CAJ | 학술논문

目的：应用弥散张量成像技术测量大脑中动脉供血区梗死患者双侧皮质脊髓束(CST)的部分各项异性(FA)值,分析不同时期部分各项异性比值(rFA)与早期偏瘫侧肢体运动功能康复效果及日常生活能力的关系。方法收集大脑中动脉供血区梗死患者42例,分为急性期(20 h~3 d)13例和亚急性期(3~7 d)29例,测量患侧和健侧 FA 值,计算出 rFA 值,评估发病15 d后患侧上肢近端、远端和下肢运动功能(MRC 评分)和日常生活能力(Barthel 指数),利用线性相关性分析急性期和亚急性期 rFA 值与 MRC 评分与Barthel 指数的相关性。结果急性期 rFA 值与患侧上肢近端、远端和下肢 MRC 评分及 Barthel 指数无明显相关性；亚急性期 rFA 值与上肢近端 MRC 评分(r =0.370,P =0.048)、远端 MRC 评分(r =0.481,P =0.038)及 Barthel 指数(r=0.481,P =0.008)呈正相关,与下肢远端 MRC 评分无明显相关性(r =0.085,P =0.663)。结论亚急性期 CST rFA 与患侧上肢近端和远端 MRC 评分呈正相关,其中与上肢远端 MRC 评分的相关性最大。因此,双侧 CST rFA 值可以用于预测大脑中动脉区梗死后早期运动功能效果。相较于急性期,亚急性期预测梗死后患者的早期运动功能效果和日常生活能力更精确。
목적：응용미산장량성상기술측량대뇌중동맥공혈구경사환자쌍측피질척수속(CST)적부분각항이성(FA)치,분석불동시기부분각항이성비치(rFA)여조기편탄측지체운동공능강복효과급일상생활능력적관계。방법수집대뇌중동맥공혈구경사환자42례,분위급성기(20 h~3 d)13례화아급성기(3~7 d)29례,측량환측화건측 FA 치,계산출 rFA 치,평고발병15 d후환측상지근단、원단화하지운동공능(MRC 평분)화일상생활능력(Barthel 지수),이용선성상관성분석급성기화아급성기 rFA 치여 MRC 평분여Barthel 지수적상관성。결과급성기 rFA 치여환측상지근단、원단화하지 MRC 평분급 Barthel 지수무명현상관성；아급성기 rFA 치여상지근단 MRC 평분(r =0.370,P =0.048)、원단 MRC 평분(r =0.481,P =0.038)급 Barthel 지수(r=0.481,P =0.008)정정상관,여하지원단 MRC 평분무명현상관성(r =0.085,P =0.663)。결론아급성기 CST rFA 여환측상지근단화원단 MRC 평분정정상관,기중여상지원단 MRC 평분적상관성최대。인차,쌍측 CST rFA 치가이용우예측대뇌중동맥구경사후조기운동공능효과。상교우급성기,아급성기예측경사후환자적조기운동공능효과화일상생활능력경정학。
Objective To explore the relationship between ration FA value of Diffusion Tensor Imaging (DTI)and motor outcome(1 5days after onset).Methods We recruited patients within a week of middle cere-bral artery stroke onset ,and divided them into acute phase(within 3 days)and subacute phase(at day 3 -7). We used DTI to evaluate bilateral CST,then calculated the ration FA.Motor outcome was evaluated by using the Medical Research Council(MRC)scale(0=null to 5=full)for separate proximal and distal of upper limb, and lower limb,the activity of daily living assessed by using Barthel index(0=null to 100=full).Results A-nalysis revealed statistically significant relationship between rFA and upper extremity(r =0.370 for proximal and 0.387 for distal ),and ADL(r=0.481)of subacute phase.But for acute phase ,there is no significant rela-tionship between rFA and upper extremity,lower extremity and ADL.Conclusions rFA of CST association with motor outcome of hemiplegia limbs,especially with upper extremity distal,suggesting that DTImay be ap-plicable for outcome prediction in stroke patients with middle cerebral artery stroke.Furthermore,as com-pared to use of DTI at acute phase of stroke onset,the application of DTI at subacute phase after stroke could more accurately predict the motor outcomes and daily living activities of patients.