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中风后再通对全身及上肢功能的影响:一项前瞻性观察研究。

Impact of Post-Stroke Recanalization on General and Upper Limb Functioning: A Prospective, Observational Study.

作者信息

Branco João Paulo, Rocha Filipa, Sargento-Freitas João, Santo Gustavo C, Freire António, Laíns Jorge, Páscoa Pinheiro João

机构信息

Physical and Rehabilitation Medicine Department, Centro Hospitalar Universitário de Coimbra, 3030-075 Coimbra, Portugal.

Faculty of Medicine, University of Coimbra, 3030-075 Coimbra, Portugal.

出版信息

Neurol Int. 2021 Feb 4;13(1):46-58. doi: 10.3390/neurolint13010005.

Abstract

The objective of this study is to assess the impact of recanalization (spontaneous and therapeutic) on upper limb functioning and general patient functioning after stroke. This is a prospective, observational study of patients hospitalized due to acute ischemic stroke in the territory of the middle cerebral artery ( = 98). Patients completed a comprehensive rehabilitation program and were followed-up for 24 weeks. The impact of recanalization on patient functioning was evaluated using the modified Rankin Scale (mRS) and Stroke Upper Limb Capacity Scale (SULCS). General and upper limb functioning improved markedly in the first three weeks after stroke. Age, gender, and National Institutes of Health Stroke Scale (NIHSS) score at admission were associated with general and upper limb functioning at 12 weeks. Successful recanalization was associated with better functioning. Among patients who underwent therapeutic recanalization, NIHSS scores ≥16.5 indicate lower general functioning at 12 weeks (sensibility = 72.4%; specificity = 78.6%) and NIHSS scores ≥13.5 indicate no hand functioning at 12 weeks (sensibility = 83.8%; specificity = 76.5%). Recanalization, either spontaneous or therapeutic, has a positive impact on patient functioning after acute ischemic stroke. Functional recovery occurs mostly within the first 12 weeks after stroke, with greater functional gains among patients with successful recanalization. Higher NIHSS scores at admission are associated with worse functional recovery.

摘要

本研究的目的是评估再通(自发再通和治疗性再通)对中风后上肢功能及患者整体功能的影响。这是一项针对因大脑中动脉区域急性缺血性中风住院患者( = 98)的前瞻性观察性研究。患者完成了一项全面的康复计划,并接受了24周的随访。使用改良Rankin量表(mRS)和中风上肢能力量表(SULCS)评估再通对患者功能的影响。中风后的前三周,患者的整体功能和上肢功能显著改善。年龄、性别和入院时的美国国立卫生研究院卒中量表(NIHSS)评分与12周时的整体功能和上肢功能相关。成功再通与更好的功能相关。在接受治疗性再通的患者中,NIHSS评分≥16.5表明12周时整体功能较低(敏感性 = 72.4%;特异性 = 78.6%),NIHSS评分≥13.5表明12周时手部无功能(敏感性 = 83.8%;特异性 = 76.5%)。自发或治疗性再通对急性缺血性中风后的患者功能有积极影响。功能恢复大多发生在中风后的前12周内,成功再通的患者功能改善更大。入院时较高的NIHSS评分与较差的功能恢复相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7fe/7931094/a1d9626775fb/neurolint-13-00005-g001.jpg

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