言语训练对脑卒中后Broca失语恢复的影响

目的:探讨早期言语训练对脑卒中Broca失语的影响。方法:因左侧大脑中动脉区域梗塞所致Broca失语患者24例,随机分为观察组和对照组各12例。2组均接受一般康复训练,观察组加用言语训练。在治疗前、治疗14d及30d后进行改良西方失语量表(AQ值)评定,治疗14d后采用fMRI评定。结果:治疗14d后,观察组较对照组在右大脑半球与Broca区相同位置呈现显著激活增强(P<0.01)。观察组的言语功能改善分值与右侧额下回区的激活强度间显著相关(r=0.682,P<0.05)。治疗30d后,2组AQ值均较治疗前明显升高(p<0.05),且观察组较对照组升高更显著(P<0.05);观察组西方失语量表各项评分较治疗前及对照组显著提高(均p<0.05)。结论:卒中后进行早期言语训练能有效促进失语的功能恢复,同时可能促进非优势半球与损伤部位同源的语言皮层的早期功能上调。

Effect of speech training in stroke patients with Broca aphasia

Objective: To study the effect of speech training in the stroke patients with Broca aphasia.Methods: 24 stroke patients with Broca aphasia of left middle cerebral artery occlusion were randomly divided into observation and control group.Both groups received traditional rehabilitation,and observation group got speech training in addition.The western aphasia battery of two groups were recorded before,14d and 30d after the treatment.fMRI were assesed 14d after the treatment.Results: 14d after the treatment,fMRI result showed that the activation in the right Broca-homologue(BHo) of observation group was more than that in control group(P<0.01).The hyperactivation of the right BHo in fMRI and the increase in naming test score were positively correlated(r=0.682,P<0.05).30d after the treatment,The AQ score of both groups were higher than that of before(P<0.05),and observation group was higher than that of control group(P<0.05).The western aphasia battery scores of observation group were higher than that of before and control group(P<0.05).Conclution: Early peech training can promot function in the stroke patients with Broca aphasia.