老年脑小血管病患者同向运动双手协调性障碍的临床研究  

Homotropic bimanual coordination dysfunction in elderly cerebral small vessel disease patients

作　　者：夏翠俏 蔡晓平[2] 赵弘轶 谢鸿阳 张微微 尹维民 黄勇华 王改青[1] Xia Cuiqiao;Cai Xiaoping;Zhao Hongyi;Xie Hongyang;Zhang Weiwei;Yin Weimin;Huang Yonghua;Wang Gaiqing(Shanxi Medical University,Taiyuan 030001,Shanxi Province,China)

机构地区：[1]山西医科大学,太原030001 [2]解放军总医院第一医学中心干三科 [3]第七医学中心神经内科

出　　处：《中华老年心脑血管病杂志》2022年第5期519-522,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的 探究老年脑小血管病(cerebral small vessel disease, CSVD)患者是否存在双手协调性障碍。方法 收集2021年1~4月于解放军总医院第七医学中心神经内科连续就诊的老年CSVD患者37例,均为右利手,根据CSVD的严重程度分为重度组19例(Fazekas评分为3分)、非重度组18例(Fazekas评分为1~2分),同期选择年龄、性别相匹配的健康体检者11例为对照组。进行词语流畅性(VFT)、画钟测验(CDT)和连线测试B(TMT-B)以及双手协调性参数等测试,运用WACOM硬件结合MovAlyzeR笔迹分析软件,比较2组空间和时间参数差异,进行相关性分析。结果 3组VFT、CDT和TMT-B比较,差异有统计学意义(P<0.05,P<0.01);与非重度组和对照组比较,重度组VFT、CDT显著下降,TMT-B用时显著延长(P<0.05)。与非重度组和对照组比较,重度组左手和右手水平方向运动(HA)均值显著下降,左手竖直方向运动(AYE)显著升高(P<0.05)。与对照组比较,重度组右手AYE显著升高(1241.63±313.80 vs 717.53±582.10,P<0.05),非重度组左手和右手HA均值显著下降、左手和右手HA变异度明显增高(P<0.05)。左手HA均值与CDT呈正相关(r=0.407,P=0.043),水平方向非对称性指数与TMT-B呈正相关(r=0.423,P=0.035)。结论 老年CSVD患者存在同向运动双手协调性障碍,主要体现在空间参数方面。Objective To study the homotropic bimanual coordination dysfunction in elderly cerebral small vessel disease(CSVD) patients.Methods Thirty-seven CSVD patients admitted to our center from January 2021 to April 2021 were divided into severe CSVD group(n=19) and non-severe CSVD group(n=18) according to their Fazekas score with 11 age-and gender-matched persons who underwent physical wxamination in our center during the same period served as a control group.The time of VFT,CDT,TMT-B and bimanual coordinability parameters were recorded.The spatial and temporal parameters were compared between severe CSVD group and non-severe CSVD group using WACOM hardware combined with MovAlyzeR handwriting analysis software and analyzed by correlation analysis.Results Significant difference was detected in time of VFT,CDT,and TMT-B among the 3 groups(P<0.05,P<0.01).The the time of VFT and CDT was significantly shorter and the bimanual coordinability parameters were significantly lower while the time of TMT-B was significantly longer in severe CSVD group than in non-severe CSVD group and control group(P<0.05).The average horizontal movement value of left and right hands was significantly lower while the average vertical movement value of left hand was significantly higher in severe CSVD group than in non-severe CSVD group and control group(P<0.05).The absolute Y error of right hand was significantly higher in severe CSVD group than in control group while the horizontal amplitude of left and right hands was significantly lower in non-severe CSVD group than in control group(1241.63±313.80 vs 717.53±582.10,P<0.05).The average horizontal amplitude value of left hand was positively related with the time of CDT(r=0.407,P=0.043) while the horizontal asymmetry index was positively related with the time of TMT-B(r=0.423,P=0.035).Conclusion Homotropic bimanual coordination dysfunction can be detected in elderly CSVD patients, which is mainly manifested in spatial parameters.

关 键 词：大脑小血管疾病 小脑共济失调 手 动作障碍 

分 类 号：R743[医药卫生—神经病学与精神病学]