高血压脑出血胼胝体纤维改变与上肢肌力相关性的初步研究

Preliminary Study on the Relationship between Changes of Corpus Callosum Fibers and Upper Limb Muscle Strength in Hypertensive Intracerebral Hemorrhage

目的 应用磁共振扩散张量成像技术研究高血压脑出血后胼胝体连接纤维的改变,探讨胼胝体连接纤维与上肢运动功能的关系。方法 共30例高血压脑出血康复期患者纳入分析,其中皮质脊髓束(CST)Ⅰ型损伤18例(A组),CSTⅡ型损伤12例(B组),健康对照者14例(C组)。CSTⅡ型损伤中肌力Ⅳ~Ⅴ级患者(B1组)5例、肌力0~Ⅲ级患者(B2组)7例。分别对患者的胼胝体连接纤维进行评分,并对A、B、C三组及B1、B2两组进行统计学分析。结果 A、B、C三组患者,胼胝体连接纤维平均评分分别为1.56分、0.75分、1.60分,计数资料秩和检验B、A组和B、C组间P<0.05差异有统计学意义。B1、B2组胼胝体连接纤维评分分别为1.00分、0.57分,B1、B2组间P>0.05,差异无统计学意义。结论 高血压脑出血患者,CST损伤伴随胼胝体连接纤维减少、肌力减低,表明胼胝体连接纤维的存在与上肢肌力有关。

Objective Magnetic resonance diffusion tensor imaging was used to study the changes of corpus callosum conjunction fibers after hypertensive cerebral hemorrhage, and to explore the relationship between corpus callosum conjunction fibers and upper limb motor function. Methods A total of 30 patients with hypertensive intracerebral hemorrhage were included in the analysis, including 18 cases of CST type Ⅰ injury(group A),12 cases of CST type Ⅱ injury(group B) and 14 healthy controls(Group C).In CST type Ⅱ injury, there were 5 patients with muscle strength grade Ⅳ-Ⅴ(Group B1) and 7 patients with muscle strength grade 0-Ⅲ(Group B2).The corpus callosum fibers of the patients were respectively scored, and statistical analysis was carried out in groups A,B,C and groups B1 and B2. Results The average score of corpus callosum conjunction fiber in group A was1.56,and that in group B was 0.75,and in group C was1.60.The rank sum test of counting data between groups B,A and B,C(P< 0.05) has statistically significant difference.The scores of corpus callosum connective fibers in B1 and B2 groups were 1.00 and 0.57 respectively.There was no statistically significant difference(P>0.05). Conclusion In patients with hypertensive intracerebral hemorrhage, CST injury was accompanied by a decrease in connective fibers of the corpus callosum and muscle strength.It shows that the existence of connective fibers of corpus callosum is related to the muscle strength of upper limb.