重复经颅磁刺激治疗急性脑梗死患者认知障碍效果的影响因素

Influencing Factors of Effect of rTMS in the Treatment of Cognitive Impairment in Patients with Acute Cerebral Infarction

目的探讨重复经颅磁刺激(rTMS)治疗急性脑梗死(ACI)患者认知障碍效果的影响因素。方法选取2018年10月至2020年10月西平县人民医院收治的100例ACI伴认知障碍患者作为研究对象,评估接受rTMS治疗4周后的效果。统计患者的一般资料,分析影响rTMS治疗ACI患者认知障碍效果的因素。结果4周后,100例ACI伴认知障碍患者临床显效30例,有效42例,有效率为72.00%(72/100);无效28例,无效率为28.00%(28/100)。无效组梗死面积、使用单一频率rTMS治疗占比、糖化血红蛋白(HbA1c)水平高于有效组,差异有统计学意义(P<0.05);组间其他一般资料比较,差异无统计学意义(P>0.05)。多因素分析显示,梗死面积较大、使用单一频率rTMS治疗、高HbA1c水平均是rTMS治疗ACI伴认知障碍效果较差的影响因素(OR>1,P<0.05)。结论梗死面积较大、使用单一频率rTMS治疗、高HbA1c水平均是rTMS治疗ACI伴认知障碍效果较差的影响因素。

Objective To explore the influencing factors of effect of repetitive transcranial magnetic stimulation(rTMS)in the treatment of cognitive impairment in patients with acute cerebral infarction(ACI).Methods The clinical data of 100 ACI patients with cognitive impairment admitted to Xiping County People’s Hospital from October 2018 to October 2020 were retrospectively analyzed,all patients were treated with rTMS,after 4 weeks of treatment,the therapeutic effect was evaluated.The basic data of patients were collected,the influencing factors of effect of rTMS in the treatment of cognitive impairment in patients with ACI were analyzed.Results After 4 weeks of treatment,among 100 ACI patients with cognitive impairment,30 cases were clinically effective,42 cases were effective,the effective rate was 72.00%(72/100),28 cases were ineffective,the ineffective rate was 28.00%(28/100);the infarct size,the proportion of single frequency rTMS treatment,and the level of glycosylated hemoglobin(HbA1c)in the ineffective group were higher than those in the effective group,the difference was statistically significant(P<0.05);there was no statistical significant difference in other baseline data between the two groups(P>0.05);after single factor analysis,a binary regression model was established,multiple factors analysis was performed and showed that large infarct size,single frequency rTMS treatment and high HbA1c level were the influencing factors of poor effect of rTMS in the treatment of ACI with cognitive impairment(OR>1,P<0.05).Conclusion Large infarct size,single frequency rTMS treatment and high HbA1c level are the influencing factors of poor effect of rTMS in the treatment of ACI with cognitive impairment.