Abstract:
Objective To explore the features of balance disorders in patients with white matter hyperintensity (WMH). Methods The clinical data of 82 patients with WMH from September 2018 to December 2018 were collected. Fazekas scale was used to evaluate the level of WMH. Berg Balance Scale (BBS)and visual-feedback balance test-training monitor were used to assessed the performance of balance. Results Fazekas classification periventricular WMH (PWMH) and deep WMH (DWMH) had negative correlation with BBS total score(rs=-0.322, P=0.027; rs=-0.414, P=0.004) and dynamic balance function scores (rs =-0.368, P=0.011; rs =-0.440, P=0.002). About the parameters of the balance monitor, the center of gravity sway circumference(rs=0.239, P=0.030)and the center of gravity sway speed(rs=0.240, P =0.030) were only positively correlated with the PWMH, center of gravity sway area ( rs =0.345, P = 0.001; rs=0.340, P=0.002),X-axis standard deviation(rs=0.302, P=0.006; rs=0.260, P=0.018),Y-axis standard deviation (rs =0.248, P=0.025; rs =0.253, P=0.022) were positively correlated with DWMH and PWMH; PWMH (rs=-0.258, P=0.019) and DWMH (rs=0.224， P=0.043) were negatively correlated with stabilitylimit. BBS total score(rs=0.572, P=0.000)and functionalreachtest(FRT; rs=0.560, P=0.000) were positively correlated with stability limit. Conclusions PWMH may be one of thefactors influencing the balance disorder in patients with WMH. The static stability, dynamic balance function, stability limit and posture stability of the patients with severe WMH are seriously degraded,there is a high risk of falling. FRT test can be used as a simple fast emergency or bedside evaluation of patients' active posture control and fall risk.
Key words:
White matter,
Magnetic resonance imaging,
Postural balance,
Statistics, nonparametric
摘要： 目的 总结脑白质高信号患者平衡障碍特征。方法 纳入2018年9-12月确诊的82例脑白质高信号患者，采用Fazekas分级评价脑白质高信号程度，Berg平衡量表（BBS）评价平衡功能，平衡测试仪测定静态平衡功能和稳定极限；Spearman秩相关分析探讨Fazekas分级与BBS评分（总评分、静态平衡功能评分、动态平衡功能评分）和平衡测试仪参数（重心摆动周长、面积和速度， X轴和Y轴标准差，稳定极限）之间的相关性。结果 BBS总评分（rs=-0.322， P=0.027； rs=-0.414， P=0.004）和动态平衡功能评分（rs=-0.368， P=0.011； rs=-0.440， P=0.002）与Fazekas分级侧脑室旁白质高信号和脑深部白质高信号均呈负相关。平衡测试仪各项参数中重心摆动周长（rs=0.239， P=0.030）和重心摆动速度（rs=0.240， P=0.030）仅与Fazekas分级侧脑室旁白质高信号呈正相关，重心摆动面积（rs=0.345， P=0.001； rs= 0.340， P=0.002）、 X轴标准差（rs=0.302， P=0.006； rs=0.260， P=0.018）、 Y轴标准差（rs=0.248， P=0.025； rs=0.253， P=0.022）与Fazekas分级侧脑室旁白质高信号和脑深部白质高信号呈正相关；而稳定极限与 Fazekas分级侧脑室旁白质高信号（rs=-0.258， P=0.019）和脑深部白质高信号（rs=-0.224， P=0.043）呈负相关。稳定极限与BBS总评分（rs=0.572， P=0.000）和功能性前伸测验（FRT）评分（rs=0.560， P=0.000）呈正相关。结论 侧脑室旁白质高信号可能是导致脑白质高信号患者平衡障碍的影响因素之一；重度 脑白质高信号患者静态稳定性、动态平衡功能、稳定极限和姿势稳定性明显下降，存在较高的跌倒风险； FRT测验可作为急诊或床旁评价患者主动姿势控制能力和跌倒风险的简捷方法。
关键词:
白质,
磁共振成像,
姿势平衡,
统计学,
非参数