肥胖对急性脑梗死后肢体瘫痪患者近期肢体康复的影响

Impact of patient's weight on stroke rehabilitation results in the near future

目的探讨肥胖对急性脑梗死后肢体瘫痪患者近期肢体康复的影响。方法采用前瞻性病历对照研究方法,对326例初次发病,有肢体偏瘫的急性脑梗死患者入院及发病6个月时肢体康复情况进行跟踪对比研究,根据体重指数(BMI)不同,患者分为体重正常组、超重组与肥胖组,肢体功能情况采用肢体功能量表评分(FMA)。结果由于各种原因73例患者无法进入统计分析,剩余253例中体重正常者80例(31.6%),超重者112例(44.3%),肥胖者61例(24.1%)。出院时体重正常组FMA评分好于超重组,超重组好于肥胖组,但无统计学意义(P>0.05)。出院6个月时体重正常组FMA评分好于超重组,但无统计学意义(P>0.05);两组与肥胖组比较均有显著统计学差异(P<0.05)。出院6个月与入院时比较,体重正常组及超重组FMA评分的提高,均好于肥胖组(P<0.001与P<0.05)。结论肥胖对脑梗死患者肢体康复情况密切相关。

Objective To evaluate the influence of patient＇s weight on rehabilitation results after first stroke in the near future. Methods Prospective, comparative study. The sample comprised 253 first-time stroke patients （80 patients in the normal- weight group, 112 in the overweight group, and 61 in the obese group）. We evaluated the difference in Fugl-Meyer Assessment （ FMA ） score improvement between normal-weight, overweight, and obese patients at discharge and at 6 months after discharge. Results The FMA score was significantly higher in normal-weight patients than in obese patients at 6 months after discharge （ P 〈 0.05 ）. So was in overweight patients （P 〈 0.05 ）. The relative improvement of FMA score was significantly higher in normal-weight patients than in obese patients, and improvement in overweight patients was significantly higher than in obese ones too. Conclusion Our study revealed that during the first 6 months, rehabilitation is statistically significantly less effective in overweight and, particularly, in obese patients （evaluated by BMI）.