小脑顶核电刺激对脑梗死患者脑执行功能的影响

目的探讨小脑顶核电刺激对脑梗死患者治疗前后脑执行功能的影响。方法脑梗死患者270例,随机分成治疗组和对照组,各135例,均接受常规药物治疗,治疗组在此基础上加用小脑顶核电刺激,于治疗前和治疗后2周、3个月进行威斯康星卡片分类测验(WCST)、Strop色词测验、连线测验、词语流畅性测验。结果治疗后2周,治疗组和对照组WCST分类次数、错误数、持续性错误数、非持续性错误数及Stroop色词测验的耗时数、正确数和连线测验A、语词流畅性均较治疗前有改善(P均<0.05);治疗后3个月,对照组在WCST分类次数、持续性错误数和Stroop色词测验的耗时数、正确数及连线测验、词语流畅性测验较治疗后2周下降(P均<0.01),治疗组在WCST持续性错误数、非持续性错误数和Stroop色词测验的耗时数、连线测验A较2周末时有改善(P均<0.05),其他测验无明显改善(P>0.05)。结论电刺激小脑顶核能改善脑梗死患者的脑执行功能。     

存在血管危险因素的老年人脑白质损害与认知功能障碍的关系

目的探讨存在血管危险因素老年人不同程度脑白质损害(WML)与认知障碍的关系。方法选择WML患者195例,根据WML程度分为轻度组(54例),中度组(63例),重度组(78例),另选健康体检者70例作为对照组。所有受试者行神经心理学测试,包括简易智能状态检查量表、蒙特利尔认知评估量表、听觉词语记忆、逻辑记忆、复杂图形记忆、Stroop色词测验、连线测验B、相似性、言语流畅、数字广度、搜钟和画钟测验。结果与对照组比较,随着WML程度加重,轻、中、重度组血管危险因素明显升高(P<0.05);轻度组记忆、注意、语言及部分执行功能评分明显较对照组差(P<0.05,P<0.01),重度组各项测验评分明显较其他各组差(P<0.01)。各项测验评分与WML严重程度评分呈负相关(P<0.01)。结论血管危险因素可加重WML;轻度WML即对认知功能有影响,重度WML表现广泛认知损害;认知障碍程度与WML严重程度呈正相关。     

精神分裂症患者与其健康同胞的注意和执行功能障碍的对照研究

用威斯康星卡片分类测验(WCST)和持续操作测验(CPT)检查患者组50例及其健康同胞50例和正常对照组45例。结果:在WCMT中,患者组和同胞组总测验次数、持续错误数、随机错误数均高于对照组,P<0.01。在CPT中,患者组评分(28.4±4.0)低     

不同类型脑小血管病伴发非痴呆血管性认知功能损害的研究

目的分析比较脑小血管病不同临床类型的非痴呆血管性认知功能的损害差异。方法纳入脑小血管病患者118例,包括52例腔隙性脑梗死灶(LI)和66例白质疏松(WML),健康对照组80例。对研究对象进行神经心理学测验,包括用蒙特利尔认知评估量表(MoCA)、简易智能状态检查表(MMSE)、语义分类流畅测验(动物)、简短Stroop测验、画钟实验、积木测验、数字广度顺背测验、数字符号测验、逻辑记忆亚测验、再生亚测验。结果与对照组比较,LI组和WML组Stroop测验评分升高,其他各项评分均降低(P<0.05)。LI组语义分类流畅测验(动物)、Stroop测验、数字符号测验、听觉词语学习测验(言语性记忆)、视觉再生亚测验(视觉性记忆)、MoCA、MMSE评分高于WML组(P<0.05)。结论 LI组和WML组患者血管性认知功能均受到损害,且总体上来说WML组患者更为严重。     

