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在首次亚急性中风患者中,对中风后复杂区域性疼痛综合征的风险因素分析

Chan Yong Kim¹, Yeo Bin Kim¹, Eun Sun Lee¹

¹Department of Physical Medicine of Rehabilitation, Wonkwang University School of Medicine Hospital, Institut of Wonkwang Medical Science, Republic of Korea.

Clinical neurology and neurosurgery

|July 5, 2025

概括

确定中风后复杂区域性疼痛综合征 (CRPS) 的危险因素至关重要. 长时间住院,上肢强度低,NIHSS初始得分高,营养不良增加了中风幸存者的CRPS风险.

科学领域:

神经学神经学
康复医学康复医学康复医学
疼痛管理疼痛管理

背景情况:

脑卒中后复杂区域性疼痛综合征 (CRPS) 是中风幸存者的一种严重并发症.
了解中风后发展CRPS的特定风险因素仍然有限.

研究的目的:

调查人口,临床和实验室风险因素,与首次次亚急性中风后的患者中CRPS的发展相关.

主要方法:

一项涉及226名亚急性中风患者的病例控制研究,其中45名被诊断为CRPS.
收集的数据包括人口统计,住院时间,病变位置,并发症,营养标记 (维生素D,蛋白质,白蛋白),血栓标记,上肢的Fugl-Meyer评估 (FMA-UE) 和国家卫生研究所中风量表 (NIHSS).
诊断CRPS遵循布达佩斯标准,并通过三相骨扫描得到确认.

主要成果:

患有中风后CRPS的患者表现出较高的 supratentorial病变和冠状动脉疾病史,血白蛋白水平较低.
确定CRPS的独立风险因素是长时间住院,低FMA-UE得分,高初始NIHSS得分和低血蛋白水平.
诸如中风病因,半球主导,病变横向性和常见的并发症 (高血压,糖尿病,脂质失调,DVT,PE,抑郁症) 等因素与CRPS发生没有显著关联.

结论:

在第一次亚急性中风患者中,中风后CRPS的关键风险因素包括延长住院时间.
上肢强度降低 (由低FMA-UE得分表明) 和初始NIHSS得分升高是显著的预测因素.
低血蛋白和白蛋白水平表明的蛋白质能量营养不良是中风后CRPS发展的关键风险因素.

关键词:

复杂的区域性疼痛综合征.营养不良营养不良营养不良风险因素风险因素风险因素一次性中风,中风.血栓塞栓症血栓塞栓症血栓塞栓症

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