CAJ | 학술논문

【目的】探讨脑卒中急性期疲劳与血糖、同型半胱氨酸（Hcy）及功能障碍的相关性，探讨卒中后疲劳（PSF）可能的相关因素。【方法】病例组来自2012年6月至2013年9月在沈阳市红十字会医院神经内科住院治疗的急性脑梗死患者，共214人。对照组为本院健康体检中心同期的健康体检者，共214人。用疲劳严重度量表（Fatigue Severity Scale ，FSS）评价疲劳的状况，FSS评分≥4分诊断为疲劳。据此将病例组分为疲劳组（F组）与非疲劳组（NF组）。用NIHSS评分来评价卒中的严重程度，用Bar-thel-20指数（BI-20）评价患者功能障碍的程度。记录患者的年龄、性别及慢性病史，并于患者入院后d2检测血糖、Hcy、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）及纤维蛋白原（FIB）水平。【结果】病例组疲劳的发病率（32．2％）明显高于对照组（4．7％），且两组相比差异有显著性（χ2＝54．038；P＜0．01）。在病例组中，F组的血糖及Hcy水平均明显高于NF组，而BI-20评分则明显低于 NF组（ P＜0．01）。病例组及对照组的年龄、性别、慢性病史、NIHSS评分以及TC、TG、HDL、LDL和FIB水平无明显差别（ P＞0．05）。在F组中，血糖及Hcy水平与FSS评分成正相关，BI-20评分与FSS评分成负相关（ P＜0．01），而年龄、NIHSS评分以及TC、TG、HDL、LDL和FIB水平与FSS评分无关（ P＞0．05）。【结论】在脑梗死急性期疲劳与血糖、Hcy及功能障碍的水平密切相关。这为研究PSF的病因及发病机制提供了理论依据。
【목적】탐토뇌졸중급성기피로여혈당、동형반광안산（Hcy）급공능장애적상관성，탐토졸중후피로（PSF）가능적상관인소。【방법】병례조래자2012년6월지2013년9월재침양시홍십자회의원신경내과주원치료적급성뇌경사환자，공214인。대조조위본원건강체검중심동기적건강체검자，공214인。용피로엄중도량표（Fatigue Severity Scale ，FSS）평개피로적상황，FSS평분≥4분진단위피로。거차장병례조분위피로조（F조）여비피로조（NF조）。용NIHSS평분래평개졸중적엄중정도，용Bar-thel-20지수（BI-20）평개환자공능장애적정도。기록환자적년령、성별급만성병사，병우환자입원후d2검측혈당、Hcy、총담고순（TC）、감유삼지（TG）、고밀도지단백（HDL）、저밀도지단백（LDL）급섬유단백원（FIB）수평。【결과】병례조피로적발병솔（32．2％）명현고우대조조（4．7％），차량조상비차이유현저성（χ2＝54．038；P＜0．01）。재병례조중，F조적혈당급Hcy수평균명현고우NF조，이BI-20평분칙명현저우 NF조（ P＜0．01）。병례조급대조조적년령、성별、만성병사、NIHSS평분이급TC、TG、HDL、LDL화FIB수평무명현차별（ P＞0．05）。재F조중，혈당급Hcy수평여FSS평분성정상관，BI-20평분여FSS평분성부상관（ P＜0．01），이년령、NIHSS평분이급TC、TG、HDL、LDL화FIB수평여FSS평분무관（ P＞0．05）。【결론】재뇌경사급성기피로여혈당、Hcy급공능장애적수평밀절상관。저위연구PSF적병인급발병궤제제공료이론의거。
[Objective]To clarify the correlation of fatigue in acute stage of stroke with blood glucose ,homocysteine(Hcy) and functional disability .[Methods] Totally 214 inpatients with acute cerebral infarction in neurological department of Sheny-ang red cross hospital from June 2012 to Sept .2013 were chosen as the case group .The control group(n=214) were healthy subjects in health examination center of our hospital during the same period .Fatigue was assessed by fatigue severity scale (FSS) .Patients with a FSS score ≥ 4 points were defined as fatigue .According the FSS score ,the patients of the case group were divided into fatigue(F group) and non-fatigue group(NF group) .National institutes of health stroke scale (NIHSS) and Barthel-20 index(BI-20) were used to evaluate the severity of stroke and the degree of functional disability ,respectively .The age ,gender and chronic disease history were recorded .Blood glucose ,Hcy ,total cholesterol(TC) ,triglyceride(TG) ,high-density lipoprotein(HDL) ,low density lipoprotein(LDL) and fibrinogen(FIB) at d2 after admission were measured .[Results]The incidence of fatigue in the case group(32 .2% ) was obviously higher than that in the control group(4 .7% )(χ2 =54 .038 ,P<0 .001) .In the case group ,the levels of blood glucose and Hcy in group F were obviously higher than those in group NF , but BI-20 score in group F was obviously lower than that in group NF ( P<0 .01) .There was no significant difference in age , gender ,chronic disease history ,NIHSS score and the levels of TC ,TG ,HDL ,LDL and FIB between two groups ( P >0 .05) .In group F ,blood glucose and Hcy were positively correlated and FSS score ,while BI-20 score was negatively correla-ted with FSS score( P <0 .01) .Age ,NIHSS score and the levels of TC ,TG ,HDL ,LDL and FIB were not correlated with FSS score( P>0 .05) .[Conclusion] Fatigue in acute stage of cerebral infarction is closely related with blood glucose ,Hcy and functional disability ,which provides theoretical basis for studying the etiology and pathogenesis of post-stroke fatigue .