摘要
目的探讨脑损伤患者瘫侧足三里（ST36）和风市（GB31）联合穴位电针刺激fMRI监测患侧脑激活簇偏侧指数LI（Late-rality index,LI）意义及其改变对临床神经功能缺损恢复程度的评定价值。方法对恢复期可配合检查19例脑损伤致偏瘫的我院住院患者,选择瘫侧足三里和风市穴位进行电针刺激fMRI,运用t检验统计学方法分析得出刺激状态与静息状态信号对比的脑功能图。15例患者相隔14~49天后再进行1次fMRI对比检查。计算出每次的针灸对侧脑激活簇偏侧指数LI,LI=（C-I）/（C＋I）,C与I分别为针灸侧的对侧与针灸侧的同侧脑激活簇数目之和。同时,计算出同期相应的临床神经功能缺损评分值S（Score）。统计分析2期LI值对比变化△LI（LI2-LI1）及其与S改变△S（S1-S2）的相关性。结果15例获得2期检查的完整资料,4例仅得到1次检查资料。19例共做53次fMRI,选择其中较优质34次脑功能图做统计分析。这34次结果中,29次LI值为正值,出现在16个病例中;仅5次LI值为负值,出现在3个病例中;15例取得2期完整对比资料中,LI变化均有不同程度提高,但无显著性差异（t=1.304,P〉0.05）;△LI和△S均为正值,且△LI与△S呈正相关（r=0.959,P〈0.001）。结论脑损伤患者瘫侧足三里和风市穴位联合电针刺激fMRI单次监测患侧脑激活簇LI表明脑激活簇是以患侧脑占主导地位的;动态监测患侧脑激活簇LI改变△LI对脑损伤神经功能缺损恢复程度具有一定的评定价值。
Aim To investigate the brain activated areas ＂laterality index ＂ （LI） significance of the contralateral versus electroacupunc- ture lateral by brain functional MRI（fMRI） after eleetroacupuncture to the hemiplegia ipsilateral acupoints Zu san li （ST36） and Feng shi （GB31） for patients with traumatic brain injury during nerve function recovery stage, and the ssessment value of nerve function damage recovery degree by LI change. Methods Nineteen cooperative patients with severe hemiplegia caused by traumatic brain injury underwent fMRI during nerve function recovery stage. All the patients had received eleetroacupuncture of ipsilateral acupoints Zu san li （ST36） and Feng shi （GB31）. After stimulation the activated areas in brain functional BOLD maps were analyzed by t-test analysis. A comparative study was made in nineteen patients who received twice of fMRI at the interval of 14 to 49 days. A ＂ laterality index ＂ （LI） of the contralateral versus electroaeupuneture lateral was calculated （LI = （C -I）/（ C ＋ I）, C and I are the activated number in the contralateral brain and that in the ipsilateral brain respectively）. Meanwhile, the assessment score of nerve function damage was calculated for every patient too. The correlation between LI change △LI （ LI2 - LI1 ） and S change △ S （ S1 - S2 ） was analyzed. Rusults Fifty-three times of fMRI were achieved in 19 patients, among which 15 patients received twice and 4 patients received only once. Thirty-four maps were selected for statistics analysis. Among the thirty maps, positive LI value was presented in 29 maps and 16 cases, and negative LI val- ue only presented in 5 maps and 3 cases. Compared with the first fMRI, the LI value increased at different degree, but no significant difference （ t = 1. 304, P 〉 0. 05）. △LI and A S are all positive, and the correlation between △LI and △ S was positive （ r = 0. 959, P 〈 0. 001 ）. Conclusion The brain activated areas LI of contralateral versus elect
出处
《安徽医药》
CAS
2009年第6期632-635,共4页
Anhui Medical and Pharmaceutical Journal
基金
铜陵市科技计划项目(No06jk1207)
