Department of Neurology, Tongji University School of Medicine, Shanghai Tenth People's Hospital, 301 Middle Yanchang Road, Shanghai 200072, China.
Department of Neurology, Tongji University School of Medicine, East Hospital, 150 Jimo Road, Shanghai 200120, China.
Curr Neurovasc Res. 2020;17(3):304-311. doi: 10.2174/1567202617666200413130101.
Hemiplegia is a common symptom after acute cerebral infarction.
This study aimed to explore the influence factors of gait performance and investigate whether donepezil could improve gait performance in patients with an acute cerebral infarction.
A total of 107 patients who experienced unilateral paresis after an acute cerebral infarction incident were enrolled in this prospectively observational study. Participants underwent a 3- month assessment. At the study's conclusion, patients were divided into 2 groups-those who received donepezil daily (observation Group) and those who did not (Control Group).
There was a significant difference (t=3.269, P=0.001) of Wisconsin Gait Scale (WGS) score between single site infarction (27.11±6.65) and multiple sites infarction (31.54±6.42). For gender, smoking, drinking, hypertension, hyperlipidemia and diabetes, there was no difference in WGS scores between subgroups (P>0.05), respectively. The patient's admission National Institute of Health Stroke Scale(NIHSS) score had a strongly positive correlation with WGS score (r=0.850, P<0.001). Besides, age (r=0.218, P=0.024), glycosylated hemoglobin (r=0.274, P=0.004), MMSE (r=-0.261, P=0.007) and Montreal Cognitive Assessment (MoCA) (r=-0.272, P=0.005) had a weak correlation with WGS scores. Multivariate analysis showed age (95% CI: 0.0420.188, P=0.002), admission NIHSS score (95% CI: 2.4053.137, P<0.001) and multiple sites infarction (95% CI: 0.044~2.983, P=0.044) were independent risk factors of WGS scores. WGS scores of both observation and control groups gradually decreased after admission (P<0.001). At 3 months after admission, WGS score of the observation group was significantly lower than the control group (t=2.468, P=0.015). There were no significant differences between observation and control group at admission and 1 month after admission (P>0.05) and WGS scores of both single site and multiple sites infarction gradually decreased at one month and three months after admission (P<0.001), while there was no significant difference between two groups (P>0.05).
Admission NIHSS score, age and multiple sites infarction were independent risk factors of WGS score. Donepezil could improve gait performance in patients with acute cerebral infarction.
偏瘫是急性脑梗死的常见症状。
本研究旨在探讨影响步态表现的因素，并研究多奈哌齐是否能改善急性脑梗死患者的步态表现。
本前瞻性观察研究共纳入 107 例急性脑梗死后单侧瘫痪患者。参与者接受了 3 个月的评估。在研究结束时，患者分为两组——每天服用多奈哌齐的观察组（n=54）和未服用多奈哌齐的对照组（n=53）。
单部位梗死（27.11±6.65）和多部位梗死（31.54±6.42）的威斯康星步态量表（WGS）评分有显著差异（t=3.269，P=0.001）。对于性别、吸烟、饮酒、高血压、高血脂和糖尿病，亚组间 WGS 评分无差异（P>0.05）。患者入院时的国立卫生研究院卒中量表（NIHSS）评分与 WGS 评分呈强正相关（r=0.850，P<0.001）。此外，年龄（r=0.218，P=0.024）、糖化血红蛋白（r=0.274，P=0.004）、简易精神状态检查表（MMSE）（r=-0.261，P=0.007）和蒙特利尔认知评估（MoCA）（r=-0.272，P=0.005）与 WGS 评分有弱相关性。多变量分析显示，年龄（95%CI：0.0420.188，P=0.002）、入院 NIHSS 评分（95%CI：2.4053.137，P<0.001）和多部位梗死（95%CI：0.044~2.983，P=0.044）是 WGS 评分的独立危险因素。观察组和对照组入院后 WGS 评分逐渐下降（P<0.001）。入院 3 个月后，观察组的 WGS 评分明显低于对照组（t=2.468，P=0.015）。入院时和入院后 1 个月观察组和对照组差异无统计学意义（P>0.05），入院后 1 个月和 3 个月单部位和多部位梗死的 WGS 评分逐渐下降（P<0.001），但两组间差异无统计学意义（P>0.05）。
入院 NIHSS 评分、年龄和多部位梗死是 WGS 评分的独立危险因素。多奈哌齐可改善急性脑梗死患者的步态表现。
