摘要
目的通过测量基底节区脑出血患者康复训练前后皮质脊髓束的各向异性(FA)、FA比例(rFA)及FA不对称性(FAasy)值的变化,探讨康复训练对基底节区出血患者皮质脊髓束指标的影响。方法选取2016年1月~2019年6月收治的基底节区出血患者36例作为研究对象,21例接受康复治疗者为康复组,同期未行康复治疗的15例为对照组。分别比较两组患者治疗前后颅脑半卵圆中心、内囊后肢、大脑脚皮质脊髓束FA、rFA、FAasy的变化。结果康复组治疗后患侧半卵圆中心、内囊后肢、大脑脚皮质脊髓束FA、rFA值低于治疗前和对照组,FAasy高于治疗前和对照组,差异均有统计学意义(P<0.05)。康复组患者的健侧半卵圆中心、大脑脚的FA值较前下降,但差异无统计学意义(P>0.05)。结论基底节区脑出血患者运动功能恢复不仅与患侧皮质脊髓束重塑相关,健侧皮质脊髓束的代偿也起了重要作用。康复训练通过促进健、患侧的皮质脊髓束重塑而改善患者的肢体运动功能。
Objective To explore the effect of rehabilitation training on the corticospinal tract of patients with basal ganglia hemorrhage by measuring the fractional anisotropy(FA),FA ratio(rFA)and FA asymmetry(FAasy)of the corticospinal tract before and after rehabilitation training.Methods Thirty-six patients with basal ganglia hemorrhage from January 2016 to June 2019 were selected and divided into the rehabilitation group(21 cases received drug and rehabilitation treatment)and the control group(15 cases received drug treatment).The changes of FA,rFA and FAasy in the centrum semiovale,hind limb of internal capsule and cerebral peduncle were compared before and after treatment.Results After treatment,the values of FA and rFA of the centrum semiovale,hind limb of internal capsule,and cerebral peduncle in the affected side in the rehabilitation group were lower than those before treatment and those in the control group,and the FAasy values were higher than those before treatment and those in the control group,and there were significant differences between the two groups(P<0.05).The FA values of the centrum semiovale and cerebral peduncle in contralateral side in the rehabilitation treatment group were lower than those before treatment,but there were no significant differences between the two groups(P>0.05).Conclusion The recovery of motor function in patients with basal ganglia hemorrhage is not only related to the remodeling of the affected corticospinal tract,but also related to the compensation of the contralateral healthy corticospinal tract.Rehabilitation training may improve the limb motor function by promoting the remodeling of the corticospinal tract on the healthy and affected sides.
作者
孙凌瑜
任路明
黄灿
刘婷
李嘉敏
Sun Lingyu;Ren Luming;Huang Can;Liu Ting;Li Jiamin(Department of RehabilNation,Dongguan Donghua Hospital,Dongguan 523000)
出处
《国际老年医学杂志》
2022年第3期308-312,共5页
International Journal of Geriatrics
基金
广东省医学科学技术研究基金(201611422308780)。
关键词
基底节区出血
皮质脊髓束
重塑
磁共振弥散张量成像
Basal ganglia hemorrhage
Corticospinal tract
Remodeling
Diffusion tensor imaging
