联合可预测CSVD患者的跌倒风险。 |
| 英文摘要: |
| Objective: To investigate the correlation between total magnetic resonance imaging (MRI) burden, cognitive impairment and risk of falls in patients with cerebral small vessel disease (CSVD), and the predictive value of the total burden of MRI and cognitive impairment in risk of falls in CSVD patients. Methods: A total of 200 patients with CSVD were classified by the time up and go test (TUG) into low risk of falling (LRF, TUG<15s) group (113 cases) and high risk of falling (HRF, TUG ≥ 15 s) group (87 cases). The total burden of CSVD was evaluated using the 3.0T MRI, the Montreal cognitive assessment scale (MoCA) was used to evaluate cognitive function, and the basic information was compared between the two groups. Spearman correlation analysis was used to evaluate the relationship between the total burden of MRI, cognitive impairment and risk of falls in patients with CSVD. The influencing factors of the risk of falls in CSVD patients were analyzed by Logistic regression method. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of total MRI burden and MoCA score in risk of falls in patients with CSVD, and external verification set was performed. Results: Compared with the LRF group, the HRF patients had a significant history of falls, increased MRI total burden score, and decreased MoCA score (all P<0.05). The risk of falling was positively associated with total MRI burden in patients with CSVD and negatively with MoCA score (all P<0.05). Results of Logistic regresstion analysis showed that increased total MRI burden and decreased MoCA score were risk factors for falls in CSVD (P<0.05) and had some predictive value, the area under curve (AUC) of combination was 96.8%, with AUC values of 87.3% in the external verification set. Conclusion: The total MRI burden and cognitive impairment may be related to the risk of falls in patients with CSVD, which can predict the risk of falling in CSVD patients. |
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