文章摘要
杨云凤,刘菊华,辜建伟,等.超低频重复经颅磁刺激对老年缺血性脑卒中病人吞咽功能及血清神经元特异性烯醇酶的影响[J].安徽医药,2021,25(1):72-75.
超低频重复经颅磁刺激对老年缺血性脑卒中病人吞咽功能及血清神经元特异性烯醇酶的影响
Effect of ultralow?frequency rTMS on swallowing function and serum NSE in elderly patients with ischemic stroke
  
DOI:10.3969/j.issn.1009?6469.2021.01.018.
中文关键词: 卒中  吞咽障碍  经颅磁刺激  神经元特异性烯醇酶  老年人
英文关键词: Stroke  Deglutition disorders  Transcranial magnetic stimulation  Neuron?specific enolase  Aged
基金项目:四川省医学会高血压疾病(泰阁)专项科研课题(2019TG16);四川省干部保健科研课题(川干研 2017?1601);川北医学院科研发展计划项目(CBY13?A?QN17)
作者单位E-mail
杨云凤 川北医学院附属医院老年病科川南充637000  
刘菊华 成都中医药大学临床医学院四川成都 610000 289991830@qq.com 
辜建伟 川北医学院附属医院老年病科川南充637000  
刘利 川北医学院附属医院老年病科川南充637000  
董文菊 川北医学院附属医院老年病科川南充637000  
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中文摘要:
      目的探讨超低频重复经颅磁刺激(rTMS)对老年缺血性脑卒中吞咽功能障碍病人吞咽功能及血清神经元特异性烯醇酶(NSE)的影响。方法选取川北医学院附属医院 2017年 3月至 2018年 3月收治的老年缺血性脑卒中吞咽障碍病人,将符合入组条件的 60例病人按照随机数字表法分为 rTMS组(30例)和对照组(30例)两组病人均进行常规药物治疗和吞咽训练, rTMS组病人在此基础上于病侧脑部初级运动皮质区(M1区)进行超低频(10 mHz)重,复经颅磁刺激,每天 1次,连续 2周共计 14次刺激。分别于治疗前、后采用:洼田饮水试验、藤岛一郎吞咽障碍评分评估吞咽功能;行血清神经元特异性烯醇酶(NSE)测定。结果与对照组比较, rTMS组洼田饮水实验等级及 NSE含量均明显降低(24.40±6.27)μg/mL,藤岛一郎吞咽障碍评分[M(P25,P75)]显著提高 7.5(7,8)(均 P<0.05); rTMS组治疗前、后 NSE值与吞咽功能评分均呈负相关。结论超低频重复经颅磁刺激可以明显改善老年缺血性脑卒中吞咽障碍病人的吞咽功能,并降低血清 NSE水平,其中降低 NSE水平可能是其作用机制之一。
英文摘要:
      Objective To investigate the effect of ultralow?frequency repetitive transcranial magnetic stimulation(rTMS)on swal? lowing function and serum NSE in elderly patients with dysphagia after ischemic stroke.Methods The elderly patients with dys?phagia after ischemic stroke admitted in Affiliated Hospital of North Sichuan Medical College from March 2017 to March 2018,60 patients who met the enrollment conditions were divided into the rTMS group(30 cases)and control group(30 cases).Both groups received routine drug treatment and swallowing training.On this basis,patients in the rTMS group received utralow?frequency(10mHz)rTMS treatment,which were carried out on the primary motor cortex of the injured side once a day for two weeks.Serumlevels of NSE and swallowing function which was evaluated by Watian drinking water test and Fujima Ichiro dysphagia score weremeasured before and after treatment.Results After rTMS treatment,the results of Watian drinking water test and serum levels of NSE were lower in rTMS group(24.40±6.27)compared with control group(P<0.05).Whereas,fujima Ichiro dysphagia score in rT? MS group 7.5(7,8)was higher than that of control group(P<0.05).Furthermore,serum level of NSE was negatively correlated with swallowing function score before and after rTMS treatment.Conclusion Ultralow?frequency repetitive transcranial magneticstimulation significantly improves swallowing function in elderly patients with dysphagia after ischemic stroke,the underline mecha? nism may be related with decreasing serum levels of NSE.
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