关键词: 缺血性卒中; 痉挛; 分布情况; 危险因素

Abstract:

Objective To investigate the prevalence and predictive factors of spasticity six months after onset of ischemic stroke in China. Methods All patients with acute ischemic stroke hospitalized in Affiliated Tongji Hospital of Tongji University between April 1st and July 31st 2013 were followed-up for six months after newlyonset of stroke. Spasticity was evaluated with the modified Ashworth Scale (MAS) by the same person. Results A total of 185 patients were recruited and 114 patients were followed-up, among whom, 32 patients showed spasticity. Among these 32 patients, 22 cases had both upper and lower limb spasm. Spasm appeared most frequently at the elbow (26 cases), then at the ankle (22 cases), the finger (20 cases), the wrist (19 cases), the knee (18 cases), the shoulder (15 cases) and the hip (7 cases). The NIHSS score on admission in the patients with spasticity (4.64, 0~23) was higher than the patients without spasticity (2.41, 0~7, P =0.001). The paralysis part of NIHSS score in the patients with spasticity (3, 2~6) was higher than the patients without spasticity (1, 0~2, P <0.001). The Barthel Index (BI) at discharge in the patients with spasticity (71.2, 5~100) was lower than the patients without spasticity (91.7, 45~100, P <0.001). Multi-factor logistic regression analysis showed that the paralysis part of NIHSS score and the BI at discharge was related to the presence of spasticity. Conclusion Post-stroke spasticity often occurs in both the upper and the lower limb. The upper limb is more frequently involved than the lower limb, while the elbow is the most frequently involved joint. The paralysis part of NIHSS score and the BI could be used as a predictive factor of post-stroke spasm.

Key words: Ischemic stroke; Spasticity; Epidemiology; Predictive factor