Bibliographic record
Abstract
目的探讨缺血性卒中后认知障碍与脑梗死牛津郡社区脑卒中项目（OCSP）分型及相关实验室指标的关系特点。方法选取2016年6月至2018年6月于我院神经内科住院的急性脑梗死患者152例为观察对象。根据OCSP分型,分为完全前循环梗死（TACI）、部分前循环梗死（PACI）、后循环梗死（POCI）和腔隙性梗死（LACI）4组。研究对象于入院时采用NIHSS量表评估神经功能缺损情况,随访至发病90d时完成蒙特利尔认知评估（Montreal Cognitive Assessment,MoCA）量表评分,评估其认知功能。根据MoCA评分分为认知功能障碍组（PSCI组）及单纯脑梗死组,对MoCA评分及相关实验室指标进行统计学分析。结果 （1）急性脑梗死发生后,其OCSP分型不同亚型均可导致PSCI,其发生率由高到低排列依次为PACI（45.37%）、LACI（33.33%）、POCI（11.11%）、TACI（10.19%）,差异有显著性（χ<sup>2</sup>=20.417,P=0.000）。组间两两比较,PACI亚型PSCI的发生率较POCI亚型高（P<0.05）。（2）脑梗死OCSP分型4种亚型比较,发病90d时MoCA评分不同,由高到低排列依次为LACI亚型、POCI亚型、PACI亚型、TACI亚型（H=27.747,P=0.000）。TACI亚型认知功能损害较重,认知域损害较全面,以命名、语言、抽象思维、延迟回忆能力受损显著;LACI亚型认知功能损害较轻,仅部分认知域受累,以视空间与执行功能、注意力受损为主。（3）与单纯脑梗死组比较,PSCI组患者入院时NIHSS评分较高、发病30d时BI评分较低,差异有显著性（t=-9.725、6.311,P<0.001）;PSCI组患者血清Hcy、hs-CRP、Cys-C、CHOL水平升高,差异有显著性（t=-4.296、-5.158、-2.942、-2.166,P<0.05）。（4）急性脑梗死患者发病90d时的MoCA评分与入院时NIHSS评分、血清Hcy、hs-CRP及Cys-C水平呈负相关（rs’=-0.813、-0.385、-0.600、-0.268,P<0.01）;与发病30d时BI评分呈正相关（rs’=0.638,P<0.01）。（5）经Logistic回归分析显示,急性脑梗死发病90d时发生PSCI的影响因素有入院NIHSS评分、发病30d时BI评分、血清Hcy水平和脑梗死分型。结论对于LACI亚型脑梗死、病情相对较重的患者,以及入院后血清Hcy、hs-CRP或Cys-C水平升高、发病30d时BI评分较低的患者,应格外注意其发病3个月时PSCI的发生。早期识别、早期积极干预PSCI相应危险因素,将对临床防治缺血性PSCI、延缓其进展带来重大意义。
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.004 | 0.003 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.152 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".