抑郁症患者抗抑郁治疗前后认知功能变化及意义

目的观察抑郁症患者抗抑郁治疗前后工作记忆、注意和执行功能的变化及意义。方法选择55例抑郁症患者（观察组）和55例健康查体者（对照组）,采用汉密顿抑郁量表（HAMD．24）评定抑郁情绪的严重程度,用数字广度测验、连续操作测验（CPT）、Stroop色词测验、威斯康星卡片分类测验（WCST）4种神经心理学评估工具评定两组的工作记忆、注意和执行功能。观察组基线期和抗抑郁治疗6周后、对照组基线期和6周后分别评估所有测验。结果观察组治疗前数字顺背和倒背、CPT三项任务正确数均显著低于对照组（P均〈0．01）,Stroop干扰分、WCST持续错误数和随机错误数均显著高于对照组（P均〈0．01）;治疗6周后上述指标有显著改善（P〈0．05或〈0．01）,但仍与对照组存在统计学差异（P〈0．05或〈0．01）。结论抗抑郁治疗可以改善抑郁症患者的工作记忆、注意和执行功能,但治疗后仍有显著的认知功能缺陷。     

缺血性脑血管病患者Stroop测验病例对照研究

目的 通过Stroop测验探讨缺血性脑血管病患者自动性加工、控制性加工、选择性注意功能的情况.方法 在124例年龄在60～90岁的缺血性脑血管病患者和126例年龄、文化程度与之相匹配的健康者中进行Stroop测验.通过对比两组人群Stroop测验各项指标,探讨缺血性脑血管病患者Stroop测验各指标的特点及与健康人群的区别.结果 两组比较,Stroop测验中卡片1的耗时数及卡片2、卡片4、字词反映干扰量(SIE)的耗时数及错误数的差异有统计学意义(均P＜0.05).结论 缺血性脑血管病患者的字词自动性加工能力无明显损害,而控制性加工能力及选择性注意能力受损.     

基底核出血和梗死后认知功能的随访研究

目的探讨基底核出血和梗死急性期及恢复期的认知损害特点和差异。方法观察组共91例患者,其中基底核出血48例,基底核梗死43例。观察组在卒中后急性期（卒中后3周内）及卒中后恢复期（卒中后6～9个月）各完成一次神经心理学测验。健康对照组77名,完成一次神经心理学测验。结果基底核出血组和梗死组在急性期的各个认知域评分与对照组比较,差异均有统计学意义（P〈0．05）。除执行功能（语义分类流畅性）外,基底核出血组恢复期的神经心理学测验评分与急性期比较,差异均有统计学意义（P〈0．05）。恢复期基底核出血组的记忆力、执行功能（语义分类流畅性）、信息处理速度（数字符号测验）、视空间结构能力（积木测验和画钟测验）评分与健康对照组比较,差异亦有统计学意义（P〈0．05）,而简易精神状态检查量表（MMSE）、注意力、执行功能（Stroop测验C）和信息处理速度（Stroop测验A）评分与健康对照组比较,差异无统计学意义（P〉0．05）。除注意力（数字广度顺背测验）、记忆力（再认）和执行功能（语义分类流畅性测验）外,基底核梗死组恢复期的神经心理学测验评分与急性期比较,差异均有统计学意义（P〈0．05）。基底核梗死组恢复期记忆力、信息处理速度（数字符号测验）、视空间结构能力（积木测验和画钟测验）评分与健康对照组比较,差异具有统计学意义（P〈0．05）,而MMSE、执行功能（Stroop测验C）和信息处理速度（Stroop测验A）评分与健康对照组比较,差异无统计学意义（P〉0．05）。结论基底核卒中急性期出现多个认知领域的损害,恢复期大部分认知域得到改善,其中部分认知域可基本达到健康对照水平。     

