脑梗死后不同时期神经纤维束与肢体肌力的相关性

Correlation between Nerve Fiber Bundles and Limb Muscle Strength in Different Periods after Cerebral Infarction

目的:分析脑梗死不同时期磁共振各向异性分数(FA)、表观弥散系数(ADC)与肢体运动功能的相关性。方法:92例急性脑梗死患者,分别在急性期、恢复期及随访期进行弥散张量成像(DTI)检查及简化福米勒运动量表(Fugl-Meyer)评分,采用一元线性回归方程分析患者脑梗死各时期、各感兴趣区FA、ADC与简化Fugl-Meyer评分的相关性。结果:急性期患者脑梗死灶中央区、边缘区的FA值、ADC值显著高于恢复期及随访期,恢复期又显著高于随访期,差异有统计学意义(P<0.05);急性期患者梗死侧内囊后肢的FA值显著高于恢复期及随访期,差异有统计学意义(P<0.05),3个时期脑梗死侧大脑脚FA值比较差异无统计学意义(P>0.05);3个时期梗死侧内囊后肢、梗死侧大脑脚的ADC值比较,差异无统计学意义(P>0.05);急性患者脑梗死各感兴趣区FA值与简化Fugl-Meyer评分呈正相关(r=0.830、0.020、0.119、0.007),ADC值与简化Fugl-Meyer评分呈负相关(r=-0.330、-0.133、-0.036),但仅梗死灶中央区FA值与简化Fugl-Meyer评分呈显著正相关(r=0.830,P<0.01)。结论:DTI检查对脑梗死后患者运动功能受损及恢复程度有一定的临床参考价值。

Objective:To investigate the correlation between fractional anisotropy(FA),apparent diffusion coefficient(ADC)and movement function in patients with cerebral infarction during different stages.Methods:Ninety-two patients with acute cerebral infarction were collected.All patients were examined by diffusion tensor imaging(DTI)and simplified Fugl-Meyer Assessment of motor function in acute,recovery phases and follow-up period,respectively.And the correlation between FA,ADC and Fugl-Meyer Assessment scores of motor function in all regions of interest in each period was analyzed.Results:FA in central and marginal areas of infarcts in each period:acute phase>recovery phase>follow-up period(P<0.05);ADC:acute phase<recovery phase<follow-up period(P<0.05).FA of the posterior limb of internal capsule of the infarction side in the acute period was lower than that in the recovery period and follow-up period.FA of each region of interest was positively correlated with simplified Fulg-Meyer Assessment scores of motor function.There was a negatively correlation between ADC and simplified Fulg-Meyer Assessment scores of motor function.Conclusion:DTI has certain clinical reference value for the impairment of motor function and recovery after cerebral infarction.