亚急性期脑梗死神经网络缺损的肢体运动障碍与情绪等因素的关联及结局分析  

Interaction between Motor Deficits and Emotion in Patients with Neural Network Defect after Sub-acute Stroke

作　　者：肖湘[1,2] 吕衍春[3] 蔡培强[3] 江利[4] 林玲[4] 黄东锋[1] 

机构地区：[1]中山大学附属第一医院康复医学科,广东广州市510080 [2]深圳市第五人民医院(罗湖人民医院)康复医学科,广东深圳市518001 [3]中山大学附属肿瘤防治中心影像与微创介入中心,广东广州市510060 [4]中山大学附属第一医院放射科,广东广州市510080

出　　处：《中国康复理论与实践》2014年第6期562-566,共5页Chinese Journal of Rehabilitation Theory and Practice

基　　金：国家自然科学基金资助项目(No.30973165)

摘　　要：目的分析亚急性期脑梗死患者运动功能障碍与情绪、认知等因素的相关性。方法对15例亚急性期脑梗死患者采用Fugl-Meyer评定量表(FMA)、10 m步行速度、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、简易精神状态检查(MMSE)、改良Barthel指数(MBI)、健康调查简表(SF-36)进行评测。比较患者弥散张量成像(DTI)参数:各向异性分数(FA)值、表观扩散系数(ADC)和FA指数、ADC指数,并对脑梗死患者DTI参数与情绪评估结果进行相关性分析。结果 FMA评分及10 m步行速度与HAMD、HAMA及MMSE评分无相关性。HAMD、HAMA、MMSE评分与SF-36中的情感职能相关(P<0.05),HAMA评分与SF-36中的躯体疼痛负相关(P<0.05)。双侧内囊后肢的FA值均与HAMD呈负相关(P<0.05)。结论神经网络缺损可导致脑梗死患者情绪变化。肢体运动功能障碍与情绪无关。情绪、认知功能相互关联而影响生活质量的功能结局。Objective To investigate the correlation of motor function and emotion, cognition in patients after stroke. Methods 15 sub-acute stroke patients were included. They were assessed with Fugl-Meyer Assessment （FMA）, 10 m walking speed, Hamilton Rating Scale for Depression （HAMD）, Hamilton Rating Scale for Anxiety （HAMA）, Mini-Mental State Examination （MMSE）, modified Barthel In- dex （MBI） and SF-36. Fractional anisotropy （FA） values, apparent diffusion coefficient （ADC）, and asymmetry indices of ADC and FA were obtained from diffusion tensor imaging. The correlation among them were analyzed. Results There was no correlation between the scores of FMA, 10 m walking speed and HAMD, HAMA, MMSE （P〉0.05）. The scores of HAMD, HAMA and MMSE correlated with emotional function of SF-36 （P〈0.05）. The HAMA score negatively correlated with body pain of SF-36. The FA value of the posterior limb of the inter- nal capsule were negatively correlated with HAMD （P〈0.05）. Conclusion Neural network defect can cause emotion changes in stroke pa- tients, but the motor function was not correlated with the emotion. Emotion and cognition may affect quality of life in these patients.

关 键 词：脑梗死 抑郁 焦虑 运动 弥散张量成像 认知 生活质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学]