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（χ2=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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.004 | 0.005 |
| Scholarly communication | 0.008 | 0.010 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
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; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".