磁共振扩散张量成像联合Fugl-Meyer量表对老年急性脑梗死患者疗效评估的作用

目的探讨磁共振扩散张量成像(DTI)、简化Fugl-Meyer(FM)运动功能量表在老年急性脑梗死偏瘫患者疗效评估中的应用价值。方法前瞻性纳入解放军第三○五医院神经内科2010年11月—2014年4月符合纳入标准的老年急性脑梗死偏瘫患者17例,入院后均给予药物联合偏瘫实用训练技术康复治疗。分别于入院第1、4、12周完成DTI检查和FM量表评估。结果 3次DTI检查感兴趣区(ROI)健患侧各向异性分数(FA)差值和FM量表评分差异均有统计学意义(F值分别为3.437和3.791,均P0.01)。急性脑梗死偏瘫患者DTI中,ROI健患侧FA差值第1周(0.19±0.06)与第4周(0.13±0.04)比较,差异有统计学意义(P﹤0.05),第4周与第12周(0.13±0.04)差异无统计学意义(P0.05)。经药物、康复综合治疗后FM量表评分:入院第1周(69±9)分]与第4周(74±6)分]、第4周与第12周(82±10)分]比较,差异均有统计学意义(均P0.05)。入院第1次DTI中ROI对应的健患侧FA差值与第1阶段(4周)康复治疗前后FM量表评分差值变化呈线性负相关(rs=-0.389,P0.05)。结论 DTI和FM早期应用于脑梗死偏瘫患者预后评估有一定的预测价值。

Role of the efficacy assessment of diffusion tensor imaging in combination with Fugl-Meyer scale in old patients with acute cerebral infarct ion

Objective To investigate the application value of MR diffusion tensor imaging （DTI ） and simplified Fugl-Meyer （FM ） scale in old patients with acute cerebral infarction and hemiplegia. Methods Seventeen old patients with acute cerebral infarction and hemiplegia who met the inclusion criteria admitted to the Department of Neurology,the 305th Hospital of the People′s Liberation Army from November 2010 to April 2014 were enrolled prospectively. After admission,they were treated with rehabilitation therapy,including drugs in combination with practical training techniques for hemiplegia. After admission,the DTI examination and FM scale assessment were accomplished at the 1st,4th,and 12th weeks,respectively. Results There were significant differences in 3 times of DTI examinations between the contralateral/ipsilateral fractional anisotropy（FA）differences of the region of interest （ROI）and the differences of FM scale score （F=3. 437 and 3. 791 respectively;P〈0. 01）. In DTI of the acute cerebral infarction patients with hemiplegia,there was significant difference at the 1st week （0. 19 ± 0. 06）between the contralateral and ipsilateral FA difference of ROI compare with the 4th week （0. 13 ± 0. 04）,（P〉0. 05）. There was no significant difference between the 4th and 12th week （0. 13 ± 0. 04）（P〉0. 05）. After drug and rehabilitation treatment,the FM scale scores showed that there was significant difference between the 1st week after admission （69 ±9）and the 4th week after admission （74 ±6）,and between the 4thweek and 12week （82 ±10） （all P〈0. 05）. At the first time after admission,the corresponding contralateral/ipsilateral FA difference in ROI was negative correlated with that of the FM scale difference change at the first stage （4th week）before and after rehabilitation （rs = -0. 389,P〈0.05）. Conclusion Early application of DTI and FM in＆amp;nbsp;the prognostic evaluation of patients with cerebral infarction and hemiplegia has some predictive