本文關鍵詞： 腦梗死 失語 重復經(jīng)顱磁刺激 腦電活動 腦代謝產(chǎn)物　出處：《山東醫(yī)藥》2017年37期 　論文類型：期刊論文

【摘要】：目的觀察重復經(jīng)顱磁刺激治療左半球腦梗死失語的效果,探討其作用機制。方法將左半球腦梗死失語患者180例根據(jù)入院順序隨機分為觀察組與對照組各90例。兩組均給予語言功能訓練及抗感染、營養(yǎng)神經(jīng)、增強機體免疫等藥物治療,給予鹽酸多奈哌齊5 mg/次口服,1次/d,服用4周。觀察組在以上治療基礎上行重復經(jīng)顱磁刺激治療,每周5次,共治療20次。采用漢語失語成套測驗(ABC)對患者治療前后的語言功能進行評分,治療后根據(jù)失語癥狀改善率對療效進行評價;采集腦電信號,選取6個參數(shù)[關聯(lián)維數(shù)、點關聯(lián)維數(shù)(PD2)、李亞普諾夫指數(shù)(L1)、柯爾莫哥諾夫熵、近似熵、復雜度(Cx)]進行腦電非線性分析;測定腦代謝產(chǎn)物N-乙酰天門冬氨(NAA)、膽堿(Cho)。結果治療2、4周,觀察組ABC評分較治療前及對照組高(P均0.05)。治療后觀察組總有效率高于對照組(P0.05)。治療后觀察組左額區(qū)腦電參數(shù)較對照組升高,但差異無統(tǒng)計學意義(P均0.05);觀察組右側額區(qū)PD2、L1、Cx較對照組升高(P均0.05)。治療前兩組同側NAA、Cho相對濃度比較差異無統(tǒng)計學意義(P均0.05);兩組左側NAA相對濃度低于右側(P均0.05),左側Cho相對濃度高于右側(P均0.05)。治療1、2周,觀察組左側NAA相對濃度高于對照組,Cho相對濃度低于對照組(P均0.05)。結論重復經(jīng)顱磁刺激可有效改善左半球腦梗死患者的失語癥狀;其作用機制可能與調(diào)控神經(jīng)網(wǎng)絡,降低健側大腦半球語言區(qū)代謝水平,增加患側語言區(qū)代謝水平有關。
[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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