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目的探讨急性脑梗死(ACI)患者的肢体运动功能与梗死部位及体积的相关性。方法选取2012年11月—2013年6月在广东省佛山市中医院脑病科住院的ACI患者66例为观察组,同期在该院体检健康的老年患者30例为对照组,运用三重刺激技术(TST)检测并计算66例ACI患者患侧肢体TST剩余值,磁共振检查了解脑梗死病灶部位和体积,采用美国国立卫生院神经功能缺损评分(NIHSS)、简化Fugl-Meyer运动功能评分等方法评价ACI患者神经功能,对于对照组患者随机选择一侧进行检测并计算TST剩余值。分析ACI患者TST剩余值与梗死部位和体积的相关性。结果梗死病灶分布以基底核最常见,其次为皮质;TST剩余值与梗死体积呈负相关(rs=-0.334,P=0.006),不同梗死部位间TST剩余值差异无统计学意义(P>0.05)。TST剩余值与NIHSS评分呈负相关(rs=-0.646,P<0.000 1),与简化Fugl-Meyer运动功能评分呈正相关(rs=0.594,P<0.000 1)。结论 TST具有准确、客观、量化的优点,是临床评估ACI患者运动功能的理想指标,对评估患者治疗效果及预后具有重要指导意义。ACI患者的肢体运动功能与梗死体积呈负相关,而与梗死部位暂无统计学意义。
Objective To investigate the correlation between limb motor function and infarct size and volume in patients with acute cerebral infarction (ACI). Methods Sixty-six patients with ACI who were hospitalized in Foshan Department of Traditional Chinese Medicine Hospital of Foshan City, Guangdong Province from November 2012 to June 2013 were selected as the observation group and 30 healthy elderly patients in the same hospital were selected as the control group. Triple stimulation TST) were used to detect and calculate the residual TST in 66 patients with ACI. MRI examination was performed to understand the location and volume of cerebral infarction. NIHSS score and simplified Fugl-Meyer motor function score were evaluated ACI patients with neurological function were randomly selected in the control group to test side and calculate the TST residual value. Analysis of ACI patients TST residual value and the infarct size and volume correlation. Results The distribution of infarction was the most common in the basal nuclei, followed by the cortex. The residual TST was negatively correlated with infarct volume (rs = -0.334, P = 0.006). There was no significant difference in TST between different infarct sites (P> 0.05 ). The residual TST was negatively correlated with the NIHSS score (rs = -0.646, P <0.0001), and positively correlated with the simplified Fugl-Meyer motor score (rs = 0.594, P <0.0001). Conclusion TST has the advantages of accuracy, objectivity and quantification. It is an ideal index for clinical evaluation of motor function in patients with ACI. It has important guiding significance for evaluating the therapeutic effect and prognosis of patients. ACI patients with limb motor function and infarction volume was negatively correlated, but not with the infarct site was not statistically significant.