目的 探讨中青年缺血性脑卒中患者身体活动对卒中后疲劳的影响路径，为制订卒中后疲劳身体活动方案提供依据。方法 采用便利抽样，于2025年2-8月选取广东省3所三级甲等医院的267名中青年缺血性脑卒中患者为研究对象，采用一般资料调查表、国际身体活动问卷、改良Rankin量表、病人健康问卷、疲劳严重程度量表展开调查。结果 身体活动既能直接负向影响卒中后疲劳[β=-0.786,95%CI(-1.218~-0.257)]，也可通过抑郁、功能障碍的单独中介作用[β=-0.554,95%CI(-0.898~-0.278)；β=-0.296,95%CI(-0.630~-0.122)]，以及功能障碍-抑郁的链式中介作用[β=-0.291,95%CI(-0.596~-0.122)]，负向影响卒中后疲劳。结论 中青年缺血性脑卒中患者进行身体活动，可经由多种途径缓解卒中后疲劳。临床工作人员应全面评估患者的功能障碍程度与抑郁状况，制订兼具功能导向与心理效益的身体活动方案。

Objective To explore the influencing pathways of physical activity on post-stroke fatigue in young and middle-aged patients with ischemic stroke,so as to provide evidence for formulating physical activity interventions targeting post-stroke fatigue.Methods A total of 267 young and middle-aged patients with ischemic stroke were recruited from 3 tertiary A hospitals in Guangdong Province by the convenience sampling method from February to August 2025.Data were collected using a general information questionnaire,the International Physical Activity Questionnaire,the modified Rankin Scale,the Patient Health Questionnaire,and the Fatigue Severity Scale.Results Physical activity not only had a direct negative effect on post-stroke fatigue [β=-0.786,95%CI(-1.218,-0.257)],but also exerted a negative influence on post-stroke fatigue through the separate mediating effects of depression and functional impairment [β=-0.554,95%CI(-0.898,-0.278);β=-0.296,95%CI(-0.630,-0.122)],as well as the serial mediating effect of functional impairment and depression [β=-0.291,95%CI(-0.596,-0.122)].Conclusions Physical activity can alleviate post-stroke fatigue through multiple pathways in young and middle-aged patients with ischemic stroke.Clinical staff should comprehensively assess the degree of dysfunction and depression status of patients,and develop physical activity programs with both functional orientation and psychological benefits.

R473.74

国家自然科学基金青年项目（72204278）