不同高频rTMS对ACI患者运动功能、认知功能及血清hs-CRP水平的影响

Effects of different high-frequency rTMS on motor function, cognitive function and serum hs-CRP level in patients with ACI

目的探究不同高频重复经颅磁刺激(rTMS)对急性脑梗死(ACI)患者运动功能、认知功能及血清超敏C-反应蛋白(hs-CRP)水平的影响。方法选取本院2018年1月至2019年7月收治的ACI患者165例,依据随机数表法分为5 Hz组、10 Hz组及对照组,每组55例。3组均给予常规药物治疗和康复训练,5 Hz、10 Hz组分别在患侧脑M1区给予5 Hz、10 Hz高频rTMS刺激,对照组于患侧同区域给予假刺激。观察治疗前及治疗后3组患者肢体运动功能[Fugl-Meyer评定量表(FMA)]、认知功能[简易智力状态检查量表(MMSE)]及血清hs-CRP水平变化,比较治疗后3组患者不良反应情况。结果治疗后,3组FMA上、下肢评分均较治疗前显著升高,5 Hz、10 Hz组上肢评分明显高于对照组,上述差异均有统计学意义(均P<0.05)。治疗后,3组MMSE评分较治疗前显著升高,5 Hz、10 Hz组MMSE评分明显高于对照组,3组血清hs-CRP水平较治疗前显著降低,5 Hz、10 Hz组血清hs-CRP水平明显低于对照组,上述差异均有统计学意义(均P<0.05)。3组不良反应总发生率比较差异无统计学意义(P>0.05)。结论 5 Hz、10 Hz两种高频rTMS治疗ACI后均可获得良好效果,疗效相当且安全性良好,有利于提高患者预后。

Objective To explore the effects of different high-frequency repetitive transcranial magnetic stimulation(rTMS) on motor function, cognitive function and serum high-sensitivity C-reactive protein(hs-CRP) level in patients with acute cerebral infarction(ACI).Methods A total of 165 patients with ACI admitted to our hospital were enrolled in the study. According to the random number table method, they were divided into 5 Hz group, 10 Hz group and control group, with 55 cases in each group. All the three groups were given conventional drug treatment and rehabilitation training, and 5 Hz group and 10 Hz group were given 5 Hz and 10 Hz high-frequency rTMS stimulation in the M1 area of the affected side respectively, and control group was given sham stimulation in the same area of the affected side. The changes of limb motor function [Fugl-Meyer Assessment Scale(FMA)], cognitive function [Mini-Mental State Examination(MMSE)] and serum hs-CRP level were observed before treatment and after 15 d of treatment. The adverse reactions at the end of course were compared among the three groups.Results After treatment, the upperextremity and lower extremity FMA scores and MMSE score in the three groups were significantly increased compared with those before treatment while the serum hs-CRP level was significantly decreased compared with that before treatment(all P<0.05). The upper extremity score and MMSE score in 5 Hz group and 10 Hz group were significantly higher than those in control group while the level of serum hs-CRP was significantly lower than that in control group(all P<0.05), and there were no significant differences between the two groups(all P>0.05). The lower extremity score in 5 Hz group and 10 Hz group was not significantly different from that in control group, and there was no statistically significant difference between the two groups(all P>0.05). During the course of treatment, there was no statistically significant difference in the total incidence rate of adverse reactions among the three groups(P>0.05).Conclusion Both 5 Hz and 10 Hz high-frequency rTMS can achieve good results and same efficacy in the treatment of ACI, and they can improve the limb motor function and cognitive function, and decrease the serum hs-CRP level, and they have good safety and are beneficial to prognosis of patients.