不同频率重复经颅磁刺激对急性脑梗死患者静脉溶栓治疗的影响  

Influence of repetitive transcranial magnetic stimulation with different frequencies on intravenous thrombolytic therapy in patients with acute cerebral infarction

作　　者：顾正天[1] 卢建新[1] 张守成[1] 郭学建[2] 周威[1] 徐蓉贞[1] 徐珊珊[1] 

机构地区：[1]高淳县人民医院神经内科,211300 [2]高淳县人民医院影像科,211300

出　　处：《临床神经病学杂志》2011年第5期345-348,共4页Journal of Clinical Neurology

摘　　要：目的比较不同频率的重复经颅磁刺激（rTMS）对急性脑梗死患者静脉溶栓治疗的影响。方法 141例急性脑梗死患者随机分为假rTMS治疗组、rTMS 1 Hz组、rTMS 2 Hz组、rTMS 5 Hz组、rTMS 10 Hz组和溶栓对照组,均予以尿激酶溶栓治疗。rTMS 1~10 Hz各组依次分别在溶栓同时给予rTMS 1 Hz、2 Hz、5 Hz、10 Hz治疗,假rTMS治疗组予以假rTMS刺激。所有患者于治疗前及治疗后24 h时进行美国国立卫生研究院卒中量表（NIHSS）评分,观察并记录各组不良反应情况。结果各组治疗后NIHSS评分均较治疗前明显下降（均P〈0.05）。治疗后rTMS 1~10 Hz各组NIHSS评分均较溶栓对照组明显下降,其中rTMS 5 Hz组NIHSS评分最低（均P〈0.05）。rTMS 1~10 Hz各组有效率（64.0%、76.2%、81.8%、83.3%）均明显高于假rTMS治疗组（42.3%）和溶栓对照组（47.8%）（均P〈0.05）。其中,rTMS 2 Hz组、rTMS 5 Hz组与rTMS 10 Hz组有效率均高于rTMS 1 Hz组（均P〈0.05）。各组间不良反应的比较,差异无统计学意义。结论 rTMS可提高溶栓治疗的疗效,且rTMS频率为10 Hz、5 Hz、2 Hz时效果较好,无明显不良反应。Objective To compare the influence of repetitive transcranial magnetic stimulation（rTMS） with different frequencies on intravenous thrombolytic therapy in patients with acute cerebral infarction.Methods One hundred and fourty-one patients with acute cerebral infarction were randomly divided into sham rTMS group,rTMS 1 Hz group,rTMS 2 Hz group,rTMS 5 Hz group,rTMS 10 Hz group and thrombolytic control group.All of them were accepted thrombolytic therapy by urokinase.At the same time of thrombolytic therapy,the rTMS 1-10 Hz groups respectively received 1 Hz,2 Hz,5 Hz,10 Hz rTMS treatment in order,and the sham rTMS group received sham rTMS treatment.The National Institutes of Health Stroke Scale（NIHSS） scores of all the patients were measured before and 24 h after the treatment,and the adverse reactions were observed and recorded.Results The NIHSS scores of all the groups after treatment were significantly lower than that before treatment（all P0.05）.After the treatment,the NIHSS scores of rTMS 1-10 Hz groups were all significantly lower than that of thrombolytic control group,and the NIHSS score of rTMS 5 Hz group was the lowest（all P0.05）.The effective rates of rTMS 1-10 Hz groups（64.0%,76.2%,81.8%,83.3%,respectively） were all significantly higher than sham rTMS group（42.3%） and the thrombolytic control group（47.8%）（all P0.05）.And effective rates of rTMS 2 Hz group,rTMS 5 Hz rTMS group and rTMS 10 Hz group were significantly higher than rTMS 1 Hz group（all P0.05）.There was no significant difference of adverse reaction among all the groups.Conclusions rTMS can improve the efficacy of thrombolytic therapy,and the efficacy may be better when the frequencies are 10 Hz,5 Hz or 2 Hz.There is no obvious adverse reaction.

关 键 词：脑梗死 溶栓 重复经颅磁刺激 疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]