DTI技术及血清BDNF水平评价肌电生物反馈疗法治疗脑梗死偏瘫的疗效

Clinical Efficacy of Electromyographic Biofeedback Therapy on Patients with Cerebral Infarction by DTI and BDNF Evaluation

目的:结合弥散张量成像(DTI)及血清脑源性神经营养因子(BDNF)指标评价脑梗死偏瘫患者应用肌电生物反馈疗法的临床疗效。方法:73例脑梗死偏瘫患者分为肌电组及对照组,对照组给予常规药物及康复训练,肌电组在对照组相同治疗的基础上结合肌电生物反馈疗法治疗8周;采用美国国立卫生研究院卒中量表(NIHSS)对两组患者的神经功能缺损程度进行评分,根据Barthel指数(ADL评分)评价患者的日常生活能力,Fugl-Meyer运动功能评定量表(FMA)评估患者患肢运动功能;检测血清BDNF水平与DTI中局部各向异性指数值(FA值)评价治疗效果。结果:治疗8周后两组患者的NIHSS评分较治疗前下降,ADL评分、FMA评分、血清BDNF水平及FA值上升率均显著较治疗前增加,且肌电组上述指标均优于对照组,差异均具有统计学意义(P<0.05)。结论:肌电生物反馈疗法可改善脑梗死偏瘫患者的神经功能,提高日常生活能力,其机制可能与提高BDNF水平有关。

Objective： To investigate the clinical efficacy of electromyographic biofeedback therapy on patients with cerebral infarction hemiplegia combined with DTI technology and serum BDNF index evaluation. Methods： 73 cerebral infarction patients were divided into hemiplegia group and control group; control group was given routine medication and rehabilitation training; hemiplegia group was given additional 8 weeks electromyographic biofeedback therapy. Adopting American NIHSS scale to evaluate the neurological function damage degrees,adopting Barthel ADL score to evaluate daily life skills of patients,adopting Fugl-Meyer Assessment to evaluate limb motor function; detecting serum BDNF level and DTI FA value to evaluate clinical efficacy. Results： After 8 weeks,NIHSS score of both groups decreased than before treatment. ADL score,FMA score,serum BDNF level and FA value increase rate increased significantly than before treatment; above indexes of hemiplegia group were better than control group,differences were statistically significant（ P〈0. 05）. Conclusions： Electromyographic biofeedback therapy could improve neurological function of cerebral infarction patients,and improve the ability of daily life. Its mechanism might be correlated with improved BDNF level.