重复经颅磁刺激治疗左半球脑梗死失语的效果及作用机制

发布时间：2018-02-11 04:12

  本文关键词： 脑梗死 失语 重复经颅磁刺激 脑电活动 脑代谢产物　出处：《山东医药》2017年37期 　论文类型：期刊论文

【摘要】：目的观察重复经颅磁刺激治疗左半球脑梗死失语的效果,探讨其作用机制。方法将左半球脑梗死失语患者180例根据入院顺序随机分为观察组与对照组各90例。两组均给予语言功能训练及抗感染、营养神经、增强机体免疫等药物治疗,给予盐酸多奈哌齐5 mg/次口服,1次/d,服用4周。观察组在以上治疗基础上行重复经颅磁刺激治疗,每周5次,共治疗20次。采用汉语失语成套测验(ABC)对患者治疗前后的语言功能进行评分,治疗后根据失语症状改善率对疗效进行评价;采集脑电信号,选取6个参数[关联维数、点关联维数(PD2)、李亚普诺夫指数(L1)、柯尔莫哥诺夫熵、近似熵、复杂度(Cx)]进行脑电非线性分析;测定脑代谢产物N-乙酰天门冬氨(NAA)、胆碱(Cho)。结果治疗2、4周,观察组ABC评分较治疗前及对照组高(P均0.05)。治疗后观察组总有效率高于对照组(P0.05)。治疗后观察组左额区脑电参数较对照组升高,但差异无统计学意义(P均0.05);观察组右侧额区PD2、L1、Cx较对照组升高(P均0.05)。治疗前两组同侧NAA、Cho相对浓度比较差异无统计学意义(P均0.05);两组左侧NAA相对浓度低于右侧(P均0.05),左侧Cho相对浓度高于右侧(P均0.05)。治疗1、2周,观察组左侧NAA相对浓度高于对照组,Cho相对浓度低于对照组(P均0.05)。结论重复经颅磁刺激可有效改善左半球脑梗死患者的失语症状;其作用机制可能与调控神经网络,降低健侧大脑半球语言区代谢水平,增加患侧语言区代谢水平有关。
[Abstract]:Objective To observe the effect of repetitive transcranial magnetic stimulation on left hemisphere cerebral infarction aphasia, and to explore its mechanism. Methods the left hemisphere aphasia after cerebral infarction in 180 patients according to the order of admission were randomly divided into observation group and control group with 90 cases in each group. The two groups were given the language training and anti infection, nutrition nerve, immune enhancement and other drugs treatment with donepezil hydrochloride 5 mg/ orally, 1 times /d, taking 4 weeks. The observation group in the above treatment based on the treatment of repetitive transcranial magnetic stimulation, 5 times a week for 20 times. The Chinese aphasia test battery (ABC) were evaluated before and after treatment for language function in patients after treatment according to aphasia the symptom improvement rate to evaluate the curative effect; EEG signal, selects 6 parameters [correlation dimension, correlation dimension (PD2), Lyapunov index (L1), Karl Mogenuofu entropy, approximate entropy, complexity (Cx)] EEG Nonlinear 鏋，

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