目的探究大动脉粥样硬化与心源性栓塞急性缺血性脑卒中(AIS)梗死特征的差异。方法回顾性纳入2016年10月至2018年6月于我院急诊入院治疗,且入院后、治疗前均行多模态计算机断层扫描(CT)检查的AIS患者99例,其中大动脉粥样硬化46例,心源性...目的探究大动脉粥样硬化与心源性栓塞急性缺血性脑卒中(AIS)梗死特征的差异。方法回顾性纳入2016年10月至2018年6月于我院急诊入院治疗,且入院后、治疗前均行多模态计算机断层扫描(CT)检查的AIS患者99例,其中大动脉粥样硬化46例,心源性栓塞53例。比较两组患者的入院时美国国立卫生研究院卒中量表(NIHSS)评分和格拉斯哥昏迷量表(GCS)评分、梗死核心区和缺血半暗带体积及二者差值以及后循环血管闭塞率、颅内大动脉闭塞率。结果大动脉粥样硬化组AIS患者入院时NIHSS评分低于心源性栓塞组[9.5(2.0,16.0)分vs 15.0(6.0,24.0)分,Z=2.31,P<0.001],GCS评分高于心源性栓塞组[(13.52±2.69)分vs(11.60±3.31)分,t=1.04,P=0.002]。心源性栓塞组梗死核心区和缺血半暗带体积分别为1(0,22)m L和64(30,126)m L,均大于大动脉粥样硬化组[分别为0(0,1)m L和10(0,70)m L;Z=3.85、3.43,P均<0.001];但心源性栓塞组和大动脉粥样硬化组缺血半暗带与梗死核心区体积的差值差异无统计学意义[46(4,103)m L vs 10(0,64)m L,Z=1.92,P>0.05]。大动脉粥样硬化组颅内大动脉闭塞率和后循环血管闭塞率分别为30.43%(14/46)和36.96%(17/46),与心源性栓塞组[分别为50.94%(27/53)和9.43%(5/53)]相比差异均有统计学意义(χ~2=11.82、6.77,P均<0.001)。结论大动脉粥样硬化与心源性栓塞AIS患者的临床症状、脑组织改变及颅内大动脉改变不同,基于临床及多模态CT检查的病因学评估有助于精确评估AIS患者缺血状态。展开更多
Supratentorial cerebral infarction can cause functional inhibition of remote regions such as the cerebellum, which may be relevant to diaschisis. This phenomenon is often analyzed using positron emission tomography an...Supratentorial cerebral infarction can cause functional inhibition of remote regions such as the cerebellum, which may be relevant to diaschisis. This phenomenon is often analyzed using positron emission tomography and single photon emission CT. However, these methods are expensive and radioactive. Thus, the present study quantified the changes of infarction core and remote regions after unilateral middle cerebral artery occlusion using apparent diffusion coefficient values. Diffu- sion-weighted imaging showed that the area of infarction core gradually increased to involve the cerebral cortex with increasing infarction time. Diffusion weighted imaging signals were initially in- creased and then stabilized by 24 hours. With increasing infarction time, the apparent diffusion co- efficient value in the infarction core and remote bilateral cerebellum both gradually decreased, and then slightly increased 3-24 hours after infarction. Apparent diffusion coefficient values at remote regions （cerebellum） varied along with the change of supratentorial infarction core, suggesting that the phenomenon of diaschisis existed at the remote regions. Thus, apparent diffusion coefficient values and diffusion weighted imaging can be used to detect early diaschisis.展开更多
目的探讨调督针法联合核心稳定性训练在脑梗死恢复期患者治疗中的应用效果。方法选取我院收治的110例脑梗死恢复期患者,采用简单随机化分组法将其分为对照组(n=55)与观察组(n=55)。对照组给予常规药物治疗与康复训练,观察组在此基础上...目的探讨调督针法联合核心稳定性训练在脑梗死恢复期患者治疗中的应用效果。方法选取我院收治的110例脑梗死恢复期患者,采用简单随机化分组法将其分为对照组(n=55)与观察组(n=55)。对照组给予常规药物治疗与康复训练,观察组在此基础上给予调督针法联合核心稳定性训练。比较两组干预前及干预4周后BBS、Sheikh评分、10 m MWS及TUGT时间。结果干预4周后,两组患者的BBS、Sheikh评分均升高,且观察组高于对照组(P<0.05);干预4周后,两组患者的10 m MWS均升高,TUGT时间均缩短,且观察组均优于对照组(P<0.05)。结论将调督针法联合核心稳定性训练应用于脑梗死恢复期患者治疗中,能改善患者躯体平衡能力、躯干控制能力,提高患者步行能力及肢体反应速度。展开更多
