弥散张量成像联合Fugl-Meyer量表在预测缺血性脑卒中后运动转归中的应用  

Predicting motor improvement after ischemic stroke with diffusion tensor imaging and Fugl-Meyer scale assessment

作　　者：姜蔼玲[1] 胡才友[1] 庞国防[1] 李嫦[1] 何丽艳 秦娇琴[1] 周苗[1] 陈梓斌[1] 李宁虎[1] 黎祖越[1] JIANG Ailing;HU Caiyou;PANG Guofang;LI Chang;HE Liyan;QIN Jiaoqin;ZHOU Miao;CHEN Zibin;LI Ninghu;LI Zuyue(Guangxi Jiangbin hospital,Nanning 530021,China)

机构地区：[1]广西壮族自治区江滨医院,530021

出　　处：《中国老年保健医学》2018年第4期33-36,共4页Chinese Journal of Geriatric Care

摘　　要：目的探讨弥散张量成像(DTI)和Fugl-Meyer量表在预测急性缺血性脑卒中患者运动转归的应用价值。方法前瞻性随机选择2017年1月至12月在广西壮族自治区江滨医院神经内科住院的40例急性缺血性脑卒中患者,所有患者入院后均给予药物和偏瘫肢体功能康复治疗,并于入院后第1周、12周完成核磁共振DTI检查和Fugl-Meyer量表评估,对比分析治疗前后DTI参数和FMA与运动功能转归的情况。结果 (1)入院不同部位DTI参数比较差异有统计学意义。(2)观察组患者第1周和第12周感兴趣区(ROI)患健侧各向异性分数比值(rFA)和FMA量表评分相关,差异有统计学意义(r=0.31,p=0.01;r=0.46,p=0.03)。(3)多因素回归分析表明,大脑脚FA值在运动功能转归总体变异度中的贡献占26.5%。内囊后肢FA在运动功能转归总体变异度中的贡献占22.4%。感兴趣区FA值联合FMA在运动功能转归总体变异度中的贡献占40.6%。结论 DTI联合Fugl-Meyer量表评估急性缺血性卒中患者运动功能转归优于单独使用Fugl-Meyer量表,对卒中患者运动功能转归具有一定的预测价值。Objective To investigate the application value of MR diffusion tensor imaging（DTI） and Fugl-Meyer scale assessment（FMA） in predicting motor improvement in patients after ischemic stroke. Methods Fourty patients with acute ischemic stroke who met the inculsion criteria admitted to the Department of Neurology,Jiangbin Hospital of Guangxi Zhuang Autonomous Region from January 2017 to December 2017 were enrolled prospectively. After admission,they were treated with rehabilitation therapy,including drugs in combination with practical trainning techniques for hemiplegia. After admission,the DTI examination and FM scale assessment were accomplished at the 1 st and 12 th weeks,respectively. The relationship compared DTI parameters and FMA with motor function outcome were analysed before and after treatment. Results （1）There were significant differences in DTI parameters at different sites.（2）The results showed that r FA of motor-related brain regions were correlated with FMA at the first week and the 12 th week（r = 0. 31,p = 0. 01; r = 0. 46,p = 0. 03）.（3）A multiple regression model show that FA value of the cerebral peduncle explained 26. 5% of the variability in motor function outcome. The adjusted R2 of the regression model with FA value of posterior limb of internal capsule as an independent variable was 22. 4%,and that of using the region of interest（ROI） with FMA as an independent variable was 40. 6%. Conclusion Combined use of DTI and FMA in evaluating motor outcome in patients after acute ischemic stroke is better than that of using Fugl-Meyer scale alone,which may play a certain role in predicting the prognostic of motor function in patients after ischemic stroke.

关 键 词：弥散张量成像 Fugl-Meyer量表 缺血性脑卒中 运动功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]