预测基底核性失语患者早期言语功能结局的研究

发布时间：2018-01-01 11:37

本文关键词：预测基底核性失语患者早期言语功能结局的研究　出处：《中国康复医学杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的:通过观察分析卒中后单侧基底核性失语患者的CT表现,探讨CT评分与患者言语功能早期恢复的相关性。方法:前瞻性收集了2013年12月—2015年6月入住我院的基底核区卒中患者89例,分别在发病后的第3个月、第6个月进行随访。基底核性失语症患者的CT评分方法——卒中改变发生在尾状核、豆状核、内囊、外囊、放射冠这5个区域中;每累及一个区域得1分。按照CT评分结果分为5个组。结合患者临床特征,选择性别、年龄、病因(出血性、缺血性)、卒中病灶的位置、发病后24h—72h的CT评分、汉语失语成套测验的4项(谈话、理解、复述、命名)评分作为观察指标。结果:5组组内两个时间点的言语功能评分比较用Mann-Whitney法检验,除CT评分1分组,患者卒中后6个月的谈话、理解、复述、命名能力均较入组时有显著改善(P0.01);采用Spearman相关分析研究CT评分与言语功能各项评分之间的关系,发现CT评分与上述各项评分在卒中后3个月、6个月均成显著性负相关(P0.01)。以ABC评分为参照,用ROC曲线进行诊断性评价,当CT评分≤2分时,ABC评分的谈话、理解、复述、命名各项结果的预后较好。结论:卒中后单侧基底核性失语CT评分的灵敏度及特异度较高,该评分对单侧基底核性失语的早期预后评估有一定的指导意义。
[Abstract]:Objective: through the observation and analysis of unilateral basal ganglia aphasia patients after stroke CT, to investigate the correlation between CT score and speech function in patients with early recovery. Methods: 89 patients with stroke in basal ganglia area prospectively collected from December 2013 to June 2015 in our hospital, third months after the onset of follow-up sixth months respectively.. CT score of stroke change in the caudate nucleus of basal ganglia aphasia method, lentiform nucleus, internal capsule, corona radiata in the 5 regions; each involving an area of 1 points. According to the results of CT were divided into 5 groups. Patients with clinical characteristics, gender, age the etiology, (hemorrhage, ischemic stroke), location of the lesion, after the onset of 24h - 72h CT score, 4 Chinese aphasia test (talk, comprehension, repetition, naming) score were assessed. Results: two at the time of the 5 groups in the speech function score Compared with the Mann-Whitney test, the CT scores of the 1 groups, talk, 6 months after a stroke of understanding, retelling, naming ability than the group were significantly improved (P0.01); using CT correlation analysis the relationship between Spearman score and speech function of the score, CT score and found the score of 3 in the months after stroke, 6 months showed a significant negative correlation with ABC score (P0.01). As a reference, using ROC curve of diagnostic evaluation, when the CT score is less than or equal to 2 points, the score of ABC conversation, understanding, retelling, naming the results of good prognosis after stroke. Conclusion: unilateral basal sensitivity nuclear CT aphasia score and higher specificity of evaluation, the score has a certain guiding significance on early prognosis of unilateral basal ganglia aphasia.

【作者单位】：上海交通大学医学院附属瑞金医院北院康复医学科;上海交通大学医学院附属瑞金医院康复医学科;上海交通大学医学院附属瑞金医院卢湾分院康复医学科;
【分类号】：R743.3;R49
【正文快照】： 基底核性失语(basal ganglia aphasia)是皮质下失语(subcortical aphasia)的一种类型。目前有很多关于基底核性失语的横断面研究,但是缺少相关的神经影像学评价。长期以来,损伤结构被认为是决定失语症患者临床特点的主要因素[1]。基底神经节的主要功能核团是尾状核、豆状核,其

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