[目的]探讨重复经倾磁刺激技术(repeated transcranial magnetic stimulation,rTMS)联合高压氧治疗对重型颅脑损伤昏迷患者炎症因子、认知功能及脑血流的影响。[方法]选择2017年10月至2020年2月本院收治的120例重型颅脑损伤昏迷患者,根...[目的]探讨重复经倾磁刺激技术(repeated transcranial magnetic stimulation,rTMS)联合高压氧治疗对重型颅脑损伤昏迷患者炎症因子、认知功能及脑血流的影响。[方法]选择2017年10月至2020年2月本院收治的120例重型颅脑损伤昏迷患者,根据随机数表法分为观察组和对照组,各60例。分别采用rTMS治疗和rT-MS联合高压氧治疗,并对比两组患者脑电图(EEG)以及治疗后各时间段的炎症因子、脑血流动力学、格拉斯哥昏迷量表评分(GCS)、修订版昏迷恢复量表评分(CRS-R)、简易智力状态检查量表评分(MMSE)的变化情况。[结果]治疗后2周和4周观察组患者GCS评分分别为(10.49±3.26)分和(13.87±1.41)分;CRS-R评分分别为(16.49±3.62)分和(21.32±1.39)分,两组间比较差异具有统计学意义(P<0.05)。观察组患者治疗后4周的MMSE总分为(27.46±2.46)分,高于对照组的(23.39±2.33)分,其差异具有统计学意义(P<0.05)。治疗后2周和4周患者脑血管平均血流速度(Vm)、舒张期末血流速度(Vd)、大脑中动脉收缩期峰流速(Vs)、搏动指数(PI)、白介素6(IL-6)、肿瘤坏死因子(TNF-α)、C反应蛋白(CRP)改变情况均优于对照组(P<0.05)。[结论]rTMS联合高压氧治疗重型颅脑损伤昏迷患者临床疗效显著,可下调患者炎症因子水平,改善脑血流,促使其认知功能恢复。展开更多
Physical exercise can minimize dysfunction and optimize functional motor recovery after stroke by modulating cortical plasticity.However,the limitation of physical exercise is that large amounts of time and effort are...Physical exercise can minimize dysfunction and optimize functional motor recovery after stroke by modulating cortical plasticity.However,the limitation of physical exercise is that large amounts of time and effort are necessary to significantly improve motor function,and even then,substantial exercise may not be sufficient to normalize the observed improvements.Thus,interventions that could be used to strengthen physical exercise-induced neuroplasticity may be valuable in treating hemiplegia after stroke.Repetitive transcranial magnetic stimulation seems to be a viable strategy for enhancing such plasticity.As a non-invasive cortical stimulation technique,repetitive transcranial magnetic stimulation is able to induce longterm plastic changes in the motor system.Recently,repetitive transcranial magnetic stimulation was found to optimize the plastic changes caused by motor training,thereby enhancing the long-term effects of physical exercise in stroke patients.Therefore,it is believed that the combination of repetitive transcranial magnetic stimulation and physical exercise may represent a superior method for restoring motor function after stroke.展开更多
文摘[目的]探讨重复经倾磁刺激技术(repeated transcranial magnetic stimulation,rTMS)联合高压氧治疗对重型颅脑损伤昏迷患者炎症因子、认知功能及脑血流的影响。[方法]选择2017年10月至2020年2月本院收治的120例重型颅脑损伤昏迷患者,根据随机数表法分为观察组和对照组,各60例。分别采用rTMS治疗和rT-MS联合高压氧治疗,并对比两组患者脑电图(EEG)以及治疗后各时间段的炎症因子、脑血流动力学、格拉斯哥昏迷量表评分(GCS)、修订版昏迷恢复量表评分(CRS-R)、简易智力状态检查量表评分(MMSE)的变化情况。[结果]治疗后2周和4周观察组患者GCS评分分别为(10.49±3.26)分和(13.87±1.41)分;CRS-R评分分别为(16.49±3.62)分和(21.32±1.39)分,两组间比较差异具有统计学意义(P<0.05)。观察组患者治疗后4周的MMSE总分为(27.46±2.46)分,高于对照组的(23.39±2.33)分,其差异具有统计学意义(P<0.05)。治疗后2周和4周患者脑血管平均血流速度(Vm)、舒张期末血流速度(Vd)、大脑中动脉收缩期峰流速(Vs)、搏动指数(PI)、白介素6(IL-6)、肿瘤坏死因子(TNF-α)、C反应蛋白(CRP)改变情况均优于对照组(P<0.05)。[结论]rTMS联合高压氧治疗重型颅脑损伤昏迷患者临床疗效显著,可下调患者炎症因子水平,改善脑血流,促使其认知功能恢复。
基金supported by the Shanghai Jiao Tong University School of Medicine-Institute of Neuroscience,Chinese Academy of SciencesLeading Startup Project of Brain Diseases Clinical Research Center of China,No.2017NKX002(to QX)。
文摘Physical exercise can minimize dysfunction and optimize functional motor recovery after stroke by modulating cortical plasticity.However,the limitation of physical exercise is that large amounts of time and effort are necessary to significantly improve motor function,and even then,substantial exercise may not be sufficient to normalize the observed improvements.Thus,interventions that could be used to strengthen physical exercise-induced neuroplasticity may be valuable in treating hemiplegia after stroke.Repetitive transcranial magnetic stimulation seems to be a viable strategy for enhancing such plasticity.As a non-invasive cortical stimulation technique,repetitive transcranial magnetic stimulation is able to induce longterm plastic changes in the motor system.Recently,repetitive transcranial magnetic stimulation was found to optimize the plastic changes caused by motor training,thereby enhancing the long-term effects of physical exercise in stroke patients.Therefore,it is believed that the combination of repetitive transcranial magnetic stimulation and physical exercise may represent a superior method for restoring motor function after stroke.