拉莫三嗪对部分性发作癫痫患者认知功能及生活质量的影响

目的 评价拉莫三嗪(LTG)对部分性发作癫痫患者认知功能以及生活质量的影响.方法 对26例新诊断的部分性发作的癫痫患者随机分为两组,LTG组14例,给予LTG治疗,卡马西平(CBZ)组12例,给予CBZ治疗,在用药前及用药后16周进行认知功能评定及生活质量调查.认知功能评定包括数字广度,词语流畅、连线测验(A、B型)、Stroop字色干扰测验、威斯康星卡片分类测验(WCST)、延迟逻辑记忆、延迟视觉记忆、计算力、数字符号转换测验;生活质量调查采用癫痫患者生活质量评定量表-31(QOLIE-31). 结果癫痫患者应用LTG治疗16周后认知功能与用药前比较词语流畅性增加,A型、B型连线测验时间缩短,WCST正确数、分类数增加,持续错误、操作时间减少,数字符号转换测验增加,延迟逻辑记忆增加,延迟视觉记忆增加,均有统计学意义(t=3.043、-3.287、-2.543、3.167、3.028、-2.191、-3.216、3.061、3.036、3.021,P<0.01或P<0.05).两组治疗前后差值比较,LTG组比CBZ组Stroop读色时间减少,数字符号转换测验增加,计算力增加,差异均有统计学意义(t=3.167、2.142、2.101,P<0.01或P<0.05).QOLIE-31调查结果显示,与治疗前比较,LTG组和CBZ组治疗后综合生活质量、总体健康水平、认知功能、社会功能得分均增加(LTG组:t=3.321、2.462、3.294、3.512;CBZ组:t=3.314、3.149、3.294、3.202;P<0.01或P<0.05);LTG组与CBZ组治疗前后差值比较,认知功能、社会功能明显改善(t=2.257、2.140,均P<0.05),对发作的担心也减少(t=2.147、P<0.05). 结论 拉莫三嗪能够改善新诊断的部分性发作的癫痫患者认知功能,并提高生活质量.     

奥氮平与喹硫平对缺陷型精神分裂症患者执行功能影响的对比研究

目的比较奥氮平与喹硫平对缺陷型精神分裂症患者执行功能的影响。方法选取2015年11月—2017年10月张家港市第四人民医院收治的缺陷型精神分裂症患者65例,采用随机数字列表法分为A组34例和B组31例。A组患者给予奥氮平治疗,而B组患者给予喹硫平治疗;两组患者均连续治疗8周。比较两组患者治疗前后简易精神状态检查量表(MMSE)评分及数字广度测验(DS)、数字符号替换测验(DSST)、词语流畅性测验(VFT)、连线测验(TMT)、斯特鲁色词测验结果。结果 A组患者中3例中途退出研究,B组患者中2例中途退出研究。治疗前后两组患者MMSE、DS顺背、DS倒背、DSST、VFT评分及TMT-A耗时、TMT-B耗时比较,差异无统计学意义(P0.05);治疗后两组患者MMSE评分高于治疗前(P0.05)。治疗前后两组患者卡片1耗时及正确数、卡片2耗时及正确数、卡片3耗时及正确数、卡片4耗时及正确数、反应干扰量(SIE)正确数及治疗前SIE耗时比较,差异无统计学意义(P0.05);治疗后A组患者SIE耗时长于B组,且两组患者卡片4正确数高于治疗前(P0.05)。结论奥氮平与喹硫平对缺陷型精神分裂症患者执行功能的影响相似,但服用喹硫平者抗干扰能力较服用奥氮平者强。     

轻度血管性认知功能障碍执行功能特点的研究

目的探讨轻度血管性认知功能障碍(MVCI)患者执行功能特点.为临床诊断提供依据。方法选择患者58例,分为MVCI组21例、脑血管病无认知障碍组(CVD组)15侧、对照组22例。测查各组患者记忆力、注意力、语言能力、执行功能、视觉空间功能及头颅MRI。结果 MVCI组总体认知功能、执行功能较CVD组明显下降(P<0.01)。MVCI组画钟测验、画图、语言、连线A和B、Stroop字和色、阿尔茨海默病评价量表认知分表(ADAScog)总分和单词回忆分项的Z值低于对照组的1.5个标准差,简易智能状态检查、语言流畅性测验、数字符号转换、Stroop字和色、ADAS-cog单词辨认成绩Z值低于对照组的1～1.5标准差。而CVD组与对照组以上指标差异无统计学意义(P>0.05)。结论 MVCI患者存在执行功能异常。MVCI诊断标准有较高的一致性和准确性。     

