早期康复治疗对小量脑出血病人功能恢复的作用及其可能机制

Effect and possible mechanism of early rehabilitation on functional recovery of patients with small cerebral hemorrhage

[目的]探讨早期康复治疗对小量脑出血病人功能恢复的作用及其可能机制。[方法]选取在我院就诊并住院的180例病人,将其随机分成常规治疗组、非早期康复组和早期康复组,所有病人均采取常规内科药物治疗方案,早期康复组的病人给予早期康复治疗,非早期康复组在住院后第14天给予康复治疗,比较在治疗前以及治疗4周后的Barthel指数以及Fugl-Meyer评分,并检测3组病人在治疗前后血清中血管内皮生长因子(VEGF)和循环内皮祖细胞(EPCs)水平的变化。[结果]与常规治疗组和非早期康复组比较,早期康复组病人治疗后Barthel指数与Fugl-Meyer评分均提高(P<0.05);与常规治疗组比较,早期康复组病人血清中VEGF和循环EPCs水平也明显升高(P<0.05)。[结论]小量脑出血病人接受早期康复治疗可有效改善其日常生活自理能力以及肢体运动功能,作用机制可能与血清中VEGF和循环EPCs水平的升高有关。

Objective：To probe into the effect and possible mechanism of early rehabilitation on functional recovery of patients with small cerebral hemorrhage.Methods：A total of 180 patients in our hospital were randomly divided into routine treatment group,non early rehabilitation group and early rehabilitation group.All patients were given routine internal medicine drug treatment program.Early rehabilitation treatment was given for patients in the early rehabilitation group.Non early rehabilitation group patients were given rehabilitation treatment for fourteenth days in hospitalization.Before treatment and after 4weeks of treatment,the Barthel index and Fugl-Meyer score were compared.The changes of serum vascular endothelial growth factor（VEGF）and circulating endothelial progenitor cell（EPCs）levels were detected in 3groups before and after treatment.Results：Compared with the routine treatment group and non early rehabilitation group,the Barthel index and Fugl-Meyer scores were significantly improved after treatment in the early rehabilitation group（P〈0.05）.Serum levels of VEGF and circulating EPCs were also significantly increased（P〈0.05）.Conclusion：Small cerebral hemorrhage patients receiving early rehabilitation therapy can effectively improve their daily living ability and body movement function.The possible mechanism was related to the increase of VEGF and EPCs levels in serum.