Dynamic Cardiophysiologic Variables Correlate with Lesion Location and FIMTM in Patients with Ischemic Stroke
Dynamic Cardiophysiologic Variables Correlate with Lesion Location and FIMTM in Patients with Ischemic Stroke
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DOI：
10.1097/00002060-200208000-00006
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发表时间：
2002-08
影响因子：
3
通讯作者：
M. Arad;H. Ring;S. Abboud;M. Radai;A. Tamir;A. Adunsky
中科院分区：
文献类型：
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作者：
M. Arad;H. Ring;S. Abboud;M. Radai;A. Tamir;A. Adunsky
Arad M, Ring H, Abboud S, Radai MM, Tamir A， Adunsky A：缺血性脑卒中患者的动态心脏生理变量与病灶位置和FIMTM相关。[J]中华医学杂志，2002;31(1):591 - 596。目的探讨近期缺血性脑卒中康复患者的临床功能指标与康复期间记录的心脏生理指标之间的相关性。设计：一项队列研究，包括连续患者样本，无心脏病史或节律障碍，在缺血性幕上卒中后入院康复。检查所有患者的FIM™评分和动态心脏生理变量。分析结果与脑卒中位置的关系。38名患者参与了这项研究。10例为浅表病变，20例为深部病变，8例ct未见明显病变。入院后48-72小时用FIM仪测量功能，出院前1周重复。在物理治疗期间记录心电图活动。发现心电图波形中RR和QT间期的关系可以估计两个心脏生理学变量，常数(a)和斜率(b)值，反映了物理治疗期间QT的动态变化。结果只有在脑深部病变患者亚组中，FIM仪器的运动项目在入院和出院评分上与斜率变量(b)有统计学显著的关系，与常数变量(a)有负统计学显著的关系。结论脑深部梗死可导致自主神经系统明显功能障碍，表现为QT间期动力学行为扭曲，功能表现受损。
Arad M, Ring H, Abboud S, Radai MM, Tamir A, Adunsky A: Dynamic cardiophysiologic variables correlate with lesion location and FIMTM in patients with ischemic stroke. Am J Phys Med Rehabil 2002;81:590–596. Objective To examine the correlation between a clinical measure of function in patients undergoing rehabilitation who had recently had an ischemic stroke and to examine cardiophysiologic measures registered during effort. Design A cohort study comprising a sample of consecutive patients, without a history of cardiac disease or rhythm disturbances, admitted for rehabilitation after an ischemic supratentorial stroke. All patients were examined for the FIM™ score and dynamic cardiophysiologic variables. Results were analyzed in relation to stroke location. Thirty-eight patients participated in the study. Ten patients had a superficial lesion, 20 had a deep brain lesion, and eight had no noticeable lesion by computed tomographic imaging. Function was measured with the FIM instrument 48–72 hr after admission and repeated at 1 wk before discharge. Electrocardiographic activity was recorded during physiotherapy treatment. The relationship between the RR and QT intervals in the electrocardiographic waveforms was found to estimate two cardiophysiologic variables, the constant (a) and the slope (b) values, reflecting the dynamic change of QT during physiotherapy effort. Results Only for the subgroup of patients who sustained a deep brain lesion did the motor items in the FIM instrument on admission and discharge scores have a statistically significant relationship with the slope variable (b) and an inverse statistically significant relationship with the constant variable (a). Conclusions Deep brain infarction seems to result in a significant dysfunction of the autonomic nervous system, manifesting itself as distorted dynamic behavior of the QT interval and with impaired functional performance.