脑卒中后肢体运动功能障碍的生物学评估指标分析

被引：38

作者：

杨雅馨

李颖

袁海峰

傅静

李文娟

张慧

马奔

张巧俊

机构：

[1] 西安交通大学第二附属医院康复医学科,西安

来源：

中华物理医学与康复杂志 | 2019年 / 41卷 / 10期

关键词：

脑卒中; 运动功能障碍; 弥散张量成像; 运动诱发电位;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）];

学科分类号：

100204 [神经病学];

摘要：

目的探讨弥散张量成像(DTI)及运动诱发电位(MEP)能否作为评估脑卒中后肢体运动能障碍程度的生物学指标。方法选取60例脑卒中偏瘫患者并给予简式Fugl-Meyer运动功能(FMA)评定, 同时进行DTI及MEP检查, 分析DTI、MEP参数与肢体FMA评分间的相关性, 并利用受试者工作特征曲线(ROC)明确其在评定重度运动功能障碍时的检验效能。结果①DTI参数大脑脚部分各向异性不对称系数(aFA)与患侧上、下肢FMA评分均具有负相关性(P<0.05);内囊后肢aFA值与患侧上肢FMA评分具有负相关性(P<0.05), 与患侧下肢FMA评分无明显相关性(P>0.05);MEP参数中枢运动传导时间(CMCT)、运动阈值(MT)异常程度均与该侧肢体FMA评分具有负相关性(P<0.05);②ROC曲线显示内囊后肢aFA值为评定上肢重度运动功能障碍的最佳指标, 分界值为0.167, 具有较好的检验效能;MEP波形缺失作为重度运动功能障碍的评定标准, 其灵敏度较高, 但特异度较低;③联合DTI及MEP进行系列检查, 可提高识别上肢重度运动功能障碍的特异度。结论 DTI及MEP相关参数可作为评估脑卒中后肢体运动功能障碍的生物学指标, 且对评定上肢重度运动功能障碍具有较好效能。

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