低频重复经颅磁刺激治疗急性脑梗死后失眠的疗效  

Observation of low-frequency repetitive transcranial magnetic stimulation in the treatment of insomnia after acute cerebral infarction

作　　者：钟志耕[1] 李又佳[1] 罗宋宝 韩小妍 黄燕[1] 陈妍[1] 黄惠琴 吴振梅[1] ZHONG Zhi-geng;LI You-jia;LUO Song-bao(Department of Neurology,Zhaoqing First People's Hospital,Zhaoqing 526000,China)

机构地区：[1]广东省肇庆市第一人民医院,526000

出　　处：《中国实用医药》2022年第11期1-4,共4页China Practical Medicine

基　　金：肇庆市科技创新指导类项目(项目编号:201904030749)。

摘　　要：目的 研究低频重复经颅磁刺激(rTMS)治疗急性脑梗死后失眠的疗效。方法 100例急性脑梗死后失眠患者,采用随机数字表法分为rTMS组和对照组,每组50例。两组患者均给予常规诊疗, rTMS组患者在此基础上加用低频rTMS治疗。分析患者预后,比较rTMS组治疗前后匹兹堡睡眠质量指数(PSQI)、改良Rankin量表(MRS)评分及两组治疗后PSQI、MRS评分。结果 研究过程中无失访、脱落患者。rTMS治疗期间无相关不良事件发生。两组均无病例死亡,无卒中复发,未发生自杀事件。治疗7 d, rTMS组的PSQI评分(7.260±2.739)分低于治疗前的(11.460±3.032)分,差异有统计学意义(P<0.05);随访90 d, rTMS组的MRS评分(1.683±0.522)分低于治疗前的(3.202±0.563)分, MRS评分0~2分占比74.0%高于治疗前的34.0%,差异有统计学意义(P<0.05)。治疗7 d, rTMS组PSQI评分(7.260±2.739)分低于对照组的(9.900±3.086)分,差异具有统计学意义(P<0.05);随访90 d, rTMS组MRS评分(1.683±0.522)分低于对照组的(2.132±0.614)分, MRS评分0~2分占比74.0%高于对照组的54.0%,差异具有统计学意义(P<0.05)。结论 低频rTMS治疗能安全有效的改善急性脑梗死后失眠及预后。Objective To study the efficacy of low-frequency repetitive transcranial magnetic stimulation(r TMS) in the treatment of insomnia after acute cerebral infarction. Methods A total of 100 patients with insomnia after acute cerebral infarction were divided into rTMS group and control group by random numerical table, with 50 cases in each group. Both groups received conventional diagnosis and treatment, and patients in the rTMS group were additionally treated with low-frequency rTMS. The prognosis of the patients was analyzed, and the Pittsburgh sleep quality index(PSQI) and modified Rankin scale(MRS) scores in the rTMS group before and after treatment were compared, and the PSQI and MRS scores between the two groups after treatment were compared.Results No patients were lost to follow-up or dropped-out during the study. No related adverse events occurred during rTMS treatment. There were no deaths, no recurrence of stroke, and no suicide events in either group. After 7 d of treatment, the PSQI score(7.260±2.739) points of rTMS group was lower than(11.460±3.032) points before treatment, and the difference was statistically significant(P<0.05). After 90 d of follow-up, the MRS score(1.683±0.522) points in the rTMS group was lower than(3.202±0.563) points before treatment, and the proportion of MRS score 0-2 points 74.0% was higher than 34.0% before treatment, and the difference was statistically significant(P<0.05). After 7 d of treatment, the PSQI score(7.260±2.739) points of the rTMS group was lower than(9.900±3.086) points of the control group, and the difference was statistically significant(P<0.05). After 90 d of follow-up, the MRS score(1.683±0.522) points of the rTMS group was lower than(2.132±0.614) points of the control group, and the proportion of MRS score 0-2 points was 74.0% higher than 54.0% of the control group, and the difference was statistically significant(P<0.05). Conclusion Low-frequency rTMS can improve insomnia and prognosis after acute cerebral infarction safely and effectively.

关 键 词：低频重复经颅磁刺激 急性脑梗死 失眠 匹兹堡睡眠质量指数 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R740[医药卫生—临床医学]