肉毒毒素对偏瘫患者脑CT改变与步行能力研究

Study of botulinum toxin on cerebral CT changes and walking ability in hemiplegic patients

目的探讨肉毒毒素对偏瘫患者脑CT改变与步行能力变化的影响。方法选取郑州市中医院神经内科收治的脑卒中偏瘫患者60例,随机分为2组,其中对照组30例,给予常规康复运动训练治疗,1个月为1个疗程,持续3个疗程;实验组30例,在康复运动训练之前于患侧下肢肌肉群注射肉毒毒素,每个点5~10 u,总剂量不超过600 u。治疗结束后,对比2组患者脑CT改变、步行能力情况及临床疗效。结果 2组患者脑CT均得到不同程度改善,且实验组血流最大峰值时间(10.15±1.19)s、血流通过时间(3.30±0.41)s、脑血流量(74.65±2.19)m L/(100g·min)、脑容量(4.15±0.93)m L/(100g·min)均显著优于对照组血流最大峰值时间(13.21±2.10)s、血流通过时间(3.92±0.31)s、脑血流量(68.41±2.51)m L/100g·min、脑容量(3.92±0.98)m L/(100g·min),差异有统计学意义(P<0.05);2组患者步行能力均有不同程度恢复,且实验组较对照组疗效明显,差异有统计学意义(P<0.05);2组患者均具有很高的临床有效率,但实验组临床疗效(93.33%)显著优于对照组(80.00%),差异有统计学意义(P<0.05)。结论肉毒毒素能够明显改善脑血流量及脑容量恢复、促进步行能力提升,并提高临床疗效,对临床具有指导意义。

Objective To investigate the clinical efficacy of botulinum toxin on patients with hemiplegia cerebral CT changes and changes in walking ability. Methods 60 patients with hemiplegic stroke admitted in our hospital were randomly divided into two groups,30 patients of control group were treated with conventional therapy rehabilitation exercise training,a month for a course of treatment,sustained three courses; 30 cases of experimental group were injected botulinum toxin in the lower limb muscles at 10-15 points,each point 5-10 u,total dose does not exceed 600 u,then took exercise training,a month for a course of treatment lasts 3 courses. After the end of treatment,CT changes,walking ability and clinical efficacy between two groups were compared. Results Two groups of patients were improved brain CT to varying degrees,and the maximum peak flow in the experimental group was( 10. 15 ± 1. 19) s,blood flow through time was( 3. 30 ± 0. 41) s,cerebral blood flow was( 74. 65 ± 2. 19) m L /( 100g·min),brain volume was( 4. 15 ± 0. 93) m L /( 100g·min),which were all significantly better than that in control group[the maximum peak flow was( 13. 21 ±2. 10) s,blood flow through time was( 3. 92 ± 0. 31) s,cerebral blood flow was( 68. 41 ± 2. 51) m L /( 100g·min),brain volume was( 3. 92 ± 0. 98) m L /( 100g·min),the difference were statistically significant( P < 0. 05); walking ability in two groups of patients had varying degrees of recovery,and compared with the control group,the experimental group was significantly improved,and the difference was statistically significant( P < 0. 05). Patients in both groups had high clinical effectiveness,clinical efficacy in the experimental group( 93. 33%) was better than control group( 80. 00%),the difference was statistically significant( P < 0. 05). Conclusion Botox can significantly improve cerebral blood flow and cerebral capacity to restore and promote walking ability to enhance and improve the clinical efficacy.