循证急诊救治联合躯干控制训练对缺血性脑卒中患者运动耐量的影响及相关因素分析  

Effect of evidence-based emergency treatment combined with trunk control training on exercise tolerance and related factors in patients with ischemic stroke

作　　者：侍露 吴敏[1] 陈婷[1] 钱堃 季学丽[1] SHI Lu;WU Min;CHEN Ting;QIAN Kun;JI Xueli(Jiangsu Provincial People’s Hospital,Nanjing 210029,China;The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]江苏省人民医院,江苏南京210029 [2]南京医科大学第一附属医院,江苏南京210029

出　　处：《中国实用神经疾病杂志》2025年第3期346-350,共5页Chinese Journal of Practical Nervous Diseases

基　　金：江苏省康复医学创新中心资助项目(编号:CXZX202222)。

摘　　要：目的分析循证急诊救治联合躯干控制训练对缺血性脑卒中患者运动耐量的影响及相关因素。方法选取江苏省人民医院2021-04—2023-04收治的缺血性脑卒中患者100例,均接受循证急诊救治联合躯干控制训练,观察患者治疗前后心肺运动试验结果的变化。依据峰值摄氧量占预估值的百分比分为运动耐量正常组(n=35)和运动耐量降低组(n=65)。比较2组患者临床资料,通过Pearson相关性分析心肺运动试验相关指标与缺血性脑卒中的关系,Logistic回归分析缺血性脑卒中患者发生运动耐量降低的影响因素。结果治疗后,研究对象运动级数、总运动时间、代谢当量、峰值摄氧量均高于治疗前,且ST段下降≥0.1 mV者少于治疗前(P<0.05)。2组患者病程、酗酒史、高血压、高脂血症、运动级数、总运动时间、代谢当量、峰值摄氧量、ST段下降情况存在统计学差异(P<0.05)。Pearson相关性分析显示,运动级数、总运动时间、代谢当量、峰值摄氧量与缺血性脑卒中呈负相关,ST段下降≥0.1 mV与缺血性脑卒中呈正相关(P<0.05)。Logistic回归分析显示,病程、酗酒史、高血压、运动级数、总运动时间、代谢当量、峰值摄氧量、ST段下降≥0.1 mV是缺血性脑卒中患者发生运动耐量降低的影响因素(P<0.05)。结论循证急诊救治联合躯干控制训练在改善缺血性脑卒中患者运动耐量方面具有重要作用,部分患者治疗后仍出现运动耐量降低的情况,可能与患者病程、酗酒史、高血压、运动级数、总运动时间、代谢当量、峰值摄氧量、ST段下降情况有关,因此需尽早进行干预,减少患者运动耐量降低的状况。Objective To analyze the impact and related factors of evidence-based emergency treatment combined with trunk control training on exercise tolerance in patients with ischemic stroke.Methods One hundred cases of ischemic stroke patients admitted to Jiangsu Provincial People’s Hospital from April 2021 to April 2023 were selected,all of them received evidence-based emergency treatment combined with trunk control training,and changes in cardiopulmonary exercise test results were observed before and after the patients’treatment.The patients was divided into normal exercise tolerance group(n=35)and reduced exercise tolerance group(n=65)based on peak oxygen uptake as a percentage of the predicted value.The clinical data of the two groups were compared,the relationship between cardiopulmonary exercise experiment and ischemic stroke was analyzed by Pearson correlation,and the influencing factors for reduced exercise tolerance in patients with ischemic stroke were analyzed by Logistic regression.Results After treatment,the exercise levels,total exercise time,metabolic equivalents,and peak oxygen uptake were higher than those before treatment,and ST-segment decline≥0.1 mV was less than that before treatment(P<0.05).Statistical differences were found between the two groups in the course of disease,history of alcohol abuse,hypertension,hyperlipidemia,exercise levels,total exercise time,metabolic equivalents,peak oxygen uptake,and ST-segment decreases(P<0.05).Pearson’s correlation analysis showed that the exercise levels,total exercise time,metabolic equivalents,and peak oxygen uptake were negatively correlated with ischemic stroke,and ST-segment decline≥0.1 mV were positively correlated with ischemic stroke(P<0.05).Logistic regression analysis showed that disease duration,history of alcohol abuse,hypertension,exercise level,total exercise time,metabolic equivalents,peak oxygen uptake,and ST-segment decline≥0.1 mV were influential factors in the occurrence of reduced exercise tolerance in patients with ischemic str

关 键 词：缺血性脑卒中 运动耐量 影响因素 躯干控制训练 循证急诊救治 

分 类 号：R743.33[医药卫生—神经病学与精神病学]