谭峰，顾卫，黄涛，王金良，吴海科，丁德权，李广兴.早期康复对脑梗死患者运动功能及血小板膜糖蛋白与肿瘤坏死因子的影响[J].中华物理医学与康复杂志,2004,(9):
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| 早期康复对脑梗死患者运动功能及血小板膜糖蛋白与肿瘤坏死因子的影响 |
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| DOI： |
| 中文关键词: 早期康复 脑梗死 血小板CD62P 肿瘤坏死因子 神经功能 |
| 英文关键词: Early rehabilitation Cerebral infarction Platelet CD62p Tumor necrosis factor α Neurologic function |
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| 中文摘要: |
| 目的观察早期康复训练对急性脑梗死（ACI）患者的运动功能、血小板膜糖蛋白（CD62P）阳性表达率与肿瘤坏死因子-α(TNF-α)含量动态变化的影响。 方法67例ACI患者随机分为两组，治疗组（34例）采用早期康复训练和盐酸川芎嗪等常规治疗，对照组（33例）仅采用盐酸川芎嗪等常规治疗。用流式细胞仪（FCM）和电化学发光等技术，测定两组治疗前和治疗1，2，4周后CD62P的阳性表达率与TNF-α水平，并与31例健康人作正常值参照及相关分析。用改良爱丁堡-斯堪的纳维亚脑卒中评定表（MESSS）、简化Fugl-Meyer法(FMA)及Barthel指数(BI)评定患者的运动功能。 结果两组ACI患者治疗前CD62P、TNF-α水平均显著高于健康组（P<0.01,P<0.05），ACI患者CD62P表达与TNF-α水平升高呈正相关；ACI患者治疗前与治疗后1周、2周时的CD62P、TNF-α水平均显著高于健康组（P<0.01,P<0.05）；治疗组2周时CD62P、TNF-α水平较对照组差异降低（P<0.05），TNF-α较对照组降低更明显（P<0.01）,MESSS评分低于对照组（P<0.05），FMA下肢评分明显高于对照组（P<0.05）；治疗组4周时FMA上肢评分、ADL评分高于对照组（P<0.05）；治疗组基本痊愈率、显著进步率明显优于对照组（P<0.05，P<0.01）。 结论早期康复训练能促进ACI患者运动功能的恢复，其对血小板活化、细胞因子的影响机制尚待进一步探讨。 |
| 英文摘要: |
| Objective To observe the effect of early rehabilitation on motor function(MF), performance in activity of daily living(ADL),positive expression rate of platelet CD62P and tumor necrosis factor α(TNF-α) level in patients with acute cerebral infarction(ACI). MethodsSixty-seven patients with ACI within the first 72 hours of onset were randomly divided into a treatment group(n=34) and a control group (n=33). All patients were treated with regular therapy with Ligustrazine Hydrochloride and Sodium Chloride Injection, while patients in the treatment group received early rehabilitation. Another group of 31 health adults was set up for normal control. Platelet CD62P positive expression rate was measured by flow cytometry and the TNF-α level by electrochemoluminescence in patients with ACI before and after 1, 2, 4 weeks of treatment; functional recovery was evaluated using MESSS, FMA, and ADL was measured by Barthel index(BI). ResultsBefore treatment, the CD62P positive expression rate and the TNF-α level were significantly higher in the patients with ACI than those in the normal group (P<0.01, P<0.05), CD62P expression in patients with ACI was positively correlated with TNF-α level. The CD62P positive expression rate and the TNF-α level were significantly higher in the patients with ACI before treatment, and after 1, 2 weeks of treatment than those in the normal control(P<0.01,P<0.05).However, after 2 weeks of treatment, the CD62P positive expression rate and the TNF-α level decreased significantly in the treatment group as compared to those in the control group(P<0.05), especially the TNF-α level(P<0.01); scores of MESSS were lower and those of FMA were higher in treatment group than those of the control group(P<0.05),and so were the FMA and ADL after 4 weeks treatment. The clinical cure rate and effective rate in treatment group were also super to those in the control group(P<0.05, P<0.01). ConclusionEarly rehabilitation could promote the recovery of MF and ADL in patients with ACI. The mechanism is probably related to its actions of decreasing platelet activation, relieving the immune response and inflammation damage of central nerve system mediated by cytokines. |
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