重复经颅磁刺激联合注射用尤瑞克林对脑梗死患者运动功能及血清学指标的影响

Effects of Repetitive Transcranial Magnetic Stimulation Combined with Urinary Kallidinogenase on Motor Function and Serological Markers in Patients with Cerebral Infarction

目的探讨重复经颅磁刺激(rTMS)联合注射用尤瑞克林对脑梗死患者运动功能及血清学指标的影响。方法选取2018年6月至2019年9月在郑州大学第二附属医院神经康复科住院的患者,将符合入组标准的60例急性脑梗死患者作为研究对象,按照随机数字表法将患者分为对照组和观察组,每组30例。两组接受脑梗死常规治疗,对照组接受注射用尤瑞克林,观察组在对照组基础上对健侧初级运动皮质区(M1)给予低频rTMS。分别于治疗前和治疗14 d后,比较两组患者干预前后美国国立卫生研究院卒中量表(NIHSS)评分、Fugl-Meyer运动功能(FMA)评分以及改良Barthel指数(MBI),同时检测两组血清中同型半胱氨酸(Hcy)、C反应蛋白(CRP)和D-二聚体(D-D)水平。结果治疗前两组各指标水平相比,差异无统计学意义(P>0.05)。治疗14 d后,观察组和对照组的血清Hcy、CRP和D-D水平较治疗前下降,且观察组水平低于对照组(P<0.05)。两组NIHSS评分低于治疗前,且观察组NIHSS评分低于对照组(P<0.05)。两组FMA评分和MBI较治疗前均升高,且观察组高于对照组(P<0.05)。治疗过程中患者未出现晕厥、癫痫发作等不适症状。结论rTMS联合注射用尤瑞克林治疗脑梗死患者效果较好,可促进脑梗死患者运动功能的恢复,降低患者血清Hcy、CRP和D-D的表达水平。

Objective To investigate the effects of repetitive transcranial magnetic stimulation(rTMS)combined with urinary kallidinogenase on motor function and serum parameters in patients with cerebral infarction.Methods A total of 60 patients with acute cerebral infarction who met the inclusion criteria and were hospitalized in the Department of Neurological Rehabilitation of the Second Affiliated Hospital of Zhengzhou University from June 2018 to September 2019 were randomly divided into control group and observation group according to the random table method,with 30 cases in each group.The two groups received conventional treatment.The control group received urinary kallidinogenase,and the observation group was given low-frequency rTMS to the healthy primary motor cortical area(M1)on the basis of the control group.Before treatment and after 14 days of treatment,the National Institute of Health stroke scal(NIHSS),Fugl-Meyer assessment of motor function(FMA)and modified Barthel index(MBI)were compared between the two groups of patients.Homocysteine(Hcy),C-reactive protein(CRP)and D-dimer(DD)levels were simultaneously detected between the two groups.Results There was no statistical difference between the two groups before treatment(P>0.05).After 14 days of treatment,the levels of Hcy,CRP and D-D in control group and observation group decreased,and those in observation group were lower than those in control group(P<0.05).The NIHSS scores of the two groups were lower than those before treatment,and the NIHSS score of observation group was lower than that of control group(P<0.05).The FMA score and MBI of the two groups were higher than those before treatment,and those in observation group were higher than those in control group(P<0.05).During the whole treatment,the patients did not appear syncope,seizure or other uncomfortable symptoms.Conclusion rTMS combined with urinary kallidinogenase is effective in the treatment of patients with cerebral infarction,which could promote the recovery of motor function in patients with cerebral infarction,and can reduce the expression levels of serum Hcy,CRP and D-D.