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| 认知康复训练联合高频重复经颅磁刺激对脑卒中后认知障碍患者认知功能和血清BDNF、VEGF的影响* |
| Effects of Cognitive Rehabilitation Training Combined With High Frequency Repetitive Transcranial Magnetic Stimulation on Cognitive Function and Serum BDNF, VEGF in Patients With Post-Stroke Cognitive Impairment |
| 投稿时间：2021-09-04 修订日期：2021-09-04 |
| DOI： |
| 中文关键词: 认知康复训练 高频 重复经颅磁刺激 脑卒中后认知障碍 认知功能 脑源性神经营养因子 血管内皮生长因子 |
| 英文关键词: Cognitive rehabilitation training High frequency Repetitive transcranial magnetic stimulation Post-stroke cognitive impairment Cognitive function Brain derived neurotrophic factor Vascular endothelial growth factor |
| 基金项目:北京市科委（国家重大计划匹配项目）项目（Z161100002616019） |
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| 中文摘要: |
| 目的 观察脑卒中后认知障碍（PSCI）患者在认知康复训练基础上辅助高频重复经颅磁刺激（rTMS）治疗后，其认知功能和血清脑源性神经营养因子（BDNF）、血管内皮生长因子（VEGF）水平变化。方法 选择我院2020年1月~2020年12月期间接收的300例PSCI患者，以随机数字表法将患者分为实验组（150例）、对照组（150例）。对照组在常规治疗基础上联合认知康复训练，实验组则在对照组的基础上联合高频rTMS。对比两组认知功能、日常生活能力、听觉事件相关电位、血清BDNF和VEGF水平及不良反应。结果 两组治疗4周后蒙特利尔认知评估量表（MoCA）各条目评分及总分均较治疗前升高，且实验组高于对照组（P<0.05）。两组治疗4周后改良Barthel指数（MBI）评分较治疗前升高，且实验组高于对照组（P<0.05）。实验组治疗4周后P300潜伏期短于对照组，P300波幅高于对照组（P<0.05）。两组治疗4周后血清BDNF、VEGF水平升高，且实验组高于对照组（P<0.05）。两组不良反应发生率组间对比无统计学差异（P>0.05）。结论 认知康复训练联合高频rTMS可有效改善PSCI患者认知功能，上调其血清BDNF、VEGF水平，改善听觉事件相关电位，从而提高患者日常生活能力。 |
| 英文摘要: |
| Objective To observe the changes of cognitive function and serum levels of brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) in patients with post-stroke cognitive impairment (PSCI) after cognitive rehabilitation training combined with high frequency repetitive transcranial magnetic stimulation (rTMS). Methods 300 patients with PSCI who were received in our hospital from January 2020 to December 2020 were selected, and they were randomly divided into experimental group (150 cases), control group (150 cases) by the random number table method. The control group was combined with cognitive rehabilitation training on the basis of conventional treatment, while the experimental group was combined with high-frequency rTMS treatment on the basis of the control group. The cognitive function, ability of daily life, auditory event-related potential, serum BDNF and VEGF levels and adverse reactions of the two groups were compared. Results 4 weeks after treatment, the items and total scores of Montreal Cognitive Assessment Scale (MoCA) in the two groups were higher than those before treatment, and the experimental group was higher than the control group (P<0.05). 4 weeks after treatment, the modified Barthel index (MBI) score in the two groups was higher than that before treatment, and the experimental group was higher than the control group (P<0.05). 4 weeks after treatment, the incubation period of P300 in the experimental group was shorter than that in the control group, and the amplitude of P300 was higher than that in the control group (P<0.05). 4 weeks after treatment, serum BDNF and VEGF levels in the two groups increased, and the experimental group were higher than the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Cognitive rehabilitation training combined with high frequency rTMS can effectively improve the cognitive function of patients with PSCI, up regulate the BDNF and VEGF levels, improve auditory event-related potential, and improve the ability of daily life of patients. |
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