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目的:观察早期综合康复治疗对急性脑梗死(ACI)患者的运动功能、血清可溶性细胞间黏附因子(sICAM-1)的表达和白细胞介素-6(IL-6)含量动态变化的影响。方法:86例ACI患者随机分为两组,综合治疗组(44例)采用早期综合康复训练和金纳多等常规治疗,常规治疗组(42例)仅采用金纳多等常规治疗。用双抗体夹心酶联免疫吸附法(ELISA法)测定两组患者治疗前和治疗1、2、4周后外周血sICAM-1的表达和IL-6的含量,并选择30例健康者作对照。分别用改良爱丁堡-斯堪的纳维亚脑卒中评定表(MESSS)、Fugle-Meyer功能评定(FMA)、Barthel指数(BI)来评定疗效。结果:两组ACI患者治疗前与治疗后1、2周时sICAM-1的表达和IL-6水平均显著高于对照组(P<0.05或P<0.01);综合治疗组治疗1、2周时sICAM-1的表达和IL-6水平较常规治疗组低(P<0.05),治疗2周时综合治疗组MESSS评分低于常规治疗组(P<0.05),FMA评分明显高于常规治疗组(P<0.05);综合治疗组4周时FMA、BI评分高于常规治疗组(P<0.05),MESSS评分低于常规治疗组(P<0.05);综合治疗组临床有效率高于常规治疗组(P<0.05)。结论:早期综合康复训练能促进ACI患者运动功能的恢复,其机制可能与调节sICAM-1的表达和IL-6水平有关,但具体机制尚待进一步探讨。
Objective: To observe the effects of early comprehensive rehabilitation on the motor function, the expression of sICAM-1 and the dynamic changes of interleukin-6 in patients with acute cerebral infarction (ACI). Methods: Eighty-six patients with ACI were randomly divided into two groups. The general treatment group (44 cases) received general rehabilitation training and the routine treatment of Ginaton, while the conventional treatment group (42 cases) received only routine treatment with Ginaton. Peripheral blood sICAM-1 expression and IL-6 levels were measured by ELISA before and after 1, 2 and 4 weeks of treatment. Thirty healthy controls were selected as controls . Efficacy was assessed using the Modified Edinburgh Scandinavian Stroke Scale (MESSS), Fugle-Meyer Functional Assessment (FMA), and Barthel Index (BI). Results: The expression of sICAM-1 and the level of IL-6 in ACI patients before and after 1 and 2 weeks of treatment were significantly higher than those in control group (P <0.05 or P <0.01) The expression of sICAM-1 and the level of IL-6 were lower than those of the conventional treatment group (P <0.05). The MESSS score of the comprehensive treatment group was lower than that of the conventional treatment group (P <0.05) and the FMA score was significantly higher than that of the conventional treatment group (P <0.05). The scores of FMA and BI in the comprehensive treatment group were higher than those in the conventional treatment group (P <0.05) at 4 weeks and MESSS scores were lower than those in the conventional treatment group (P <0.05). The clinical effective rate in the comprehensive treatment group was higher than that in the conventional treatment group Group (P <0.05). CONCLUSION: Early comprehensive rehabilitation can promote the recovery of motor function in ACI patients. The mechanism may be related to the regulation of sICAM-1 expression and IL-6 level, but the specific mechanism remains to be further explored.