| 施爱梅,郑琦,陆旭东,等.急性期脑梗死患者双侧膈肌功能与其躯干控制能力和平衡功能的相关性研究[J].中华物理医学与康复杂志,2026,48(9):790-796 |
| 急性期脑梗死患者双侧膈肌功能与其躯干控制能力和平衡功能的相关性研究 |
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| DOI：10.3760/cma.j.cn421666-20250927-00837 |
| 中文关键词: 急性脑梗死 膈肌 超声检查 躯干控制 平衡 |
| 英文关键词: Acute cerebral infarction Diaphragm Ultrasonography Trunk control Balance |
| 基金项目:浙江省医药卫生科技计划项目（2024KY445） |
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| 中文摘要: |
| 目的 分析急性期脑梗死患者的双侧膈肌功能与其躯干控制和平衡功能的相关性。 方法 募集急性期脑梗死患者28例设为观察组，另募集男女比例、年龄、身高、体重相近的健康志愿者28例设为对照组。采用超声测量2组受试者的膈肌移动度（DE）和膈肌增厚分数（DTF），同时采用躯干损伤量表（TIS）及其子项目（静态平衡、动态平衡、协调性）和Berg平衡量表（BBS）分别评估2组受试者的躯干控制能力和平衡功能。采用独立样本t检验对2组受试者评估结果进行组间比较，同时采用Pearson法或Spearman法分析急性期脑梗死患者的膈肌功能参数与其躯干控制能力和平衡功能的相关性。 结果 观察组受累侧的DTF［（18.8±5.0）%］和DE［（1.11±0.37）cm］均显著低于组内非受累侧及对照组（P<0.05），非受累侧的DTF［（27.9±7.2）%］和DE［(1.64±0.42)cm］亦显著低于对照组（P<0.05）；观察组的TIS总分及其静态平衡、动态平衡、协调性评分，以及BBS评分均显著低于对照组（P<0.05）。经相关性分析，观察组受累侧的DTF与其TIS动态平衡（r=0.607，P<0.001）和BBS评分（r=0.609，P<0.001）呈强正相关，与TIS静态平衡（r=0.412，P=0.011）呈中等相关，与TIS协调性（r=0.376，P=0.022）呈弱相关。观察组受累侧的DE与其TIS动态平衡（r=0.538，P=0.001）和BBS评分（r=0.492，P=0.003）呈中等相关，其非受累侧的DTF与其BBS评分（r=0.401，P=0.018）呈中等相关。 结论 急性期脑梗死患者存在双侧膈肌功能障碍，且受累侧膈肌功能与其躯干控制能力和平衡功能密切相关，本研究支持将床旁超声技术作为评估膈肌功能的客观手段，并建议将其纳入脑梗死患者的早期康复评估体系。 |
| 英文摘要: |
| Objective To analyze the correlation of ultrasonographic assessment of bilateral diaphragmatic function with trunk control and balance function in patients with acute cerebral infarction. Methods A total of 28 ACI patients with were enrolled as the observation group, and 28 healthy volunteers matched for sex, age, height, and body weight served as the control group. Diaphragmatic excursion (DE) and diaphragmatic thickening fraction (DTF) were measured using ultrasonography in both groups. Trunk control ability was assessed using the Trunk Impairment Scale (TIS) and its subscales (static sitting balance, dynamic sitting balance, and coordination), while balance function was evaluated using the Berg Balance Scale (BBS). Independent samples t-tests were used for inter-group comparisons. Pearson or Spearman correlation analyses were performed to examine the relationships between diaphragmatic functional parameters and trunk control/balance function in patients with ACI. Results In the observation group, DTF ［(18.8±5.0)%］ and DE ［(1.11±0.37) cm］ on the affected side were significantly lower than those on the unaffected side ［(27.9±7.2)% and (1.64±0.42) cm, respectively］ and in the control group (P<0.05). Furthermore, DTF and DE on the unaffected side were also significantly lower than those in the control group (P<0.05). The total TIS score, its subscores (static balance, dynamic balance, coordination), and the BBS score were all significantly lower in the observation group compared to the control group (P<0.05). Correlation analysis revealed that DTF on the affected side was strongly positively correlated with the TIS dynamic balance score (r=0.607, P<0.001) and the BBS score (r=0.609, P<0.001), moderately correlated with the TIS static balance score (r=0.412, P=0.011), and weakly correlated with the TIS coordination score (r=0.376, P=0.022). Additionally, DE on the affected side showed a moderate correlation with the TIS dynamic balance score (r=0.538, P=0.001) and the BBS score (r=0.492, P=0.003), while DTF on the unaffected side was moderately correlated with the BBS score (r=0.401, P=0.018). Conclusions Patients with acute cerebral infarction exhibit bilateral diaphragmatic dysfunction. The function of the affected diaphragm is closely related to their trunk control and balance capabilities. This study supports the use of bedside ultrasonography as an objective tool for assessing diaphragmatic function and recommends its incorporation into the early rehabilitation assessment system for patients with cerebral infarction. |
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