重复经颅磁刺激联合躯体感觉诱发电位及运动诱发电位在脑卒中治疗中的应用  

The application of transcranial magnetic stimulation combined with somatosensory evoked potential and motor evoked potential in the treatment of cerebral apoplexy

作　　者：陈奕杰 余茜 崔微 徐丽 CHEN Yijie;YU Qian;CUI Wei;XU Li(Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital Rehabilitation,Chengdu 610072,China)

机构地区：[1]四川省医学科学院.四川省人民医院康复科,成都610072

出　　处：《实用医学杂志》2018年第24期4115-4119,共5页The Journal of Practical Medicine

基　　金：四川省卫生和计划生育委员会资助课题(编号:16PJ457)

摘　　要：目的探讨重复经颅磁刺激(rTMS)联合躯体感觉诱发电位(SEP)及运动诱发电位(MEP)在脑卒中治疗中的应用。方法将180例初发脑卒中患者随机分为试验组(n=91)和常规组(n=89),常规组仅给予常规康复治疗,试验组在常规组基础上进行重复经颅磁刺激治疗,对两组患者分别行MEP及SEP检查,并进行FMA、Bathel指数、MMSE、Berg平衡等康复评定。检测常规组及试验组患者治疗前后的皮质手区及腿区的潜伏期、SEP中枢传导时间(CCT)、N20及P40波的潜伏期、MEP中枢运动传导时间(CMCT)、静息态阈值(RMT)。结果治疗前两组患者FMA、Bathel指数、MMSE、Berg平衡评定得分及患侧皮质手区及腿区的潜伏期、CMCT、N20及P40波的潜伏期、CCT、和RMT无明显差异(P均> 0.05)。与治疗前和常规组同期水平比较,治疗后试验组FMA、Bathel指数、MMSE、Berg平衡评定得分明显提高(P均<0.05),患侧皮质手区及腿区的潜伏期、CMCT、N20及P40波的潜伏期、CCT较明显缩短(P均<0.05);静息态阈值(RMT)明显下降(P均<0.05)。结论 TMS联合SEP、MEP联合检查能有效改善并敏感全面地反映脑卒中患者运动、感觉神经功能状态。Objective To explore the application of repetitive transcranial magnetic stimulation(rTMS) combined with somatosensory evoked potential(SEP) and motor evoked potential(MEP) in the treatment of stroke.Methods 180 patients with initial stroke were randomly divided into the observation group and the control group,90 cases in each group. The control group was only given conventional rehabilitation therapy,while the observation group was treated with repetitive transcranial magnetic stimulation on the basis of the control group.The two groups of patientswere examined by MEP and SEP,and the rehabilitation evaluation of FMA,Bathel index,MMSE and Berg balance was carried out.The changes of two groups of rehabilitation assessment and changes of the latency period of cortical hand and leg area,the latency of N20 and P40 waves,SEP central conduction time (CCT),MEP central motor conduction time(CMCT)and resting state threshold(RMT)were observed.Results There were no significant differences in FMA,Bathel index,MMSE and Berg balance score,the latency period of cortical hand and leg area,the latency of N20 and P40 waves,MEP central motor conduction time(CMCT),SEP central conduction time(CCT)and resting state threshold(RMT)between the two groups before treatment (P >0.05). The the latency period of cortical hand and leg area,the latency of N20 and P40 waves,CMCT and CCT in the observation group were significantly shorter(P < 0.05),resting state threshold(RMT)in the observationgroup decreased significantly(P < 0.05),FMA,Bathel index,MMSE and Berg balance score in the observation group increased significantly(P < 0.05)than the control group at the same time and themselves before treatment.Conclusion rTMS combined with SEP and MEP can effectively improve and reflect the motor and sensory nerve function of stroke patients.

关 键 词：重复经颅磁刺激 躯体感觉诱发电位 运动诱发电位 脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]