脑小血管病患者多模态磁共振成像特征及其与认知功能损伤的相关性分析

目的分析脑小血管病(CSVD)患者多模态磁共振成像(MRI)特征及其与认知功能损伤的相关性。方法选取2017—2018年无锡市第五人民医院神经内科收治的CSVD患者184例,根据多模态MRI检查结果分为腔隙性脑梗死(LI)组(n=55)、脑白质高信号(WMH)组(n=48)、脑微出血(CMB)组(n=41)及合并组(n=40);另选取同期体检健康者42例作为对照组。比较五组受试者认知功能指标〔包括简易智能精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分、认知障碍发生率、连线测验(TMT)时间、数字符号编码测验(SDMT)评分、数字广度测验(DST)评分、画钟测验(CDT)及词语流畅性测验(VFT)评分〕,有无认知障碍患者LI、CMB发生率及脑白质病变分级;LI、CMB病灶及脑白质病变分级与CSVD患者MoCA评分的相关性分析采用Spearman秩相关分析。结果LI组、WMH组、CMB组及合并组患者MMSE评分、MoCA评分、SDMT评分、DST评分、CDT评分及VFT评分低于对照组,认知障碍发生率高于对照组,TMT时间长于对照组(P<0.05);合并组患者MMSE评分、MoCA评分、SDMT评分、DST评分、CDT评分及VFT评分低于LI组、WMH组、CMB组,认知障碍发生率高于LI组、WMH组、CMB组,TMT时间长于LI组、WMH组、CMB组(P<0.05)。有认知障碍患者LI、CMB发生率高于无认知障碍者,脑白质病变分级劣于无认知障碍者(P<0.05)。Spearman秩相关分析结果显示,LI病灶(rs=-0.340)、CMB病灶(rs=-0.290)及脑白质病变分级(rs=-0.213)与CSVD患者MoCA评分呈负相关(P<0.05)。结论CSVD患者存在认知功能损伤,合并2种及以上MRI异常表现的CSVD患者认知功能损伤更严重,且多模态MRI检查结果LI、CMB病灶及脑白质病变分级与CSVD患者认知功能损伤程度有关。     

An examination of the ravello profile--a neuropsychological test battery for anorexia nervosa

The Ravello Profile test battery was developed to ensure a consistent methodology when researching neuropsychological functioning in anorexia nervosa (AN). To date, 157 patients with AN have been assessed with the full Ravello Profile. The present review is the first study to systematically investigate the tests included in the battery. Fifteen experimental studies, comparing AN patients with healthy control participants on at least one of the Ravello Profile tests, were identified, and effect sizes were calculated. Three of the tests, Verbal Fluency Test (VFT), Rey Complex Figure Test (RCFT) and Trail Making Test (TMT), were meta-analysed, and the pooled standardized effect size was significant for all three tests (0.25, -0.68 and 0.49, respectively). Patients with AN performed significantly better than healthy control participants on assessment of verbal fluency (VFT) and worse on tests of visual memory (RCFT) and set-shifting (TMT). The Ravello Profile test battery appears to consist of tests that are appropriate for assessing characteristic neuropsychological profiles specific in AN.     

