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平萍, 巴春贺, 张洪霞, 王义围. 急性脑梗死患者低频重复经颅磁刺激疗效分析[J]. 中国公共卫生, 2017, 33(7): 1141-1144. DOI: 10.11847/zgggws2017-33-07-30
引用本文: 平萍, 巴春贺, 张洪霞, 王义围. 急性脑梗死患者低频重复经颅磁刺激疗效分析[J]. 中国公共卫生, 2017, 33(7): 1141-1144. DOI: 10.11847/zgggws2017-33-07-30
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PING Ping, BA Chun-he, ZHANG Hong-xia.et al, . Therapeutic effect of low frequency repetitive transcranial magnetic stimulation on acute cerebral infarction[J]. Chinese Journal of Public Health, 2017, 33(7): 1141-1144. DOI: 10.11847/zgggws2017-33-07-30
Citation: PING Ping, BA Chun-he, ZHANG Hong-xia.et al, . Therapeutic effect of low frequency repetitive transcranial magnetic stimulation on acute cerebral infarction[J]. Chinese Journal of Public Health, 2017, 33(7): 1141-1144. DOI: 10.11847/zgggws2017-33-07-30
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急性脑梗死患者低频重复经颅磁刺激疗效分析

Therapeutic effect of low frequency repetitive transcranial magnetic stimulation on acute cerebral infarction

    摘要
  • 摘要: 目的 分析低频重复经颅磁刺激（rTMS）对急性脑梗死患者的疗效，为急性脑梗死的治疗提供科学依据。方法 整群抽取2016年1-11月在河北承德医学院附属医院接受治疗的200例急性脑梗死伴有偏瘫患者，将其随机分为rTMS组和常规组各100例，2组均给予常规康复治疗，rTMS组同时给予rTMS治疗，比较2组患者的美国国立卫生研究院卒中量表（NIHSS）评分、巴氏指数（BI）、Fugl-Meyer评分、运动诱发电位（MEP）潜伏期、MEP波幅、中枢运动传导时间（CMCT）和汉密尔顿焦虑量表（HAMA）评分等指标，以评价rTMS对急性脑梗死患者的疗效。结果 rTMS组与常规组患者治疗前比较，2组患者NIHSS评分、BI指数、Fugl-Meyer评分、MEP潜伏期、MEP波幅、CMCT、HAMA评分等指标差异均无统计学意义（均P>0.05）；治疗2周后，rTMS组患者的BI指数（69.43±7.85）%、Fugl-Meyer评分（65.20±6.84）分和MEP波幅（1.04±0.19） mv均高于常规组患者的（63.18±8.40）%、（60.88±7.47）分和（0.91±0.15） mv，NIHSS评分（5.13±1.96）分、MEP潜伏期（23.72±0.43） ms和CMCT（10.11±0.49） ms均低于常规组患者的（5.72±1.88）分、（24.10±0.38） ms和（10.67±0.43） ms，差异均有统计学意义（均P<0.05）；治疗4周后，rTMS组患者的BI指数（83.20±8.17）%、Fugl-Meyer评分（74.12±6.65）分和MEP波幅（1.15±0.16） mv均高于常规组患者的（76.94±9.35）%、（69.36±7.17）分和（0.96±0.18） mv，NIHSS评分（3.27±1.05）分、MEP潜伏期（23.12±0.36） ms、CMCT（9.62±0.51） ms和HAMA评分（7.53±1.86）分均低于常规组患者的（4.06±1.13）分、（23.70±0.47） ms、（10.01±0.64） ms和（8.96±1.97）分，差异均有统计学意义（均P<0.05）。结论 rTMS可明显改善急性脑梗死患者的运动功能及焦虑状态。

     

    Abstract: Objective To evaluate the effect of low frequency repeated transcranial magnetic stimulation (rTMS) on patients with acute cerebral infarction (ACI),and to provide a basis for the treatment of ACI.Methods A total of 200 ACI patients complicated with hemiplegia were recruited in Affiliated Hospital of Chengde Medical College from January through November 2016 and then randomly divided into a rTMS group and a routine treatment group (100 patients in each group).All the patients received routine rehabilitation treatment while the patients of rTMS group accepted rTMS at the same time.We analyzed differences in scores of National Institutes of Health Stroke Scale (NIHSS) and Fugl-Meyer,Barthel Index (BI),latency and amplitude of motor evoked potential (MEP),central motor conduction time (CMCT),and score of Hamilton Anxiety Scale (HAMA)between the two groups after 2 and 4 weeks' treatments.Results There were no statistically significant differences between the two groups in NIHSS score,BI index,Fugl-Meyer score,MEP latency,MEP amplitude,CMCT,and HAMA score before the treatments (P>0.05 for all).Compared to those of the routine treatment group,significantly higher BI index (69.43±7.85% vs.63.18±8.40%),Fugl-Meyer score (65.20±6.84 vs.60.88±7.47),and MEP amplitude (1.04±0.19 mv vs.0.91±0.15 mv)and lower NIHSS score (5.13±1.96 vs.5.72±1.88),MEP latency (23.72±0.43 ms vs.24.10±0.38 ms),and CMCT (10.11±0.49 ms vs.10.67±0.43 ms)were observed in the rTMS group (all P<0.05) after 2 weeks' treatments;by the end of 4 weeks' treatments,the rTMS group showed significantly higher BI index (83.20±8.17% vs.76.94±9.35%),Fugl-Meyer score (74.12±6.65 vs.69.36±7.17),and the MEP amplitude (1.15±0.16 mv vs.0.96±0.18 mv) and lower NIHSS score (3.27±1.05 vs.4.06±1.13),MEP latency (23.12±0.36 ms vs.23.70±0.47 ms),CMCT (9.62±0.51 ms vs.10.01±0.64 ms),and HAMA score (7.53±1.86 vs.8.96±1.97) compared to the routine treatment group (all P<0.05).Conclusion rTMS could significantly improve motor function and anxiety in patients with acute cerebral infarction.

     

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