目的 探讨老年脑卒中患者内在能力（intrinsic capacity，IC）的纵向发展轨迹及分析其影响因素，为制订相关干预方案提供参考依据。方法 2023年10月至2025年1月，采用便利抽样法选取上海市某三级甲等医院神经内科的老年脑卒中患者307例为研究对象，在出院时、出院后1个月、3个月、6个月、9个月、12个月从认知功能（简易智能精神状态量表）、心理功能（简版老年抑郁量表）、营养状况（微型营养评定简表）、运动能力（简易躯体功能状态评估量表）、感官功能（自我报告）5个方面评估IC水平。利用组轨迹模型识别患者IC轨迹，运用多元Logistic回归分析患者IC轨迹的影响因素。结果 IC总分为2.00(1.00,4.00)分，其中认知维度得分（26.42±4.02）分,心理维度得分4.00（1.25,5.00）分,营养维度得分（10.80±2.13）分,运动维度得分（9.12±3.04）分。识别出3种IC轨迹，即高起点下降组（42.02%）、持续低水平组（49.84%）、中等起点上升组（8.14%）。多元Logistic回归分析结果显示，跌倒史、功能障碍、合并慢性病、再次发作、个人月收入、吸烟史是老年脑卒中患者IC轨迹类别的影响因素（均P＜0.05）。结论 老年脑卒中患者IC呈现不同的变化轨迹，医护人员应重视影响患者IC变化的因素，并针对不同轨迹特征给予个性化护理干预，以提升其IC，促进健康老龄化。

Objective To explore the longitudinal trajectories of intrinsic capacity (IC) in elderly stroke patients and analyze influencing factors，and to provide a reference basis for formulating relevant intervention plans.Methods From October 2023 to January 2025，307 elderly stroke patients from the Neurology Department of a tertiary A hospital in Shanghai were selected by the convenience sampling method.The utilization level of IC should be assessed from five aspects，namely cognitive function (mini-mental state examination)，psychological function (geriatric depression scale-15 item)，nutritional status (mini nutritional assessment short-form)，motor ability (short physical performance battery)，and sensory function (self-report)，at the time of discharge，as well as 1 month，3 months，6 months，9 months and 12 months after discharge.Group-based trajectory modeling (GBTM) was employed to identify the development trajectory of patients’ IC，and multiple Logistic regression was applied to analyze the influencing factors of the development trajectory of patients’ IC.Results The total score of IC was 2.00(1.00,4.00),with scores of (26.42±4.02) for the cognitive dimension，4.00（1.25,5.00）for the psychological dimension，(10.80±2.13) for the nutritional dimension，and (9.12±3.04) for the motor dimension.Three distinct IC trajectories were identified：a high-baseline declining group (42.02%)，a persistently low-level group (49.84%)，and a moderate-baseline ascending group (8.14%).The results of multivariate Logistic regression analysis showed that history of falls，functional impairment，combined chronic diseases，recurrence，personal monthly income，and smoking history were the influencing factors of IC trajectory categories in elderly stroke patients (all P＜0.05).Conclusions The development of IC in elderly stroke patients shows different change trajectories.Medical staff should pay attention to the factors influencing the changes in patients’ IC and provide personalized nursing intervention based on different trajectory characteristics to improve their IC and promote healthy aging.

R473.74

国家自然科学基金资助项目（72074168）；上海市第十人民医院护理部科研课题（SYHLKYZ-202301）