优势半球卒中失语症患者二次卒中后失语商与大脑脚形态学变化相关性研究  

A Correlation Study of Morphological Changes of Cerebral Peduncles and Aphasia Quotient after Recurrent Stroke in Patients with Post-Dominant Hemisphere Stroke Aphasia

作　　者：杜秀玉 翟晓东 刘志 杨静[1] 任惠敏 陈静[2] 胡鸿鹏 戈蕾[3] 杨金水 DU Xiu-yu;ZHAI Xiao-dong;LIU Zhi;YANG Jing;REN Hui-min;CHEN Jing;HU Hong-peng;GE Lei;YANG Jin-shui(Department of Neurosurgery,the First Affiliated Hospital of Heibei North University,Heibei Zhangjiakou 07500,China;Department of Medical Imaging Center,the First Affiliated Hospital of Heibei North University,Heibei Zhangjiakou 07500,China;Department of Rehabilitation,the First Affiliated Hospital of Heibei North University,Heibei Zhangjiakou 07500,China;Department of Neurology,the First Affiliated Hospital of Heibei North University,Heibei Zhangjiakou 07500,China)

机构地区：[1]河北北方学院附属第一医院神经外科,河北张家口075000 [2]河北北方学院附属第一医院医学影像中心,河北张家口075000 [3]河北北方学院附属第一医院康复科,河北张家口075000 [4]河北北方学院附属第一医院神经内科,河北张家口075000

出　　处：《神经损伤与功能重建》2022年第12期735-738,共4页Neural Injury and Functional Reconstruction

基　　金：河北省卫健委医学研究重点科技研究计划(No.20200514);河北省技术创新引导计划项目(No.19977797D)。

摘　　要：目的:探讨优势半球卒中失语症患者二次卒中(RS)后失语商(AQ)与大脑脚形态学变化相关性。方法:回顾性分析优势半球首次卒中(FS)后合并失语症的RS患者40例的临床资料。根据RS与FS的侧别关系将患者分为同侧卒中组19例与对侧卒中组21例,分析2组患者的一般情况、RS前后AQ变化及其与大脑脚非对称比例(CPAR)的关系。结果:2组患者的年龄、性别、病程,合并高血压、高脂血症、糖尿病、心脏病,不良习惯,卒中类型,语言康复情况差异均无统计学意义(P>0.05)。缺血性RS患者的AQ高于出血性患者(P<0.05)。对侧卒中组RS后AQ值明显低于RS前(P<0.01)及同侧卒中组(P<0.01);对侧卒中组RS前后AQ变化值显著高于同侧卒中组(P<0.01)。同侧卒中组和对侧卒中组的CPAR差异无统计学意义(P>0.05)。CPAR与对侧卒中组RS后AQ显著相关(P<0.01),与2组患者RS前AQ及同侧卒中组RS后的AQ无明显相关(P>0.05)。结论:优势半球FS后失语症患者在对侧RS后的AQ变化与CPAR密切相关。Objective:To explore the correlation between morphological changes of cerebral peduncles and aphasia quotient(AQ)after recurrent stroke(RS)in patients with post-dominant hemisphere stroke aphasia(PSA).Methods:The clinical data of 40 patients with RS and also PSA after first-time stroke(FS)were analyzed retrospectively.According to the side of RS onset,they were divided into the ipsilateral stroke group(n=19)and contralateral stroke group(n=21),and the demographic characteristic,difference in AQ before and after RS,and the correlation between AQ and cerebral peduncle asymmetry rate(CPAR)was analyzed.Re⁃sults:There was no significant difference in age;gender;course of disease,comorbidities of hypertension,hyperlipidemia,diabetes,and heart disease;unhealthy habits;stroke type;and speech recovery(P>0.05).The AQ of ischemic RS patients was higher than that of hemorrhagic RS patients(P<0.05).In the contralateral stroke group,the post-RS AQ was significantly lower than the pre-RS AQ and the ipsilateral stroke group AQ(P<0.01).Change of AQ pre-and post-RS in the contralateral stroke group was significantly higher than that in the ipsilateral stroke group(P<0.01).There was no significant difference in CPAR between the contralateral stroke group and ipsilateral stroke group(P>0.05).There existed an apparent correlation between CPAR and the post-RS AQ of the contralateral stroke group(P<0.01)and no apparent correlation between CPAR and the pre-RS AQ of both groups and the post-RS AQ of the ipsilateral stroke group(P>0.05).Conclusion:The changes in AQ after RS in patients with PSA showed a significant association with CPAR.

关 键 词：脑卒中 大脑脚 非优势半球 失语 失语商 

分 类 号：R741[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学] R816