50例脑卒中患者双上肢F波的研究

F wave study of upper limbs in 50 cases patients with post-stroke

关键词:  脑卒中  F 波  改良Ashworth评分  功能康复

Key words:  stroke  F wave  modified Ashworth score  functional rehabilitation

摘要:

目的　观察脑卒中患者不同时期的双上肢正中神经F波的变化特点，为脑卒中患者的肢体功能康复提供客观的评估指标。方法　选择大连医科大学附属第二医院神经内科住院的脑卒中患者50例，采用Nicolet肌电图/诱发电位仪对患者双侧正中神经进行F波的检测，同时采用改良Ashworth评分评定患侧上肢的痉挛程度，并评价F波的参数变化与改良Ashworth评分的相关性，F波的参数主要包括潜伏期、波幅、F波波幅与M 波波幅比率以及出现率。结果　发病1周患侧正中神经F波潜伏期（28.0±1.34）ms，波幅（196.12±80.25）μv，出现率（92±1）%，改良Ashworth评分（0.5±0.2）。发病1个月患侧正中神经F波潜伏期（31.5±5.27）ms和波幅（550.65±57.87）μv与正常对照组比较，差异有显著性意义(P<0.05)；出现率（97±3）%。改良Ashworth评分（3.2±0.58）；改良Ashworth评分和F波波幅、潜伏期呈正相关（P<0.05）。结论　随着病程的进展，脑卒中患者F波潜伏期延长，波幅增加，和改良Ashworth评分呈正相关。F波联合改良Ashworth评分是评估脑卒中患者肢体功能康复的客观指标。

Abstract:

Objective 　To investigate the features of F-wave in median nerves in stroke patients, and to find an objective evaluation index for limb function rehabilitation. 　Methods 　The data of inpatients diagnosed with stroke were collected in the Second of Affiliated Hospital of Dalian Medical University. F-wave amplitude, latency, persistence and F/M ratio were measured in median nerve. The modified Ashworth score (MAS) was evaluated for upper extremity spasticity. Meanwhile, the relation of F-wave parameters and MAS were also explored in median nerve. 　Results 　One week after the onset, latency of F wave in ipsilateral median nerve was (28.0±1.34)ms, the amplitude of (196.12±80.25)μv, persistence of （92±1）%, modified Ashworth score of 0.5±0.2. One month after the onset, latency of F wave was (31.5±5.27)ms, the amplitude of (550.65±57.87)μv, persistence of （97±3）%, modified Ashworth score of 3.2±0.58. The modified Ashworth score and F wave amplitude, latency were correlated (P<0.05). 　Conclusion 　As the disease progresses, F wave latency and amplitude are increased in stroke patients, and the modified Ashworth score was positively related to F wave parameters. F wave combined with modified Ashworth score are an objective index to assess rehabilitation of limb function in stroke patients.