急性脑梗死患者瘫痪上肢主动运动与其预后的相关性分析

Correlation between the active upper limb movement and the prognosis for acute cerebral infarction patients

目的探讨急性期脑梗死患者瘫痪上肢主动运动功能对预后的影响。方法共选取2007年8月至2008年4月间入住郑州大学第一附属医院神经内科的脑梗死患者171例，于发病后第14天时对患者瘫痪上肢主动运动功能进行评定，于发病1年后采用盲法对患者进行随访，采用Barthel指数（BI）评估其日常生活活动（ADL）能力，使用多元Logistic回归方程进行预后影响因素相关性分析。结果共获得150例患者有效数据，经统计分析发现，脑卒中发病14d时瘫痪上肢远端运动总分与1年后BI评分具有正相关性（P=0．034）；另外发病到入院时间、人院时美国国立卫生研究院卒中量表（NIHSS）评分、脑卒中史等也与发病1年后BI评分具有明显相关性。结论于发病后14d时对脑梗死患者瘫痪上肢远端运动功能进行评定，有助于准确评估患者预后。

Objective To assess the influence of active movement of the affected upper limb on the prognosis for patients after acute cerebral infarction. Methods From 2007 to 2008, 171 consecutive patients with acute cerebral infarction were registered prospectively in this study. Active movement of the hemiplegic upper limb was assessed on the 14th day after stroke onset. Ability in the activities of daily living was assessed using the Barthel index one year later. Results Finger flexion and extension on the 14th day after stroke onset correlated positively with Barthcl index scores l year later. NIHSS scores at admission, the time interval from onset to admission and stroke history were significant predictors of the prognosis 1 year later. Conclusion Assessing the active movement of the hemiplegic upper limb on the 14th day after stroke has good predictive power for the prognosis of acute cerebral infarction patients.