脑卒中后偏瘫与骨质疏松的临床研究

Study On the Relationship Between the Post-stroke Hemiplegia and Osteoporosis

目的比较分析脑卒中后偏瘫患者患侧肢体与健侧肢体、健康人股骨近端骨密度的变化情况,探讨脑卒中后偏瘫与继发性骨质疏松的关系。方法选择我院神经内科住院及门诊复诊的脑卒中后偏瘫患者136例作为观察组。选择作健康体检的正常人为对照组118例。采用双能X线骨密度仪测定患者组患侧、健侧和对照组,不同病程、不同Brunstrom分期、不同生活活动能力患者的骨密度。结果进入结果分析脑卒中后偏瘫患者136例,健康人118例。①研究组的患侧股骨颈、大转子和Ward三角的骨密度值明显低于对照组和健侧(P<0.05～0.01)。②病程长组患肢股骨颈和大转子骨密度明显低于病程短组(P<0.05)。③BrunnstromⅠ～Ⅱ期患者患肢股骨颈、大转子和Ward三角骨密度均明显低于Ⅲ～Ⅳ期和Ⅴ～Ⅵ期患者(P<0.05)。④日常生活活动能力差组患侧股骨颈、大转子和Ward三角骨密度明显低于日常生活活动能力佳组(P<0.05)。结论脑卒中后偏瘫患者常出现骨质疏松表现,患侧肢体运动能力越差、病程越长、日常生活活动能力越差,股骨近端骨密度越低。

Objective To study the femoral proximal bone mineral density among the affected and unaffected limbs with post-stroke hemiplegia and healthy people. Methods Totally 136 patients with post-stroke hemiplegia were as observation group. Results The femoral proximal bone mineral density of the affected and unaffected limbs of the patients and the normal controls was determined with the dual energy X-ray absorptiometry,and those of the affected limb of patients with different disease course,different Brunnstrom staging and different activities of daily life were also determined. Conclusion Patients with post-stroke hemipegia usually manifest by the loss of bone mass; The femoral proximal bone mineral density of the affected limb is lower than that of healthy people and the unaffected limb; The worse the motor ability of the affected limb,or the longer the disease course,or the worse the activities of daily life,the lower the femoral proximal bone mineral density.