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大脑中动脉平均血流速度与缺血性脑卒中患者康复成功相关。

Mean flow velocity in the middle cerebral artery is associated with rehabilitation success in ischemic stroke patients.

机构信息

Loewenstein Hospital Rehabilitation Center, Ra'anana, Israel.

出版信息

Arch Phys Med Rehabil. 2010 Nov;91(11):1737-40. doi: 10.1016/j.apmr.2010.08.008.

Abstract

OBJECTIVE

To evaluate the association between mean flow velocity (MFV) in the middle cerebral artery (MCA) measured by using transcranial Doppler (TCD) and functional and neurologic impairment change during rehabilitation after acute stroke.

DESIGN

Cross-sectional observational study.

SETTING

Acute neurologic rehabilitation department.

PARTICIPANTS

Consecutive patients (N=67; 53 men, 14 women; mean ± SD age, 61.54±8.92y) referred to the rehabilitation center during the first 6 months of 2006 for a first ischemic stroke in the MCA area.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

All subjects were evaluated on admission and at discharge by using the National Institutes of Health Stroke Scale (NIHSS) and the FIM. TCD measurements of MFV of the ipsilateral and contralateral MCA were performed on admission (during the first 20 days after stroke) and a few days before discharge.

RESULTS

Contralateral MFV at admission was associated significantly with all indexes of functional rehabilitation success (FIM score at discharge [β=.169; P=.010], change in FIM score [β=.554; P=.010], relative improvement in FIM score [β=.783; P=.003]). No significant association was found between indexes of NIHSS change and ipsilateral or contralateral MFV.

CONCLUSIONS

Ipsilateral or contralateral MFV measured at admission did not change during the 2-month rehabilitation period. Our data showed a significant association between blood flow velocity in the contralateral MCA and functional rehabilitation parameters of patients after first ischemic stroke in the MCA area.

摘要

目的

评估经颅多普勒(TCD)测量的大脑中动脉(MCA)平均流速(MFV)与急性卒中后康复期间功能和神经功能损伤变化之间的相关性。

设计

横断面观察性研究。

地点

急性神经康复科。

参与者

连续患者(N=67;53 名男性,14 名女性;平均年龄±标准差,61.54±8.92 岁)在 2006 年的前 6 个月内因 MCA 区域的首次缺血性卒中被转诊至康复中心。

干预措施

不适用。

主要观察指标

所有患者在入院时和出院时均采用国立卫生研究院卒中量表(NIHSS)和功能独立性量表(FIM)进行评估。入院时(卒中后 20 天内)和出院前几天进行了对侧和同侧 MCA 的 TCD 测量 MFV。

结果

入院时的对侧 MFV 与所有功能康复成功指标均有显著相关性(出院时的 FIM 评分[β=0.169;P=0.010]、FIM 评分变化[β=0.554;P=0.010]、FIM 评分相对改善[β=0.783;P=0.003])。NIHSS 变化指标与同侧或对侧 MFV 之间未发现显著相关性。

结论

在 2 个月的康复期间,入院时测量的同侧或对侧 MFV 未发生变化。我们的数据显示,MCA 区域首次缺血性卒中后患者的对侧 MCA 血流速度与功能康复参数之间存在显著相关性。

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