摘要
目的观察低频重复经颅磁刺激(rTMS)联合认知训练对脑卒中后认知障碍患者甲状腺激素水平及认知功能的影响,为临床康复治疗提供参考依据。方法选取2019年10月至2020年12月在石家庄市人民医院康复治疗且符合纳入标准的80例卒中后认知障碍患者,随机分为治疗组和对照组各40例。治疗后,治疗组脱落3例,余37例,对照组脱落2例,余38例。治疗组给予rTMS联合认知训练,对照组给予同样刺激参数的假rTMS,治疗4周。采用蒙特利尔认知量表(MoCA)评估2组患者治疗前后的认知功能,并检测2组患者治疗前后甲状腺激素水平。结果2组患者治疗后的血清三碘甲状腺原氨酸(T3)、促甲状腺激素(TSH)水平均高于治疗前,且治疗组显著高于对照组(P均<0.05)。治疗组MoCA总分及各子项目评分均高于治疗前,对照组患者MoCA总分及语言能力、延迟回忆、定向力评分均高于治疗前,治疗组患者MoCA总分及注意力、延迟回忆评分均高于对照组,差异均有统计学意义(P<0.05)。结论低频rTMS能够提高脑卒中后认知障碍患者的血清T3、TSH水平,改善认知功能。
Objective To investigate the effects of low frequency repetitive transcranial magnetic stimulation(rTMS)combined with cognitive training on the thyroid hormone levels and cognitive function in patients with cognitive impairment after cerebral stroke,so as to provide reference for clinical rehabilitation treatment.Methods Eighty patients with post-stroke cognitive impairment who were treated in our hospital from October 2019 to December 2020 were enrolled in the study,who were randomly divided into observation group and control group,with 40 cases in each group.After treatment,3 cases fell off in observation group,and 2 cases were fell off.The patients in observation group were treated by rTMS combined with cognitive training,however,the patients in control group were treated by the same stimulation parameters of false rTMS,with a treatment course of 4 wekks for both groups.Montreal Cognitive Scale(MoCA)was used to evaluate the cognitive function of patients before and after treatment,and thyroid hormone levels before and after treatment were detected.Results After treatment the serum levels of triiodothyronine(T3)and thyroid stimulating hormone(TSH)in both were significantly increased,moreover,which in observation group were significantly higher than those in control group(P<0.05).The total scores of MoCA and the scores of each subproject in observation group were significantly higher than those before treatment.And the total scores of MoCA and the scores of language ability,delayed recall and orientation in observation group were significantly higher than those before treatment,moreover,which in observation group were significantly higher than those in control group(P<0.05).Conclusion The low frequency rTMS can improve the serum levels of T3 and TSH in patients with cognitive impairment after cerebral stroke,and can improve the cognitive function of patients.
作者
马将
李红
张俊
赵青青
史万英
黄力平
吕士英
周帅
MA Jiang;LI Hong;ZHANG Jun(Shijiazhuang People’s Hospital,Hebei,Shijiazhuang 050030,China;不详)
出处
《河北医药》
CAS
2021年第16期2436-2441,共6页
Hebei Medical Journal
基金
河北省科技厅重点研发计划项目(编号:20377727D)。
关键词
重复经颅磁刺激
脑卒中
认知
认知障碍
甲状腺激素
repetitive transcranial magnetic stimulation
cerebral stroke
cognition
cognitive impairment
thyroid hormone
