应用DTI技术对脑出血早期康复的疗效分析

Application of DTI technology analysis of cerebral hemorrhage curative effect of early rehabilitation

目的：探讨磁共振弥散张量成像（ DTI）对单侧基底节区脑出血患者进行早期介入中西医结合康复技术治疗预后评估及康复实际疗效的对比研究。方法：利用弥散张量纤维束成像观察38例基底节区脑出血患者入院后皮质脊髓束的损伤情况，分析患者双侧肢体运动功能变化，观察临床预后与皮质纤维束受损情况的关系。并采用简化 Fugl-Meyer 运动功能（ F-M 量表）评分，于发病后5天病情稳定后开始行物理康复治疗，治疗第4周及第8周复查头颅MRI和DTI。并再次行Fugl-Meyer 运动功能（ F-M量表）评分。结果：急性脑出血患者发病后5天内病灶区平均各向异性分数（ FA）值（0．3861±0．1021）较健侧相应部位（0．7012±0．1030）降低，差异有统计学意义（ P ＜0．01）；康复治疗前、后DTI 中病灶部位不同兴趣区（ ROI）对应的FA差值变化和F-M量表评分差值变化均有统计学意义（ P ＜0．01）；入院5天内DTI中ROI对应的健患侧 FA差值同康复治疗前后 F-M量表评分差值变化呈线性正相关关系（ r＝0．4961，P ＜0．05）。结论：DTI 中FA值改变与神经损伤程度、康复疗效存在关联性，DTI对肢体功能障碍康复治疗疗效评定有一定的价值，可作为临床判断病人预后的辅助指标。并可作为证实康复疗效指标之一。

Objective：To study the magnetic resonance diffusion tensor imaging （ DTI） of unilateral Basal ganglia cerebral hemorrhage patients for early intervention of Chinese and western medicine combined with rehabilitation technology treatment prognosis assessment and rehabilitation of the comparison of the actual effect .Methods：38 patients by using diffusion tensor imaging of the bundle observation JiDe -JieOu cerebral hemorrhage patients after admission the corticospinal tract injury situation , analysis of patients with bilateral limb movement function changes , clinical outcomes and cortical fiber beam damage relations .And the simplified Fugl -Meyer movement function （ F）-m scale score , 5 days after onset in stable condition after physical rehabilitation therapy , treatment of the fourth week and eight weeks review head MRI and DTI .And line again Fugl -Meyer movement function （ F） -m scale score .Results：the patients with acute cere-bral hemorrhage within 5 days after onset lesion area average anisotropic score （FA） value （0.3861 ＋/-0.1021） corresponding parts （0.7012 ＋0.1030） than that, the difference was statistically significant （P 〈0.01）;Rehabilitation treatment before and after differ-ent interest in the DTI lesion area （ ROI） corresponding to the FA difference changes and F -M rating scale difference had statistical sig-nificance （P ＆lt;0.01）;Reducing DTI in 5 days, ROI corresponds to the health of FA difference with rehabilitation treatment F -M rat-ing scale difference before and after the change was linear positive correlation （r =0.4961, P ＆lt;0.05）.Conclusion：DTI in FA values change with the degree of nerve damage , rehabilitation efficacy correlation , DTI function obstacle for rehabilitation efficacy evaluation had a certain value , could be used as auxiliary indexes in clinical estimate the prognosis of patients .And could be used as confirmed one of re-habilitation therapeutic indexes .