经颅磁刺激治疗急性大脑中动脉狭窄或闭塞临床效果观察  

Clinical observation of transcranial magnetic stimulation in the treatment of acute middle cerebral artery stenosis or occlusion

作　　者：陈克尚 赵懿 林应源 高金勇 翟宇 CHEN Keshang;ZHAO Yi;LIN Yingyuan;GAO Jinyong;ZHAI Yu(Neurology Department,Hainan Western Central Hospital,Danzhou 571700,China)

机构地区：[1]海南西部中心医院神经内科,海南儋州571700

出　　处：《山东医药》2025年第1期43-47,共5页Shandong Medical Journal

基　　金：海南省医药卫生科研项目(2105032054A2002)。

摘　　要：目的观察经颅磁刺激治疗急性大脑中动脉(MCA)狭窄或闭塞患者的临床效果。方法选择急性MCA狭窄或闭塞患者150例,按随机数字表法分为观察组、对照组,每组75例。对照组予常规药物及传统康复治疗,观察组在对照组基础上予经颅磁刺激治疗,连续治疗30 d。治疗前1 d及治疗1个月后,用美国国立卫生研究院卒中量表(NIHSS)评估神经功能缺损程度,用Barthel指数评估日常生活活动能力,用Fugl-Meyer运动功能评分量表(FMA)评估运动障碍程度,用彩色超声诊断仪检测MCA、大脑前动脉(ACA)、大脑后动脉(PCA)、基底动脉(BA)、椎动脉(VA)的血流动力学指标[血管收缩期血流速度(Vp)、平均血流速度(Vm)、舒张末期血流速度(Vd)、脉冲指数(PI)、阻力指数(RI)、收缩期血流速度与舒张末期血流速度的比值(S/D)]。结果两组治疗后NIHSS、Barthel指数、FMA评分均高于治疗前(P均<0.05);观察组治疗后NIHSS评分低于对照组治疗后,Barthel指数、FMA评分均高于对照组治疗后(P均<0.05)。观察组治疗后MCA的Vp、Vm、Vd均高于治疗前,并且观察组治疗后MCA的Vp、Vm、Vd均高于对照组治疗后(P均<0.05);两组治疗后MCA的PI、RI、S/D比较差异均无统计学意义(P均>0.05)。两组治疗后ACA、PCA、BA、VA血流动力学相关指标比较差异均无统计学意义(P均>0.05)。结论经颅磁刺激治疗急性MCA狭窄或闭塞能够有效改善患者神经功能缺损程度、日常生活活动能力、运动障碍程度以及MCA血流动力学。Objective To investigate the clinical efficacy of transcranial magnetic stimulation in the treatment of acute middle cerebral artery(MCA)stenosis or occlusion in patients.Methods Totally 150 patients with acute MCA stenosis or occlusion were selected and randomly divided into the observation group and control group,with 75 cases in each group.Patients in the control group received conventional medication and traditional rehabilitation therapy,while patients in the observation group received transcranial magnetic stimulation therapy in addition to the treatment given in the control group,for a continuous treatment period of 30 days.One day before treatment and one month after treatment,the degree of neurological deficit was assessed using the National Institutes of Health Stroke Scale(NIHSS),the ability to perform daily living activities was assessed using the Barthel Index,the degree of motor impairment was assessed using the Fugl-Meyer Assessment(FMA),and hemodynamic parameters[peak systolic velocity(Vp),mean velocity(Vm),end-diastolic velocity(Vd),pulsatility index(PI),resistance index(RI),and the ratio of systolic to diastolic velocity(S/D)]of the MCA,anterior cerebral artery(ACA),posterior cerebral artery(PCA),basilar artery(BA),and vertebral artery(VA)were measured using the color ultrasound diagnostic instrument.Results After treatment,the NIHSS,Barthel index,and FMA scores in both groups were significantly higher than those before treatment(all P<0.05);the NIHSS score of the observation group was significantly lower than that of the control group after treatment,while the Barthel index and FMA score were significantly higher than those of the control group after treatment(both P<0.05).After treatment,the Vp,Vm,and Vd of MCA in the observation group were significantly higher than those before treatment,and the Vp,Vm,and Vd of MCA in the observation group were significantly higher than those in the control group after treatment(all P<0.05).There were no statistically significant differences in PI,RI,or S/D o

关 键 词：缺血性脑卒中 动脉狭窄 动脉闭塞 大脑中动脉 经颅磁刺激 

分 类 号：R743[医药卫生—神经病学与精神病学] R454.1[医药卫生—临床医学]