急性脑梗死患者手肌张力增高与肌力时间的相关性分析

Correlation analysis of high muscle tension with muscle strength and evaluation time in patients with acute cerebral infarction

目的探讨急性脑梗死患者手肌张力增高与肌力、时间的相关性。方法连续收集2012-10-2014-03在我院宝山分院神经内科住院且发病时间在7d内的急性脑梗死患者78例为研究对象。采用改良的Ashworth量表（modified ashworth scale,MAS）评估瘫痪侧手的肌张力,采用Brunnstrom分级法评估手的肌力。所有患者均在入院时、3个月时由同一个人评估患者的肌张力、肌力。比较3个月内肌张力、肌力的构成比是否存在差异,并采用多分类的Logistic回归分析评估肌张力与肌力、时间的相关性。结果 78例患者入院、3个月后手肌张力的构成比无显著性改变（χ2=1.758,P=0.631）,肌力的构成比有显著性差异（χ2=16.837,P=0.003）。多分类的Logistic回归分析（似然比检验）显示,肌张力与肌力密切相关（χ2=80.472,P〈0.001）,与时间无密切相关性（χ2=64.492,P=0.090）。结论急性脑梗死前3个月肌张力无明显改善,肌张力与肌力显著相关。

Objective To investigate correlation of high muscle tension of hands with muscle strength and evaluation time in patients with acute cerebral infarction.Methods We continuously selected 78 inpatients with acute ischemic stroke within 7days after symptom onset in our hospital from October 2012 to March 2015.We used modified Ashworth scale（MAS）to assess the muscle tension of paralyzed-side hand and used Brunnstrom grading method to evaluate muscle strength.The muscle tension and strength were tested by the same person on admission and in the third month.Then we comparatively analyzed the constituent ratio of muscle tension and muscle strength and used the multinomial logistic regression analysis to assess the relationship between the muscle tension and muscle strength,evaluation time.Results On admission and in the third month,the constituent ratio of muscle tension did not showed significant changes（χ2=1.758,P=0.631）,while significant changes were found in terms of constituent ratio of muscle strength（χ2=16.837,P=0.003）.Logistic regression analysis of multi-classification（likelihood ratio test）showed muscle tension had close correlation with muscle strength（χ2=80.472,P〈0.001）,but had no correlation with the evaluation time（χ2=64.492,P=0.090）.Conclusion The muscle tension has no obvious changes in the first three months in patients with acute ischemic stoke,and which may be significantly correlated with muscle strength.