目的 探讨脑卒中后癫痫患者采用重复经颅磁刺激(rTMS)干预的临床效果。方法 选取2021年1月至2023年3月在解放军总医院第二医学中心治疗的脑卒中后癫痫患者104例,采用信封法将患者分为观察组(52例)和对照组(52例),对照组给予常规治疗,观察组在对照组基础上加用rTMS治疗,观察两组治疗疗效、癫痫发作情况。结果 (1)观察组癫痫治疗总有效率为96.15%,其治疗效果优于对照组(P＜0.05);观察组治疗后发作次数和持续时间分别为(1.01±0.27)次/月和(2.20±0.74)min/次,均较对照组减少或缩短(P＜0.05);(2)观察组治疗后简易精神状态评价量表(MMSE)评分为(25.54±2.01)分,高于对照组(P＜0.05),而美国国立卫生研究院卒中量表(NIHSS)评分为(6.14±1.82)分,低于对照组(P＜0.05);观察组治疗后生活质量综合评定问卷-74(GQOL-74)量表社会功能、躯体功能、心理功能和物质功能评分分别为(86.65±9.55)分、(72.82±8.02)分、(80.03±8.33)分和(83.34±7.94)分,高于对照组(P＜0.05);(3)观察组治疗后血清同型半胱氨酸(Hcy)、S100钙结合蛋白B(S100B)和神经元特异性烯醇化酶(NSE)分别为(7.22±1.93)μmol/L、(0.30±0.18)μg/L和(5.65±1.12)μg/L,低于对照组(P＜0.05)。结论 脑卒中后癫痫患者采用rTMS干预有较好的效果,有利于癫痫病情的控制,还可改善患者神经及认知功能。
Abstract
Objective To investigate the clinical effect of repetitive transcranial magnetic stimulation (rTMS) in patients with epilepsy after stroke. Methods A total of 104 patients with post-stroke epilepsy treated in the Second Medical Center of PLA General Hospital from January 2021 to March 2023 were divided into observation group (n=52) and control group (n=52) using envelope method. The control group received routine treatment, while the observation group received rTMS treatment on the basis of the control group. The therapeutic effect and seizure status of the two groups were observed. Results The total effective rate of the observation group was 96.15%, which was better than that of the control group (P<0.05). After treatment, the frequency and duration of attacks in the observation group were (1.01±0.27) times/month and (2.20±0.74) min/time, respectively, which were lower than those in the control group (P<0.05). The Mini-mental State Examination (MMSE) score of the observation group after treatment was (25.54±2.01), which was higher than that of the control group (P<0.05), while the National Institutes of Health Stroke Scale (NIHSS) score was (6.14±1.82), which was lower than that of the control group (P<0.05). The scores of social function, physical function, psychological function, and material function on the GQOL-74 comprehensive assessment questionnaire for quality of life after treatment in the observation group were (86.65±9.55) points, (72.82±8.02) points, (80.03±8.33) points, and (83.34±7.94) points, respectively, which was higher than those in the control group (P<0.05). After treatment, serum homocysteine (Hcy), S100 calcium binding protein B (S100B), and neuron specific enolase (NSE) in the observation group were (7.22±1.93) μmol/L, (0.30±0.18) μg/L, and (5.65±1.12) μg/L, respectively, which were lower than those in the control group (P<0.05). Conclusions rTMS intervention has a good effect on patients with epilepsy after stroke, which is beneficial to the control of epilepsy and can improve the neurological and cognitive functions of the patients.
关键词
脑卒中 /
癫痫 /
重复经颅磁刺激 /
临床效果 /
认知功能
Key words
stroke /
epilepsy /
repetitive transcranial magnetic stimulation /
clinical effect /
cognitive functions
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基金
国家自然科学基金委员会资助项目(81901274)
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