Neurocognitive performance among alcohol dependent men with and without physical violence toward their partners: a preliminary report

OBJECTIVE: There are high rates of co-occurring alcohol dependence and intimate partner violence (IPV) among men seeking substance abuse treatment. The authors examined neurocognitive performance among treatment-seeking alcohol dependent men with (IPV+) and without reported physical violence (IPV-). METHOD: Twenty-five subjects participated in this pilot study. All participants underwent a neurocognitive battery including, Continuous Performance Test (CPT), California Verbal Learning Test (CVLT), Digit Span, Iowa Gambling Test (IGT), Wisconsin Card Sort (WCST), Trail Making Test, Parts A & B, a visuospatial memory (VSWM) task and the Stroop Color Word Test (SCWT). RESULT: Alcohol dependent participants with IPV (IPV+; n = 9) had more severe deficits in attention, concentration, cognitive flexibility compared to controls (n = 7). Both the alcohol dependent (IPV-; n = 9) and IPV+ groups had significantly more impairments on tasks of impulsivity than the smoking controls. The IPV- group had significantly more impairments on executive functioning compared to smoking controls, but was not significantly different than the IPV+ group. CONCLUSIONS: Our preliminary results suggests that IPV+ males have more severe neuropsychological impairments compared to the smoking control group than did the IPV - group. The implications of these findings are discussed.     

高血压病眼底血管造影定量指标与心律失常发生率相关

目的:研究高血压患者眼底视网膜血管荧光造影定量分析与心律失常的关系。方法:在高血压患者中进行眼底视网膜血管荧光造影定量分析,将视网膜动脉显影时间（ADT）、静脉充盈时间（VFT）、毛细血管交换时间（CET）和毛细血管密度（MD）均异常者为研究组,正常者为对照组,两组性别、年龄、高血压分期和程度相匹配,每组40例。并进行心电图和动态心电图检查。结果:研究组异位心搏数、早搏及ST T缺血性改变较对照组显著增多（P<0.05,P<0.01）,并且与ADT、VFT、CET呈正相关（P<0.05,P<0.01,r=0.367～0.516）,与MD呈显著负相关（P<0.01,r=-0.673）。结论:视网膜血管造影定量分析指标与心律失常的发生率相关。     

The effect of 3-year treatment with 0.25 mg/day of micronized 17beta-estradiol on cognitive function in older postmenopausal women

OBJECTIVES: To evaluate the effect of ultra-low-dose (0.25 mg/d) micronized 17beta-estradiol on cognitive function in older postmenopausal women. DESIGN: Randomized, placebo-controlled trial conducted for 3 years. SETTING: Academic health center in greater Hartford, Connecticut. PARTICIPANTS: Fifty-seven healthy, community-dwelling, older postmenopausal women. INTERVENTION: Women received 0.25 mg/d of micronized 17beta-estradiol (estrogen therapy (ET), n=32) or placebo (n=25); all women who had not had a hysterectomy received 100 mg/d of oral micronized progesterone for 2-week periods every 6 months. MEASUREMENTS: Neuropsychological measures of memory, language, mood, and executive function were collected at baseline, 3 months, and 36 months. Measures of executive function included the Controlled Oral Word Association Test, the Trail Making Test, and the Wisconsin Card Sorting Test. The Boston Naming Test was used to measure language skills. The Symbol Digit Modalities Test was used as a measure of sustained attention. Measures of memory included the Complex Figure Test, Fuld Object Memory Test, and a selected subtest from the Wechsler Memory Scale. Scores from the Geriatric Depression Scale and the Beck Anxiety Inventory were used to assess symptoms of depression. RESULTS: No differences were found between ET and placebo on any of the neurocognitive measures or depression instruments, nor were there any differences when the groups were stratified according to age. CONCLUSION: This small study, which had adequate power to detect change in some but not all domains of cognition tested, revealed that low-dose estrogen neither benefits nor harms cognitive function in older women after 3 years of treatment, but confirmation is needed from larger trials.     

