CAJ | 학술논문

目的通过单光子发射计算机断层显像(SPECT)局部脑血流半定量分析法,探讨减重步行训练(BWSTT)治疗老年脑梗死偏瘫患者下肢运动功能障碍的机制及SPECT在脑血管病研究中的价值.方法选择7例脑梗死患者,给予10周综合康复治疗,分为三个阶段,即2周基线期(给予常规康复治疗)、6周干预期(给予常规康复治疗加BWSTT)和2周撤消期(给予常规康复治疗).在治疗前、基线期末、干预期末和撤消期末采用10 m最大步行速度(MWS)和Berg平衡量表(BBS)进行功能评定,应用SPECT观察皮质局部脑血流的动态变化情况.结果经2周基线期的治疗,患者10 m MWS和BBS评分无明显变化,差异无统计学意义(P＞0.05);6周干预期末,MWS及BBS评分明显增高,差异有统计学意义(P＜0.01);撤消期末,MWS及BBS评分均有所增高,但增高幅度小于干预期,差异无统计学意义(P＞0.05);6周干预期末,患者大脑皮质的局部脑血流变化的差异有统计学意义(P＜0.01).结论 BWSTT可以明显改善老年脑梗死患者的步行速度和平衡能力;SPECT能客观反映下肢运动功能的恢复与大脑皮质局部脑血流变化的关系,SPECT是研究脑卒中后下肢运动功能康复与脑功能重组之间关系的一种有效手段.
목적 통과단광자발사계산궤단층현상(SPECT)국부뇌혈류반정량분석법,탐토감중보행훈련(BWSTT)치료노년뇌경사편탄환자하지운동공능장애적궤제급SPECT재뇌혈관병연구중적개치.방법 선택7례뇌경사환자,급여10주종합강복치료,분위삼개계단,즉2주기선기(급여상규강복치료)、6주간예기(급여상규강복치료가BWSTT)화2주철소기(급여상규강복치료).재치료전、기선기말、간예기말화철소기말채용10 m최대보행속도(MWS)화Berg평형량표(BBS)진행공능평정,응용SPECT관찰피질국부뇌혈류적동태변화정황.결과 경2주기선기적치료,환자10 m MWS화BBS평분무명현변화,차이무통계학의의(P＞0.05);6주간예기말,MWS급BBS평분명현증고,차이유통계학의의(P＜0.01);철소기말,MWS급BBS평분균유소증고,단증고폭도소우간예기,차이무통계학의의(P＞0.05);6주간예기말,환자대뇌피질적국부뇌혈류변화적차이유통계학의의(P＜0.01).결론 BWSTT가이명현개선노년뇌경사환자적보행속도화평형능력;SPECT능객관반영하지운동공능적회복여대뇌피질국부뇌혈류변화적관계,SPECT시연구뇌졸중후하지운동공능강복여뇌공능중조지간관계적일충유효수단.
Objective To observe the effect of body-weight supported treadmill training (BWSTT) on the lower limb motor function of elderly hemiplegia patients with acute cerebral infarction using semi-quantitative analysis of regional cerebral blood flow (rCBF) through single photon emission computed tomography (SPECT). Methods Seven patients with cerebral infarction were given comprehensive rehabilitation therapy for 10 weeks in three stages: a baseline period of 2 weeks ( conventional rehabilitation therapy), an intervention period of 6 weeks ( conventional rehabilitation therapy plus BWSTT) and a withdrawal period of 2 weeks (conventional rehabilitation therapy). During the intervention period the exercise duration increased gradually from 15 to 30 minutes, once a day, 5 times a week,for 6 consecutive weeks. Dynamic changes in rCBF in the cortex were observed with SPECT before and after treat ment. Results During the baseline period there was no significant change in average MWS (maximum walking speed) or BBS ( Berg balance scale) scores. During the intervention period both scores improved significantly. During the withdrawal period there were some changes in MWS and BBS scores, but they were not significant. There was a significant change in average rCBF in the cortex after treatment compared with before. Conclusions BWSTT is effective for improving the walking speed and balance of elderly patients with acute cerebral infarction. There is a positive correlation between the recovery of lower limb motor function and changes in rCBF in the cortex.