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大脑中动脉卒中幸存者的功能性步行恢复:认知功能和极低丙氨酸转氨酶水平的预测作用:一项回顾性观察研究

Functional ambulation recovery in MCA stroke survivors: Predictive role of cognitive function and extremely low alanine aminotransferase levels: A retrospective observational study.

作者信息

Jeon Hyeonwoo, Jeon Namo, Kim Minsong, Kang Mingu, Kim Suebeen, Kim Doo Young

机构信息

Department of Rehabilitation Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.

International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.

出版信息

Medicine (Baltimore). 2025 Jun 20;104(25):e42989. doi: 10.1097/MD.0000000000042989.

Abstract

Stroke is a leading cause of disability, significantly impacting mobility. Effective rehabilitation depends on accurate predictors of recovery. Recent studies suggest that both cognitive function and certain initial laboratory biomarkers, such as alanine aminotransferase (ALT), could be crucial for predicting recovery outcomes. This study investigates how cognitive function and ALT levels can predict functional ambulation in survivors of middle cerebral artery stroke. A retrospective analysis was conducted on 87 patients who began rehabilitation within 30 days of their first middle cerebral artery stroke. Multivariate logistic regression was employed to identify predictors of ambulation recovery. The variables assessed included age, sex, National Institutes of Health Stroke Scale, Berg Balance Scale, Mini-Mental State Examination, and extremely low ALT levels. Multivariate binary logistic regression revealed that female sex, lower Mini-Mental State Examination and Berg Balance Scale scores, and extremely low ALT levels were associated with poorer odds of achieving functional ambulation. This research underscores the critical role of integrating cognitive assessments and routine biomarkers into rehabilitation practices to enhance prognostic accuracy and personalize rehabilitation strategies. The findings highlight the need for further investigation to confirm these results and explore the underlying mechanisms, with the aim of advancing individualized rehabilitation approaches and improving patient outcomes.

摘要

中风是导致残疾的主要原因,对行动能力有重大影响。有效的康复取决于准确的恢复预测指标。最近的研究表明,认知功能和某些初始实验室生物标志物,如丙氨酸转氨酶(ALT),可能对预测恢复结果至关重要。本研究调查了认知功能和ALT水平如何预测大脑中动脉中风幸存者的功能性步行能力。对87例在首次大脑中动脉中风后30天内开始康复治疗的患者进行了回顾性分析。采用多因素逻辑回归来确定步行恢复的预测指标。评估的变量包括年龄、性别、美国国立卫生研究院卒中量表、伯格平衡量表、简易精神状态检查表以及极低的ALT水平。多因素二元逻辑回归显示,女性、较低的简易精神状态检查表和伯格平衡量表得分以及极低的ALT水平与实现功能性步行的较差几率相关。本研究强调了将认知评估和常规生物标志物纳入康复实践以提高预后准确性和个性化康复策略的关键作用。研究结果凸显了进一步调查以证实这些结果并探索潜在机制的必要性,目的是推进个性化康复方法并改善患者预后。

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