不同病程脑卒中患者上肢体感诱发电位与感觉、运动功能的相关性  

Correlation of upper extremity somatosensory evoked potentials with sensory and motor functions in stroke patients in different stages

作　　者：杨世宁 马将 李红 郭立颖 刘先莹 张莉芳 YANG Shining;MA Jiang;LI Hong;GUO Liying;LIU Xianying;ZHANG Lifang(Department of Rehabilitation Medicine,Shijiazhuang People's Hospital,Shijiazhuang,Hebei 050030,China;College of Physical Education,Hebei Normal University,Shijiazhuang,Hebei 050024,China;School of Nursing and Rehabilitation,North China University of Science and Technology,Tangshan,Hebei 063210,China;Graduate School of Hebei Medical University,Shijiazhuang,Hebei 050011,China)

机构地区：[1]石家庄市人民医院康复医学科,河北石家庄市050030 [2]河北师范大学体育学院,河北石家庄市050024 [3]华北理工大学护理与康复学院,河北唐山市063210 [4]河北医科大学研究生学院,河北石家庄市050011

出　　处：《中国康复理论与实践》2024年第6期701-708,共8页Chinese Journal of Rehabilitation Theory and Practice

基　　金：河北省中医药管理局科研计划项目(No.2024130)。

摘　　要：目的探讨不同病程脑卒中患者上肢体感诱发电位(SEP)与感觉、运动功能的相关性。方法2021年6月到2023年10月,连续纳入石家庄市人民医院脑卒中患者177例,根据病程分为急性期组(14 d之内,n=25)、恢复早期组(14 d~1个月,n=110)和恢复中晚期组(1~6个月,n=42)。记录患者的一般资料;行SEP检查,记录N20潜伏期和振幅;采用单丝和两点辨别工具分别测试患者手的单丝触觉和两点辨别觉;Fugl-Meyer评定量表上肢部分(FMA-UE)评估运动功能。分析各组SEP与感觉和运动各项指标评分的相关性。结果3组单丝触觉和两点辨别觉评分无显著性差异(P>0.05)。相关性分析结果显示,急性期组SEP与感觉和运动功能不相关(P>0.05)。恢复早期组N20潜伏期与单丝触觉呈负相关(r=-0.267,P=0.005),与两点辨别觉呈正相关(r=0.220,P=0.021);N20振幅与单丝触觉(r=0.328,P<0.001)和FMA-UE评分呈正相关(r=0.418,P<0.001),与两点辨别觉呈负相关(r=-0.405,P<0.001)。恢复中晚期组N20潜伏期与FMA-UE呈负相关(r=-0.313,P=0.044),N20振幅与单丝触觉(r=0.598,P<0.001)和FMA-UE评分(r=0.393,P=0.010)呈正相关,与两点辨别觉呈负相关(r=-0.591,P<0.001)。多元线性回归分析显示,恢复中晚期患者单丝触觉的评分与N20潜伏期水平呈负相关(β=-0.510,P=0.046),FMA-UE评分与N20振幅水平呈正相关(β=0.313,P=0.026);恢复早期患者两点辨别觉评分与N20振幅水平呈负相关(β=-0.270,P=0.039)。结论病程越长,SEP与感觉和运动功能的相关性越显著。Objective To investigate the correlation between somatosensory evoked potentials(SEP)of upper limbs,and sensory and motor functions in stroke patients in different stages.Methods From June,2021 to October,2023,177 stroke patients in Shijiazhuang People's Hospital were diveded into acute stage group(within 14 days,n=25),early recovery group(14 days to one month,n=110)and middle to late recovery group(one to six months,n=42)according to the duration of the disease.General information of the patients was recorded;SEP examination was performed,and N20 lantency and amplitude were recorded.Monofilament touch and two-point discrimination sensation of the patient's hands were tested using the monofilament and two-point discrimination tools,respectively;and motor function was assessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE).The correlation between SEP,and the sensory and motor scores in each group was analyzed.Results There was no significant difference in the monofilament tactile and two-point discrimination scores among the three groups(P>0.05).SEP was not correlated with sensory and motor functions in the acute stage group(P>0.05);in the early recovery group,N20 latency was negatively correlated with monofilament tactile sensation(r=-0.267,P=0.005)and positively correlated with two-point discrimination sensation(r=0.220,P=0.021),and N20 amplitude was positively correlated with monofilament tactile sensation(r=0.328,P<0.001)and FMA-UE score(r=0.418,P<0.001),and negatively correlated with two-point discrimination(r=-0.405,P<0.001);in the middle to late recovery group,the N20 latency was negatively correlated with FMA-UE score(r=-0.313,P=0.044),and N20 amplitude was positively correlated with monofilament tactile sensation(r=0.598,P<0.001)and FMA-UE score(r=0.393,P=0.010),and negatively correlated with two-point discrimination(r=-0.591,P<0.001).Multiple linear regression analyses showed that the score of monofilament tactile sensation was negatively correlated with N20 latency(β=-0.510,P=0.046),and the FMA-U

关 键 词：脑卒中 感觉功能 运动功能 体感诱发电位 神经电生理 

分 类 号：R743.3[医药卫生—神经病学与精神病学]