抑郁对自发性高血压大鼠水通道蛋白-2的影响

目的探讨抑郁对自发性高血压大鼠水通道蛋白2（aquaporin2,AQP2）的影响,并探讨AQP2在高血压中的病理生理作用。方法60只SHR大鼠分为对照组（n=30）和抑郁组（n=30）,两组又各分为两个亚组：对照组非药物治疗亚组（n=15）、对照组贝那普利治疗亚组（n=15）;抑郁组非药物治疗亚组（n=15）、抑郁组贝那普利治疗亚组（n=15）。另外,选取Wistar Kyoto（WKY）大鼠20只作为正常组大鼠。药物治疗亚组大鼠予贝那普利10 mg.d-1.kg-1灌胃。抑郁组大鼠采用慢性不可预计温和应激（CUMS）结合行为学指标建立自发性高血压大鼠并抑郁动物模型。对照组、正常组大鼠动物正常饲养。检测并比较各组大鼠间血压的变化及血管加压素和肾脏AQP2表达的差异。结果 （1）抑郁组非药物治疗亚组血压（175±14）mm Hg高于对照组非药物治疗亚组（160±11）mm Hg及正常组（112±9）mm Hg,差异有统计学意义（P〈0.05）;贝那普利治疗后,抑郁组治疗亚组血压（136±15）mm Hg、对照组治疗亚组（113±12）mm Hg均低于各自非药物治疗组（P〈0.05）。（2）抑郁组非药物治疗亚组与正常组、对照组非药物治疗亚组及对照组贝那普利治疗亚组比较,糖水偏爱性均减低（P〈0.05）,体质量和旷场实验评分均明显下降（P〈0.05）,血浆血管加压素浓度升高[（9.31±0.42）pg/mL vs.（1.6±0.67）pg/mL、（3.04±0.97）pg/mL、（2.34±0.91）pg/mL,P〈0.05],AQP2蛋白表达增加（0.95±0.12 vs.0.12±0.07、0.44±0.06、0.24±0.06,P〈0.05）。（3）抑郁组贝那普利治疗亚组与对照组非药物治疗亚组、对照组贝那普利治疗亚组比较,糖水偏爱性均减低（P〈0.05）,体质量和旷场实验评分均明显下降（P〈0.05）,血浆血管加压素浓度升高[（4.55±0.69）pg/mL vs.（3.04±0.97）pg/mL、（2.34±0.91）pg/mL,P〈0.05],AQP2蛋白表达增加（0.62±0.17 vs.0.12±0.07、0.44±0.06,P〈0.05）。（4）对照组贝那普利治疗亚组与抑郁组非药物治疗亚组比较,糖水偏爱性亦增加（P〈0.05）,体质量和旷场实验评分升高（P〈0.05）,血浆AVP浓度下降[（4.55±0.69）pg/mL vs.（9.31±0.42）pg/mL,P〈0.05],AQP2蛋白表达减少（0.62±0.17 vs.0.95±0.12,P〈0.05）。结论抑郁可以促进自发性高血压大鼠血管加压素的分泌及肾脏AQP2的表达。抑郁可能通过促进血管加压素的分泌及肾脏AQP2的表达影响高血压的发展。     

Cortisol dysregulation and cognitive impairment in abstinent male alcoholics

BACKGROUND: Alcoholics have impaired cortisol response to stress, indicating dysregulation in the extrahypothalamic systems responsible for activating cortisol secretion in response to stressor exposure. There is a growing literature indicating a relationship between hypothalamic-pituitary-adrenocortical axis activity and neurocognitive functioning. This study examined the hypothesis that dysregulation of the hypothalamic-pituitary-adrenocortical axis may be associated with some neuropsychological impairments in alcoholics. METHODS: Serum cortisol was obtained during cognitive testing and after exposure to cold pressor and mental arithmetic stress in 48 male alcoholics abstinent for 32 +/- 6.7 days and in 30 controls; cortisol was also obtained from 18 of the alcoholic patients during withdrawal. Neurocognitive tasks included the Wechsler Memory Scale and Wisconsin Card Sorting Test. Relationships among alcoholics' cognitive test scores, cortisol levels, and drinking practices were examined by correlation and regression analyses. RESULTS: Verbal memory deficits were more severe in alcoholics who had more withdrawals and ingested a higher typical quantity of alcohol during the prior year ( p< 0.05). Higher levels of cortisol during withdrawal, an index of withdrawal severity, were associated with more errors on the Wisconsin Card Sorting Test ( p< 0.005). As previously reported, the alcoholics had lower cortisol levels after stress compared with controls. Lower poststress cortisol levels were associated with poorer logical memory on the Wechsler Memory Scale and more errors on the Wisconsin Card Sorting Test ( p< 0.05). Among controls, memory deficits occurred only in relation to higher poststress cortisol levels. CONCLUSIONS: Poorer cognitive performance in alcoholics was related to more withdrawals, heavier alcohol consumption, and higher cortisol levels during a recent withdrawal. Alcoholics' cognitive impairment was also related to attenuated stress cortisol responses. Altered stress regulation of the hypothalamic-pituitary-adrenal axis should be studied further as a potential factor related to impaired cognitive function in recovering alcoholics.     

