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目的探讨小剂量阿法骨化醇联合神经肌肉促进术对卒中后偏瘫患者骨质疏松症的预防效果。方法选取2012年10月—2013年10月我院神经内科收治的卒中后偏瘫患者100例,将其随机分为对照组和治疗组,各50例。在常规治疗的基础上对照组患者给予神经肌肉促进术治疗,治疗组患者给予小剂量阿法骨化醇联合神经肌肉促进术治疗。比较两组患者治疗前和疗程结束后3个月血清骨钙素(BGP)水平及疗程结束后6个月骨密度。结果疗程结束后6个月两组患者健侧前臂(桡骨33%)和健侧股骨颈骨密度比较,差异无统计学意义(P>0.05);治疗组患者患侧前臂(桡骨33%)和患侧股骨颈骨密度〔(0.652±0.128)g/cm2和(0.782±0.101)g/cm2〕高于对照组〔(0.616±0.152)g/cm2和(0.714±0.105)g/cm2〕(P<0.05)。两组患者治疗前血清BGP水平比较,差异无统计学意义(P>0.05);疗程结束后3个月,治疗组患者血清BGP为(16.42±4.27)μg/L,高于对照组的(14.32±3.15)μg/L(P<0.05)。结论小剂量阿法骨化醇联合神经肌肉促进术能有效提高卒中后偏瘫患者的血清BGP,增强患侧肢体骨密度,可以安全、有效地预防卒中后偏瘫患者骨质疏松症的发生。
Objective To investigate the preventive effect of low-dose alfacalciferol combined with neuromuscular stimulation on post-stroke hemiplegia patients with osteoporosis. Methods One hundred patients with post-stroke hemiplegia who were admitted to Department of Neurology in our hospital from October 2012 to October 2013 were randomly divided into control group and treatment group, 50 cases in each group. On the basis of routine treatment, patients in the control group were given neuromuscular stimulation, and patients in the treatment group were given low-dose alfacalciferol combined with neuromuscular stimulation. The level of serum BGP and the bone mineral density at 6 months after the end of treatment were compared between the two groups before treatment and 3 months after the end of treatment. Results There was no significant difference in bone mineral density between the contralateral forearm (33% of radius) and contralateral femur of the two groups at 6 months after the end of treatment (P> 0.05). The ipsilateral forearm (33% of radius) and The ipsilateral femoral neck BMD (0.652 ± 0.128 g / cm2 and 0.782 ± 0.101 g / cm2) was significantly higher than that of the control group (0.616 ± 0.152 g / cm2 vs 0.714 ± 0.105 g / cm2) <0.05). Serum BGP levels in the two groups were significantly higher than those in the control group (14.32, P <0.05), but no significant difference was found between the two groups before treatment (P> 0.05). At 3 months after the end of treatment, BGP in the treatment group was (16.42 ± 4.27) ± 3.15) μg / L (P <0.05). Conclusion Low-dose alfacalciferol combined with neuromuscular stimulation can effectively increase serum BGP in patients with hemiplegia after stroke and increase bone density in the affected side, which can prevent osteoporosis in patients with hemiplegia after stroke effectively and effectively.