《中国康复理论与实践》

《中国康复理论与实践》 ›› 2013, Vol. 19 ›› Issue (12): 1159-1162.

• 论文 • 上一篇    下一篇

脑卒中偏瘫患者上肢H反射与痉挛的相关性研究

何颖，邵西仓，李晓裔，方俐，李玉琢   

  1. 贵州省人民医院神经电生理中心，贵州贵阳市550002。
  • 收稿日期:2013-01-09 修回日期:2013-03-18 出版日期:2013-12-25 发布日期:2013-12-25
  • 通讯作者: 邵西仓

Correlation between H-reflex and Upper-extremity Spasticity after Stroke

HE Ying, SHAO Xi-cang, LI Xiao-yi, et al.   

  1. Department of Neurological Electrophysiology, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou, China
  • Received:2013-01-09 Revised:2013-03-18 Published:2013-12-25 Online:2013-12-25

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被引次数

20

摘要： 目的观察脑卒中患者上肢H反射的H最大波幅/M最大波幅(Hmax/Mmax)、H发展斜率/M发展斜率(Hslp/Mslp)和H阈值/M阈值(Hth/Mth)等指标与痉挛的相关性。方法采用改良Ashworth 量表(MAS) 评定34 例恢复期脑卒中患者上肢痉挛情况。对双上肢正中神经进行H反射检测，记录各项参数，并比较Hmax/Mmax、Hslp/Mslp和Hth/Mth。结果患侧上肢Hmax/Mmax为(0.35±0.17)，健侧为(0.14±0.07)，患侧高于健侧(P<0.05)；患侧上肢Hslp/Mslp为(0.72±0.40)，健侧为(0.26±0.22)，患侧高于健侧(P<0.05)；患侧上肢Hth/Mth为(0.93±0.14)，健侧为(0.98±0.12)，两者间无显著性差异(P>0.05)；患侧上肢Hmax/Mmax与MAS评分呈线性正相关(r=0.608, P<0.05)；患侧上肢Hslp/Mslp 与MAS 评分亦呈线性正相关(r=0.917, P<0.05)；患侧上肢Hth/Mth 与MAS 评分不相关(r=-0.128, P>0.05)。结论Hmax/Mmax和Hslp/Mslp可作为脑卒中上肢痉挛程度评价的电生理指标。

关键词: 脑卒中, 痉挛, 上肢, H反射

Abstract: Objective To evaluate the relationship between the ratio of the maximal value of the H-reflex to the maximal value of the M response (Hmax/Mmax), the ratio of the developmental slope of the H-reflex to the slope of the M response (Hslp/Mslp), and the ratio of the threshold of the H-reflex to the threshold of the M response (Hth/Mth) and upper-extremity spasticity in stroke patients. Methods Upper-extremity spasticity in 34 stroke patients was assessed by modified Ashworth Scale (MAS). H-reflex was recorded in flexor carpi radialis muscle on both sides. Hmax/Mmax, Hslp/Mslp and Hth/Mth in the spastic side were compared to the unaffected side. Results The mean of Hmax/Mmax (spastic side, 0.36±0.17; unaffected side, 0.14±0.07) and Hslp/Mslp (spastic side, 0.72±0.40; unaffected side, 0.26±0.22) showed significant difference between 2 sides (P<0.05). The mean of Hth/Mth (spastic side, 0.93±0.14; unaffected side, 0.98±0.12) showed no significant difference (P>0.05). Hmax/Mmax and Hslp/Mslp were correlated positively with score of MAS in the stroke patients (r=0.608, P<0.05; r=0.917, P<0.05), while there was no correlation between Hth/Mth and score of MAS (r=-0.128, P>0.05). Conclusion Hmax/Mmax and Hslp/Mslp could be sensitive electrophysiologic parameters to evaluate upper-extremity spasticity after stroke.

Key words: stroke, spasticity, upper-extremity, H-reflex