目的：探讨快速扰动复杂性指数（ast perturbational complexity index，PCIst）用于意识障碍（distur
bance of consciousness，DoC）患者重复经颅刺激（repetitive transcranial magnetic stimulation，rTMS）治疗反
应性评估中的效果。方法：选择2023年6月至2025年3月我院收治的DoC患者84例。所有患者均采用常
规促醒治疗+rTMS治疗方案。根据rTMS治疗结束后反应性将所有患者分为反应良好及反应不良组，而后
对比2组患者临床资料及实验室检查资料（包含PCIst）。采用Logistic回归分析影响rTMS治疗反应性的相
关因素。结果：截止2025年4月30日，经基础治疗+rTMS治疗后，共计35例患者脱离MSC状态。反应良
好组患者年龄低于反应不良组（P＜0.05）。反应良好组患者基线EEG分级情况优于反应不良组，PCIst大
于反应不良组（P＜0.05）。年龄是rTMS治疗反应性的独立危险因素、PCIst及治疗期间无并发症是rTMS
治疗反应性的独立保护因素（P＜0.05）。RCS分析显示，PCIst与意识障碍患者rTMS治疗的反应性呈显著
线性关系（非线性P=0.677，P=0.004）；ROC曲线显示，PCIst预测意识障碍患者rTMS治疗反应性的曲线下
面积为0.853（95% CI 0.798～0.896，P＜0.001）。结论：PCIst与DoC患者rTMS治疗反应性显著相关，并具
有较好的预测效能。
To evaluate the efficacy of fast perturbational complexity index (PCIst) in assessing the
therapeutic responsiveness of repetitive transcranial magnetic stimulation (rTMS) in patients with disturbance
of consciousness (DoC). Methods: Total 84 patients with DoC admitted to our hospital from June 2023 to
March 2025 were selected as the study objects. All patients were treated with conventional awakening therapy
plus rTMS. According to the reactivity after rTMS treatment, all patients were divided into good response group
and poor response group, and then the clinical data and laboratory examination data (including PCIst) of the two
groups were compared. Logistic regression was used to analyze the related factors affecting rTMS treatment
responsiveness. Results: As of April 30, 2025, a total of 35 patients had escaped from MSC status after basic
therapy plus rTMS. The age of patients in the good response group was lower than that in the poor response
group, and the difference was statistically significant (P<0.05). The baseline EEG grading in the good response
group was better than that in the poor response group, and the PCIst was higher than that in the poor response
group, the difference was statistically significant (P<0.05). Age was an independent risk factor for rTMS
treatment responsiveness, PCIst and no complications during treatment were independent protective factors for
rTMS treatment responsiveness (P<0.05). RCS analysis showed that PCIst was significantly and linearly
associated with responsiveness to rTMS treatment in patients with disorders of consciousness (nonlinear P=
0.677, P=0.004); the ROC curve showed that the area under the curve of PCIst predicting responsiveness to
rTMS treatment in patients with disorders of consciousness was 0.853 (95% CI 0.798～0.896, P<0.001).
Conclusion: PCIst was significantly associated with rTMS treatment responsiveness in patients with DoC and
had good predictive efficacy
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