血小板膜糖蛋白和D-二聚体变化与老年冠心病合并高血压患者的研究

目的探讨老年冠心病合并高血压患者体内血小板膜糖蛋白(GP)、D-二聚体的变化及意义。方法选择老年冠心病患者116例,其中稳定性心绞痛(SAP)患者36例(SAP组),不稳定性心绞痛(UAP)患者38例(UAP组),UAP合并高血压患者42例(高血压组),健康体检者48例(对照组),冠心病患者根据有无心绞痛事件发生分为有心绞痛事件发生56例和无心绞痛事件发生60例。分别测定各组体内D-二聚体、GP水平,分析有无心绞痛事件发生之间的差异,检测其与心绞痛事件发生的敏感性。结果高血压组、UAP组D-二聚体、GP水平明显高于SAP组、对照组(P<0.05,P<0.01);高血压组D-二聚体、GP水平明显高于UAP组(P<0.05);有心绞痛事件发生患者D-二聚体、GP水平明显高于无心绞痛事件发生患者(P<0.01);有心绞痛事件阳性检出率D-二聚体、GPⅡb、GPⅢa敏感性较GPⅠb明显增高。结论 GP、D-二聚体在老年冠心病合并高血压患者心绞痛事件发生中起重要的作用,D-二聚体、GPⅡb、GPⅢa可以作为预测心绞痛事件发生较为敏感的指标。     

不同类型老年高血压患者血浆同型半胱氨酸变化与动脉硬化的关系

目的比较不同类型老年高血压患者血浆同型半胱氨酸(Hcy)变化并探讨其与动脉硬化的关系。方法入选在我科住院及门诊就诊的老年高血压患者167例,分为老年单纯收缩期高血压患者(ISH组)79例及老年双期高血压患者(DH组,收缩压及舒张压均升高者)88例,另选择55例健康体检正常的老年人作为对照组,分别测定其血浆Hcy、测量踝肱指数(ABI)、颈动脉内膜中层厚度(IMT),比较各组血浆Hcy水平及其与ABI、IMT相关性。结果吸烟、舒张压水平及血清LDL-C水平3组间比较差异有统计学意义(P<0.05);与对照组比较,ISH组及DH组Hcy水平、IMT明显增高,ABI明显降低(P<0.05);与DH组比较,ISH组Hcy水平、IMT明显增高,差异有统计学意义(P<0.05)。结论老年ISH患者血浆Hcy水平较双期高血压患者及对照组明显增高,且与动脉硬化呈正相关,老年ISH患者在降压达标的同时更应关注降低血浆Hcy浓度。     

Wisconsin Card Sort Test performance in a healthy elderly population

A 64-card version of the Wisconsin Card Sort Test (WCST) was administered to 5 groups (n = 95), aged 17 to 25, 64 to 69, 70 to 74, 75 to 79 and 80 to 87 years. The elderly groups were chosen for their lack of medical problems in order to determine if previously reported age-related deficits were due to chronic medical problems or to aging per se. The resulting pattern of means showed statistically significant differences only for number of categories attained and total number of errors. For both variables, the 80- to 87-year-old group performed more poorly than the 64- to 69-year-old group. These results, although consistent with previous findings suggestive of frontal lobe vulnerability in old age, indicate that deterioration is less marked for a healthy elderly population.