基于潜类别增长模型的脑出血患者神经功能恢复轨迹及预后
Neurological recovery trajectory and prognosis of patients with cerebral hemorrhage based on latent class growth model
来源期刊：
广州医药
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收稿时间：2026/6/11 9:53:12
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- 关键词：
- 脑出血；潜类别增长模型；神经功能；恢复轨迹；预后
- cerebral hemorrhage; latent class growing model; neurological function; recovery trajectory; prognosis
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【摘要】目的：基于潜类别增长模型（LCGM）探讨脑出血患者神经功能恢复轨迹及不同轨迹对预后的影响。方法：回顾性采集360例自发性脑出血患者（2023年6月～2025年6月）的临床资料及神经功能评分[美国国立卫生研究院卒中量表（NIHSS）]，并采用LCGM识别神经功能恢复轨迹的潜在类别，分析影响恢复不良型轨迹的危险因素，对比不同轨迹的预后情况[改良Rankin量表（mRS）、格拉斯哥预后评分（GOS）]。结果：LCGM模型拟合结果显示，3类轨迹为最优拟合模型，可将360例自发性脑出血患者分为快速恢复型139例（38.61%）、稳定恢复型154例（42.78%）、恢复不良型67例（18.61%）；入院格拉斯哥昏迷量表（GCS）评分、初始NIHSS评分、机械通气、血管活性药物使用及血肿体积是神经功能恢复不良的独立影响因素（P＜0.05）；预后方面，三组患者mRS、GOS评分存在显著差异（P＜0.05）。结论：基于LCGM可有效识别脑出血患者神经功能恢复的异质性轨迹，同时还能明确影响患者神经功能修复的独立危险因素及不同神经功能恢复轨迹与预后的关联。
Abstract Objective: To explore the trajectory of neurological recovery in patients with cerebral hemorrhage and the impact of different trajectories on prognosis based on latent class growth model (LCGM). Methods: The clinical data and neurological function scores [National Institutes of Health Stroke Scale (NIHSS)] of 360 patients with spontaneous cerebral hemorrhage (June 2023 to June 2025) were retrospectively collected, and LCGM was used to identify potential categories of neurological recovery trajectories, analyze risk factors affecting poor recovery trajectories, and compare the prognosis of different trajectories [modified Rankin Scale (mRS), Glasgow Outcome Score (GOS)]. Results: The LCGM model fitting results showed that the three types of trajectories were the optimal fitting model, and 360 patients with spontaneous cerebral hemorrhage could be divided into 139 cases (38.61%) of rapid recovery type, 154 cases (42.78%) of stable recovery type, and 67 cases (18.61%) of poor recovery type; admission to Glasgow Coma Scale (GCS) score, initial NIHSS score, mechanical ventilation, use of vasoactive drugs and hematoma volume are independent influencing factors of poor neurological recovery (P＜0.05); in terms of prognosis, there were significant differences in mRS and GOS scores among the three groups of patients (P＜0.05).Conclusion: Based on LCGM, it is possible to effectively identify the heterogeneous trajectories of neurological function recovery in patients with intracerebral hemorrhage (ICH), while also identifying independent risk factors influencing neurological function repair and establishing associations between different recovery trajectories and prognosis.
