急性脑卒中患者功能结局的预测

The prediction of functional outcome in patients with acute stroke

目的:探讨影响急性脑卒中患者预后的主要因素和临床神经功能缺损程度评分量表(CNS),改良巴氏指数评分(MBI),功能综合评定量表评分(FCA)评分的相关性。方法:100例急性脑卒中患者随机分成康复组(50例)和对照组(50例),除进行常规的神经内科治疗外,康复组患者在急性期(病程21天内,病情稳定48h)至病程6个月进行规范的康复治疗,包括运动疗法、作业疗法和言语治疗等。收集关于患者人口特征、病史、体格检查、急性期CNS、MBI、FCA评分等资料。病程6个月时FCA评分作为功能结局,资料采用直线相关分析、逐步回归分析。结果:直线相关分析表明急性期CNS、MBI评分与病程6个月时FCA评分相关,逐步回归分析发现急性期CNS、MBI评分和是否经过规范康复治疗是患者病程6个月时FCA评分的预测因素。结论:急性期CNS、MBI评分和康复治疗可以预测脑卒中患者病程6个月时的功能结局,患者急性期MBI评分是病程6个月时的功能结局最主要的预测因素。

Objective： To analyze the risk factors affecting prognosis in acute stroke patients and study the correlations between Functional Comprehensive Assessment （FCA） scores clinical nerve function limitation score （CNS） and Modified Barthel Index （MBI） score. Method： One hundred acute stroke inpatients were randomly divided into two groups： rehabilitation group （50cases） and controlled group （50cases）. They were given general internal medicine. Patients in rehabilitation group were given standard physiotherapy, occupational therapy and speech therapy and so on. Data were collected with regard to the patients＇ demographic characteristics, medical history, physical examination, scores with CNS, MBI and FCA at acute stage. FCA at the end of 6th month after stroke was used as the functional outcome. The correlations were studied among CNS, MBI and FCA scores at acute stage and at the end of 6th month after stroke, stepwise regression was applied to analyze the data. Result： There were significant correlations among CNS, MBI and FCA scores at acute stage and at the end of 6th month after stroke. Stepwise regression revealed that CNS, MBI scores at acute stage and rehabilitative treatment were all significantly associated with the functional outcome at the end of 6th month after stroke. Conclusion： CNS, MBI scores at acute stage and rehabilitative treatment are reliable indexes to predict the functional outcome at the end of 6th month after stroke. There was a strong correlation between the functional outcome and MBI scores at acute stage.