对侧抑制性rTMS联合多奈哌齐治疗脑卒中后非流畅性失语

刘双洁;吕铭新;王玉琴;梁军军;李婷婷

1:廊坊市第四人民医院/承德医学院附属医院神经内科

2:廊坊市第四人民医院/承德医学院附属医院ICU

摘要
目的 探讨对侧抑制性重复经颅磁刺激(rTMS)联合多奈哌齐治疗脑卒中后非流畅性失语的疗效。方法 92例脑卒中后非流畅性失语患者分为对照组(n=46)和联合组(n=46)。两组患者均接受相同的语言康复训练和多奈哌齐治疗,联合组在此基础上增加对侧抑制性rTMS治疗,对照组在此基础上增加假刺激治疗。比较两组波士顿诊断性失语症检查(BDAE)分级、汉语失语成套测验(ABC)各分项分值及失语商(AQ)评分、日常生活交流能力量表(CADL-T)评分、美国国立卫生院神经功能缺损评分(NIHSS)和改良Rankin量表评分(mRS)、语言功能明显改善率(AQ评分提高30分及以上)和神经功能预后良好率(mRS评分≤2分)。用二元Logistic回归法分析语言功能改善与rTMS治疗的相关性。结果 与治疗前比较,两组治疗4周后BDAE分级、ABC各分项分值、AQ、CADL-T、NIHSS、mRS评分均有明显改善,但联合组的改善程度大于对照组(P<0.05)。联合组语言功能明显改善率(58.70%)和神经功能预后良好率(82.61%)明显高于对照组(32.61%和45.65%)(P<0.05)。Logistic多因素分析显示,rTMS治疗与语言功能明显改善独立相关(P<0.05)。结论 对侧抑制性rTMS联合多奈哌齐治疗有助于脑卒中后非流畅性失语的恢复。
关键词
非流畅性失语;重复经颅磁刺激;对侧抑制;多奈哌齐
基金项目(Foundation):
廊坊市科学技术研究与发展计划(2019013099)
作者
刘双洁;吕铭新;王玉琴;梁军军;李婷婷
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