大脑中动脉供血区梗死后运动功能与FA比值的相关性研究

Relationship between ration FA and early motor outcome in patients with hemiparesis after middle cerebral artery infarction

目的应用弥散张量成像技术测量大脑中动脉供血区梗死患者双侧皮质脊髓束(CST)的部分各项异性(FA)值,分析不同时期部分各项异性比值(rFA)与早期偏瘫侧肢体运动功能康复效果及日常生活能力的关系。方法收集大脑中动脉供血区梗死患者42例,分为急性期(20 h^3 d)13例和亚急性期(3~7 d)29例,测量患侧和健侧FA值,计算出rFA值,评估发病15 d后患侧上肢近端、远端和下肢运动功能(MRC评分)和日常生活能力(Barthel指数),利用线性相关性分析急性期和亚急性期rFA值与MRC评分与Barthel指数的相关性。结果急性期rFA值与患侧上肢近端、远端和下肢MRC评分及Barthel指数无明显相关性;亚急性期rFA值与上肢近端MRC评分(r=0.370,P=0.048)、远端MRC评分(r=0.481,P=0.038)及Barthel指数(r=0.481,P=0.008)呈正相关,与下肢远端MRC评分无明显相关性(r=0.085,P=0.663)。结论亚急性期CST rFA与患侧上肢近端和远端MRC评分呈正相关,其中与上肢远端MRC评分的相关性最大。因此,双侧CST rFA值可以用于预测大脑中动脉区梗死后早期运动功能效果。相较于急性期,亚急性期预测梗死后患者的早期运动功能效果和日常生活能力更精确。

Objective To explore the relationship between ration FA value of Diffusion Tensor Imaging （DTI）and motor outcome（1 5days after onset）.Methods We recruited patients within a week of middle cere-bral artery stroke onset ,and divided them into acute phase（within 3 days）and subacute phase（at day 3 -7）. We used DTI to evaluate bilateral CST,then calculated the ration FA.Motor outcome was evaluated by using the Medical Research Council（MRC）scale（0=null to 5=full）for separate proximal and distal of upper limb, and lower limb,the activity of daily living assessed by using Barthel index（0=null to 100=full）.Results A-nalysis revealed statistically significant relationship between rFA and upper extremity（r =0.370 for proximal and 0.387 for distal ）,and ADL（r=0.481）of subacute phase.But for acute phase ,there is no significant rela-tionship between rFA and upper extremity,lower extremity and ADL.Conclusions rFA of CST association with motor outcome of hemiplegia limbs,especially with upper extremity distal,suggesting that DTImay be ap-plicable for outcome prediction in stroke patients with middle cerebral artery stroke.Furthermore,as com-pared to use of DTI at acute phase of stroke onset,the application of DTI at subacute phase after stroke could more accurately predict the motor outcomes and daily living activities of patients.