弥散张量成像各向异性分数与缺血性脑卒中患者上肢运动功能的相关性  

Relationship between Fractional Anisotropy of Diffusion Tensor Imaging and Motor Function after Ischemic Stroke

作　　者：刘建华[1,2] 魏清川[3] 胡秀茹 叶赛青 闫志宇 高强[3] LIU Jian-hua;WEI Qing-chuan;HU Xiu-ru;YE Sai-qing;YAN Zhi-yu;GAO Qiang(Department of Physical Therapy,Beijing Bo'ai Hospital,China Rehabilitation Research Center,Beijing 100068,China;Capital Medical University School of Rehabilitation Medicine,Beijing 100068,China;Rehabilitation Medicine Center of West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China;Science and Therapeutics,Japan International Medical Welfare University,Otawara,Japan)

机构地区：[1]中国康复研究中心北京博爱医院运动疗法科,北京市100068 [2]首都医科大学康复医学院,北京市100068 [3]四川大学华西医院康复中心,四川成都市610041 [4]日本国际医疗福祉大学理学疗法学科,日本大田原市

出　　处：《中国康复理论与实践》2020年第7期749-752,共4页Chinese Journal of Rehabilitation Theory and Practice

基　　金：四川省科技厅重点研发项目(No.2018FZ0103)。

摘　　要：目的探讨不同区域弥散张量成像(DTI)参数与缺血性脑卒中患者上肢运动功能恢复的关系。方法2019年1月至12月,缺血性脑卒中患者20例接受常规药物和康复治疗3周,治疗前后,DTI测量梗死灶及对侧相应部位,患侧和健侧大脑脚、内囊后肢各向异性分数(FA),计算双侧FA比(rFA)。同时采用Fugl-Meyer评定量表上肢部分(FMA-UE)进行评定。结果治疗后,患者FMA-UE评分显著增加(t=9.074,P<0.001)。梗死灶FA与rFA显著升高(t>14.519,P<0.001)。治疗前后各部位患侧FA和rFA差值均与FMA-UE评分差值正相关(r=0.445~0.565,P<0.05),以患侧内囊后肢相关性最强。结论缺血性脑卒中,脑内FA的改变与上肢运动功能恢复相关,尤其是内囊后肢。Objective To explore the relationship between diffusion tensor imaging(DTI)parameter of fractional anisotropy(FA)and recovery of upper-extremity motor function in patients with ischemic stroke.Methods From January to December,2019,20 ischemic stroke patients accepted routine medication and rehabilitation for three weeks.They received DTI examination and were measured FA of the infarct and the corresponding area on the contralateral side,the cerebral foot and the posterior limb of internal capsule of affected and unaffected sides,while the bilateral FA ratio(rFA)of them were calculated,before and after treatment.Meanwhile,all the patients were assessed with Fugl-Meyer Assessment-Upper Extremity(FMA-UE).Results The FMA-UE score improved after treatment(t=9.074,P<0.001),while FA and rFA increased in infarct area(t>14.519,P<0.001).The difference before and after treatment of FA and rFA in all of the areas positively correlated with that of FMA-UE scores(r=0.445~0.565,P<0.05),which was the most in posterior limb of internal capsule of the affected side.Conclusion FA of DTI alters with the recovery of motor function of the upper extremity after ischemic stroke,especially in the posterior limb of internal capsule.

关 键 词：缺血性脑卒中 运动功能 上肢 弥散张量成像 康复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]