早期康复训练对急性脑梗死偏瘫患者的治疗效果及机制探讨

Treatment effect of early rehabilitation training on acute cerebral infarction patients with hemiplegia and its mechanism

目的观察早期康复训练对急性脑梗死偏瘫患者的治疗效果,并探讨其可能的机制。方法选取2013年1月至2016年6月该院收治的急性脑梗死偏瘫患者100例,将其分为康复训练组和对照组,各50例。对照组给予常规药物治疗,康复训练组在常规药物治疗的基础上给予早期康复训练,使用功能独立性测评(FIM)、Fugl-Meyer评分法(FMA)、改良Barthel指数(MBI)评估治疗效果;采用酶联免疫吸附双抗体夹心法测定血浆基质细胞衍生因子-1α(SDF-1α)水平,流式细胞术测定外周血CD34^+KDR^+水平。结果治疗前两组FIM总分、FIM运动功能评分、FIM认知功能评分、FMA评分、MBI评分、SDF-1α及CD34^+KDR^+水平比较,差异均无统计学意义(P>0.05)。治疗后,康复训练组FIM总分、FIM运动功能评分、FMA评分、MBI评分、SDF-1α及CD34^+KDR^+水平均高于对照组,差异均有统计学意义(P<0.05)。结论早期康复训练对急性脑梗死偏瘫患者的治疗效果显著,其机制可能与早期康复训练能够促进外周血SDF-1α和CD34^+KDR^+表达有关。

Objective To observe the treatment effect of early rehabilitation training on acute cerebral infarction patients with hemiplegia,and to explore its possible mechanism. Methods One hundred cases of acute cerebral infarction hemiplegia in our hospital from January 2013 to June 2016 were selected and divided into the rehabilitation training group （50 cases） and control group （50 cases）. The control group was given the routine medication therapy and the rehabilitation training group was given early rehabilitation training on the basis of conventional medication therapy. The functional independence assessment （FIM）, Fugl-Meyer assessment （FMA） and modified Barthel index （MBI） were used to evaluate the therapeutic effect of early rehabilitation training. The level of stromal cell-derived factor-1α （SDF-1α） in peripheral blood was measured by enzyme linked immunosorbent assay,and the level of CD34＋ KDR＋ in peripheral blood was measured by flow cytometry. Results There was no statistically significant difference in the FIM total score,FIM sports function score,FMA score, MBI score,SDF-1α and CD34＋ KDR＋ levels before treat- ment between the rehabilitation training group and the control group （P〉0.05）. After treatment,the FIM total score,FIM sports function score,FMA score,MBI score and SDF-1α and CD34＋ KDR＋ levels of the rehabilitation training group were higher than those of the control group,the dif{erences were statistically significant （P〈0.05）. Conclusion The effect of early rehabilitation training on acute cerebral infarction patients with hemiplegic is remarkable. The mechanism may be related to promoting the expres- sion of SDF-1α and CD34＋ KDR＋ in peripheral blood.