文摘目的探究大动脉粥样硬化与心源性栓塞急性缺血性脑卒中(AIS)梗死特征的差异。方法回顾性纳入2016年10月至2018年6月于我院急诊入院治疗,且入院后、治疗前均行多模态计算机断层扫描(CT)检查的AIS患者99例,其中大动脉粥样硬化46例,心源性栓塞53例。比较两组患者的入院时美国国立卫生研究院卒中量表(NIHSS)评分和格拉斯哥昏迷量表(GCS)评分、梗死核心区和缺血半暗带体积及二者差值以及后循环血管闭塞率、颅内大动脉闭塞率。结果大动脉粥样硬化组AIS患者入院时NIHSS评分低于心源性栓塞组[9.5(2.0,16.0)分vs 15.0(6.0,24.0)分,Z=2.31,P<0.001],GCS评分高于心源性栓塞组[(13.52±2.69)分vs(11.60±3.31)分,t=1.04,P=0.002]。心源性栓塞组梗死核心区和缺血半暗带体积分别为1(0,22)m L和64(30,126)m L,均大于大动脉粥样硬化组[分别为0(0,1)m L和10(0,70)m L;Z=3.85、3.43,P均<0.001];但心源性栓塞组和大动脉粥样硬化组缺血半暗带与梗死核心区体积的差值差异无统计学意义[46(4,103)m L vs 10(0,64)m L,Z=1.92,P>0.05]。大动脉粥样硬化组颅内大动脉闭塞率和后循环血管闭塞率分别为30.43%(14/46)和36.96%(17/46),与心源性栓塞组[分别为50.94%(27/53)和9.43%(5/53)]相比差异均有统计学意义(χ~2=11.82、6.77,P均<0.001)。结论大动脉粥样硬化与心源性栓塞AIS患者的临床症状、脑组织改变及颅内大动脉改变不同,基于临床及多模态CT检查的病因学评估有助于精确评估AIS患者缺血状态。
基金supported by Zhejiang Province Science and Technology Plan Project in China,No.2012C37029Public Welfare Technology Application Research Plan Project of Zhejiang Province in China,No.2011C23021
文摘Supratentorial cerebral infarction can cause functional inhibition of remote regions such as the cerebellum, which may be relevant to diaschisis. This phenomenon is often analyzed using positron emission tomography and single photon emission CT. However, these methods are expensive and radioactive. Thus, the present study quantified the changes of infarction core and remote regions after unilateral middle cerebral artery occlusion using apparent diffusion coefficient values. Diffu- sion-weighted imaging showed that the area of infarction core gradually increased to involve the cerebral cortex with increasing infarction time. Diffusion weighted imaging signals were initially in- creased and then stabilized by 24 hours. With increasing infarction time, the apparent diffusion co- efficient value in the infarction core and remote bilateral cerebellum both gradually decreased, and then slightly increased 3-24 hours after infarction. Apparent diffusion coefficient values at remote regions （cerebellum） varied along with the change of supratentorial infarction core, suggesting that the phenomenon of diaschisis existed at the remote regions. Thus, apparent diffusion coefficient values and diffusion weighted imaging can be used to detect early diaschisis.
文摘目的探讨调督针法联合核心稳定性训练在脑梗死恢复期患者治疗中的应用效果。方法选取我院收治的110例脑梗死恢复期患者,采用简单随机化分组法将其分为对照组(n=55)与观察组(n=55)。对照组给予常规药物治疗与康复训练,观察组在此基础上给予调督针法联合核心稳定性训练。比较两组干预前及干预4周后BBS、Sheikh评分、10 m MWS及TUGT时间。结果干预4周后,两组患者的BBS、Sheikh评分均升高,且观察组高于对照组(P<0.05);干预4周后,两组患者的10 m MWS均升高,TUGT时间均缩短,且观察组均优于对照组(P<0.05)。结论将调督针法联合核心稳定性训练应用于脑梗死恢复期患者治疗中,能改善患者躯体平衡能力、躯干控制能力,提高患者步行能力及肢体反应速度。
