Dornak Tomas, Justanova Maria, Konvalinkova Romana, Muzik Jan, Hoskovcova Martina, Srp Martin, Riha Michal, Navratilova Daniela, Otruba Pavel, Gal Ota, Dusek Ladislav, Jech Robert, Bares Martin, Kanovsky Petr
Department of Neurology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
Department of Neurology, Faculty of Medicine, Masaryk University Brno and St. Anne's University Hospital, Brno, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2018 May 23. doi: 10.5507/bp.2018.024.
The main aim of this study was to provide an estimate of the incidence and prevalence of spasticity following stroke in the internal carotid artery territory for Regional Stroke Centers in the Czech Republic. A secondary goal was to identify predictors for the development of spasticity.
In a prospective cohort study, 256 consecutive patients with clinical signs of central paresis due to a first-ever stroke were examined in the acute stage. All patients had primary stroke of carotid origin and paresis of the upper and/or lower limb for longer than 7 days after stroke onset. All were examined between 7-10 days after the stroke. We evaluated the degree and pattern of paresis, spasticity using the Modified Ashworth scale and the Barthel Index, baseline characteristics and demographic data.
Of 256 patients (157 males; mean age 69.9±12.4 years), 115 (44.9%) patients developed spasticity during the first 10 days after stroke onset. Eighty-three (32.5%) patients presented with mild neurological deficit (modified Rankin Scale 0 - 2) and 69 (27.0%) patients were bedridden.
Spasticity was noted in 44.9% patients with neurological deficit due to first-ever stroke in the carotid territory in the first 10 days after stroke onset. Severe spasticity was rare.
本研究的主要目的是为捷克共和国的地区性卒中中心提供颈内动脉供血区卒中后痉挛的发病率和患病率估计。次要目标是确定痉挛发生的预测因素。
在一项前瞻性队列研究中，对256例首次卒中导致中枢性瘫痪临床体征的连续患者在急性期进行了检查。所有患者均为颈动脉起源的原发性卒中，且卒中发作后上肢和/或下肢瘫痪超过7天。所有患者均在卒中后7 - 10天接受检查。我们使用改良Ashworth量表和Barthel指数评估了瘫痪程度和模式、痉挛情况、基线特征和人口统计学数据。
在256例患者（157例男性；平均年龄69.9±12.4岁）中，115例（44.9%）患者在卒中发作后的前10天内出现痉挛。83例（32.5%）患者表现为轻度神经功能缺损（改良Rankin量表0 - 2级），69例（27.0%）患者卧床不起。
在卒中发作后的前10天内，44.9%因首次颈动脉供血区卒中导致神经功能缺损的患者出现痉挛。严重痉挛很少见。
