脑卒中患者感觉障碍与运动功能障碍间的相关性分析  

The correlation between sensory impairment and motor dysfunction in stroke survivors

作　　者：王丽莎[1,2] 王刚 袁子文[1,2] 郭静 赵烨 乔晋 Wang Lisha;Wang Gang;Yuan Ziwen;Guo Jing;Zhao Ye;Qiao Jin(Department of Rehabilitation Medicine,The First Affliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Key Laboratory of Biomedical Information Engineering of the Ministry of Education,College of Life Science and Technology,Xi'an Jiaotong University,Institute of Health and Rehabilitation Science,Xi'an 710049,China)

机构地区：[1]西安交通大学第一附属医院康复医学科,西安710061 [2]生物医学信息工程教育部重点实验室,西安交通大学生命科学与技术学院,健康与康复科学研究所,西安710049

出　　处：《中华物理医学与康复杂志》2025年第3期243-248,共6页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：国家自然科学基金资助项目(32071372);陕西省一般项目——社会发展领域基金(2024SF-YBXM-693)。

摘　　要：目的按探讨脑卒中后伴感觉减退患者其感觉障碍程度与运动功能间的相关性。方法法本研究选取102例基底节区脑卒中伴感觉减退患者作为观察对象,分别采用2000Hz,250Hz和5Hz正弦交流电刺激患者健侧及偏瘫侧的示指、跨趾部位,记录患者健侧及患侧手、足电流感知阈值(CPT)和疼痛耐受阈值(PTT),并分析不同卒中类型、不同卒中侧别和不同性别卒中患者的CPT、PTT差异及相互影响,探讨偏瘫侧肢体感觉障碍程度与肢体肌力间的相关性。结果①脑出血组患者的感觉障碍程度较脑梗死组患者严重,对疼痛的耐受度组间无明显差异;不同卒中侧别患者其感觉障碍程度及对疼痛的耐受度组间均无明显差异;不同性别卒中患者其感觉障碍程度及对疼痛的耐受度组间均无明显差异;②在2000Hz,250Hz及5Hz电刺激时所有患者均表现出较高的CPT和PTT,且CPT与PTT具有正相关性;③在2000Hz,250Hz及5Hz电刺激时偏瘫侧手、足CPT值均与肢体肌力具有负相关性,即偏瘫侧肢体CPT值越高,则感觉神经纤维受损程度越严重,肢体肌力也越差。结论CPT及PTT均可精准评估脑卒中患者感觉障碍程度,不同类型卒中患者其CPT值具有明显差异,且感觉障碍程度与肢体肌力具有相关性,通过量化感觉障碍程度有助于预后判断及制订个性化康复治疗方案。Objective To seek any correlation between hypoesthesia and sensory disturbance to motor function among stroke survivors.Methods One hundred and two stroke survivors with hyperalgesia were treated with sinusoidal alternating current at 2000Hz,250Hz or 5Hz to stimulate the fingers and toes on their healthy and hemiplegic sides.Current perception thresholds(CPTs)and pain tolerance thresholds(PTTs)were recorded.The correlation between the degree of sensory disturbance in the hemiplegic limb and muscle strength was explored.Results①The degree of sensory impairment in those who had suffered a cerebral hemorrhage was significantly greater than among those with cerebral infarction,without significant difference in pain tolerance between different genders and affected sides.②All of the patients with sensory impairment showed significantly higher CPT and PTT values at the different frequencies,with a positive correlation between them.③The CPT values of the affected hand and foot at the different frequencies were negatively correlated with muscle strength on the affected side.Conclusions Both CPT and PTT can usefully represent the degree of sensory disturbance after a stroke.The CPT values of patients with different types of stroke are significantly different,and the degree of sensory disturbance is correlated with the muscle strength of the affected side.Therefore,it is helpful for prognostic judgment and individualized rehabilitation treatment planning by quantifying the degree of sensory disturbance.

关 键 词：脑卒中 感觉障碍 电流感知阈值 疼痛耐受阈值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]