幕上脑血管病与继发性大脑脚瓦勒变性的关系(附272例报告)  

The relationship between supratentorial cerebrovascular diseases and secondary Wallerian degeneration: a report of 272 cases

作　　者：于慧玲[1] 赵黎明[1] 宋克群[1] 李雪梅[1] 

机构地区：[1]解放军总医院门诊部干部诊疗科,北京100853

出　　处：《解放军医学杂志》2007年第11期1163-1164,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：目的观察幕上脑血管病后继发的瓦勒变性(WD)的发生特点,探讨WD与临床表现的关系。方法回顾性调查272例幕上脑血管病患者的CT扫描结果,分析病变分布的特点,测量患病后大脑脚的变化,并进行近期日常生活活动能力量表(ADL)测评,所得结果进行统计学分析。结果幕上脑血管病继发WD者共74例,发生率27.2%,其病灶侧大脑脚宽度明显小于健侧(P<0.01),而ADL评分明显高于非WD组(P<0.01)。结论中枢神经系统损伤后与周围神经一样可以出现继发性WD,但不易恢复;幕上脑血管病继发大脑脚WD对日常生活能力有影响;头颅CT随访有助于指导临床医生制定正确的康复计划,促进患者功能恢复。Objective To investigate the characteristics of Wallerian degeneration （WD） of secondary pyramidal tract after supraten- torial cerebrovascular diseases, and to study the relationship between secondary WD and clinical performance. Methods We retrospectively reviewed and investigated the results of brain CT films of 272 cases suffered from supratentorial cerebral vascular diseases during 2001 till 2004. The number of supratentorial disorders was counted respectively in WD group and non-WD group, the distribution feature of these disorders was analyzed, and the changes in the cerebral peduncles of the midbrain and Activities of Daily Living Scale （ADLs） were determined. The irdorrnation obtained was analyzed statistically respectively. Results Seventy-four cases of secondary WD were found, the rate of WD outbreak was 27. 2%. In WD group, the ipsilateral cerebral peduncle of supratentorial disorder was significantly narrower than con- tralateral cerebral peduncle （P〈0. 01）, and the ADLs scores were significantly higher than non-WD group. Conclusion Secondary WD similar to peripheral nerve system can appear after an injury to the central nervous system, and its recovery is difficult. Secondary WD after supratentorial cerebral vascular diseases produces obvious disability of daily life of the patiems. With these results in mind, clinicians should make a rehabilitative plan correctly to promote functional recovery in these patients. It suggests that we should follow these patients who had suffered from supratentarial cerebral vascular disease with the aid of brain CT scan and ADLs.

关 键 词：脑血管障碍 中脑 WALLER变性 日常生活活动能力量表 

分 类 号：R743[医药卫生—神经病学与精神病学]