重复外周磁刺激与吞咽恢复关联中的年龄相关异质性：一项回顾性倾向评分匹配研究
Age-Related Heterogeneity in the Association of Repetitive Peripheral Magnetic Stimulation With Swallowing Recovery: A Retrospective Propensity Score-Matched Study.
文献信息
| PMID | 42816655 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Minako Hashimoto |
| 作者单位 | Funabashi Municipal Rehabilitation Hospital, Funabashi, Japan. |
| 期刊 | Dysphagia |
| SCI 分区 | Q1 |
| IF | 3.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 重复外周磁刺激（rPMS）已用于吞咽困难康复，但比较性证据和治疗异质性仍不明确。
方法： 我们开展了一项单中心回顾性倾向评分匹配队列研究，纳入接受吞咽困难康复的住院患者。接受rPMS联合个体化常规康复治疗的患者与在rPMS实施前接受治疗的历史对照按1:1匹配（50例对50例）。主要结局为从入院至出院时食物摄入等级量表（FILS）的变化。通过治疗-by-年龄交互作用及探索性分层分析（<80岁 vs. ≥80岁）考察年龄相关异质性。
结果： 一名对照患者缺少出院时FILS，被排除于主要分析之外（n=99）。总体而言，rPMS与更大的FILS改善无关（+0.48，95%置信区间 -0.26至1.22；p=0.202）。探索性交互分析提示存在年龄相关异质性（交互作用p=0.008）：在分层分析中，rPMS与<80岁患者更大的改善相关（+1.70，95%置信区间 0.34至3.07；p=0.015），而在≥80岁患者中未观察到关联（-0.52，95%置信区间 -1.44至0.39；p=0.258）。rPMS组的认知和功能独立性评定总分变化评分更高，但残余混杂仍可能存在。
结论： 在这项匹配观察性研究中，rPMS与FILS所测功能性经口摄入的总体改善无关。探索性分析产生了可能存在年龄相关异质性的假设，但这一信号不应成为基于年龄选择治疗的依据。
英文摘要
Repetitive peripheral magnetic stimulation (rPMS) has been used in dysphagia rehabilitation, but comparative evidence and treatment heterogeneity remain unclear. We conducted a single-center retrospective propensity score-matched cohort study of inpatients undergoing dysphagia rehabilitation. Patients treated with rPMS plus individualized usual rehabilitation were matched 1:1 to historical controls treated before rPMS implementation (50 vs. 50). The primary outcome was change in Food Intake LEVEL Scale (FILS) from admission to discharge. Age-related heterogeneity was examined using a treatment-by-age interaction and exploratory stratified analyses (< 80 vs. ≥ 80 years). One control patient lacked discharge FILS and was excluded from the primary analysis (n = 99). Overall, rPMS was not associated with greater FILS improvement (+ 0.48, 95% confidence interval - 0.26 to 1.22; p = 0.202). Exploratory interaction analysis suggested age-related heterogeneity (interaction p = 0.008): in stratified analyses, rPMS was associated with greater improvement among patients aged < 80 years (+ 1.70, 95% confidence interval 0.34 to 3.07; p = 0.015), whereas no association was observed among patients aged ≥ 80 years (-0.52, 95% confidence interval - 1.44 to 0.39; p = 0.258). Cognitive and total Functional Independence Measure change scores were higher in the rPMS group, but residual confounding remained plausible. In this matched observational study, rPMS was not associated with overall improvement in functional oral intake measured by FILS. Exploratory analyses generated a hypothesis of possible age-related heterogeneity, but this signal should not justify age-based treatment selection.