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1.
目的探讨颈动脉狭窄与认知功能障碍的相关性。方法选择2011年5月至2014年2月邯郸市第一医院神经内科住院或门诊治疗的177例颈动脉狭窄患者为研究对象,根据颈动脉狭窄程度分为轻度狭窄58例,中度狭窄62例,重度狭窄57例,同期选择185例颈动脉未发生狭窄的门诊体检者作为颈动脉无狭窄组。比较各组受试者认知功能评分及完成时间,简易精神状态检查量表(MMSE)评分中各指标变化和合并症情况。结果中、重度狭窄组MMSE评分[(25.5±1.4)分、(23.8±1.3)分]显著低于轻度狭窄组[(28.7±1.7)分]和颈动脉无狭窄组[(29.2±1.6)分](P<0.05),而中、重度狭窄组完成时间[(8.1±1.1)min、(12.2±1.2)min]明显慢于轻度狭窄组[(5.6±1.3)min]和颈动脉无狭窄组[(4.8±1.5)min](P<0.05),重度狭窄组MMSE评分则明显低于中度狭窄组(P<0.05),而完成时间明显慢于中度狭窄组(P<0.05);颈动脉狭窄组患者MMSE评分中定向力、延迟回忆力、注意计算力、即刻回忆力、语言能力显著低于颈动脉无狭窄组(P<0.05),且随着狭窄程度加重上述指标均显著降低(P<0.05);颈动脉狭窄组患者糖尿病、短暂性脑缺血发作、高血压、脑白质病变及高尿酸血症发生率均显著高于颈动脉无狭窄组(P<0.05或P<0.01)。结论认知功能障碍与颈动脉狭窄存在一定的相关性,且随着狭窄程度的逐渐加深,认知功能损害程度也越严重。  相似文献   

2.
《新乡医学院学报》2017,(2):154-156
目的比较文拉法辛与舍曲林治疗老年抑郁症的临床效果。方法 2014年6月至2015年6月新乡医学院第一附属医院收治的老年抑郁症患者110例,按照随机数字表法分为文拉法辛组(n=55)和舍曲林组(n=55),分别给予文拉法辛和舍曲林治疗2个月,比较2组患者的临床治疗总有效率、抑郁状况、认知功能改善情况及不良反应发生率。结果 2组患者的治疗总有效率比较差异无统计学意义(χ2=0.326,P>0.05)。治疗前文拉法辛组和舍曲林组患者的汉密尔顿抑郁量表(HAMD)评分、威斯康星卡片分类测试(WCST)总应答数、持续性错误数、非持续性错误数、正确应答数、完成分类数指标比较差异均无统计学意义(P>0.05)。治疗后2组患者的HAMD评分均较治疗前显著降低,且文拉法辛组患者的HAMD评分低于舍曲林组(P<0.05)。治疗后,2组患者的WCST总应答数、持续性错误数、非持续性错误数均较治疗前明显降低(P<0.05),正确应答数、完成分类数指标均较治疗前明显增高(P<0.05);且文拉法辛组患者的WCST总数、持续错误数、随机错误数低于舍曲林组(P<0.05),正确应答数、完成分类数高于舍曲林组(P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论老年抑郁症患者应用文拉法辛与舍曲林治疗均有较好的临床治疗效果,但文拉法辛在改善患者的抑郁症状和认知功能障碍方面优于舍曲林。  相似文献   

3.
目的:探讨颈动脉粥样硬化与脑梗死患者认知功能障碍的关系。方法:选择2020年1月-2021年3月于浙江省台州医院诊断治疗的脑梗死患者60例为研究对象。根据患者治疗后3个月MMSE评分结果分为认知功能障碍组(观察组)33例,认知功能正常组(对照组)27例。比较两组的颈动脉狭窄程度、IMT、斑块面积、斑块形态,分析颈动脉狭窄程度、IMT、斑块面积、斑块形态与MMSE评分的相关性。结果:观察组颈动脉内膜中层厚度、斑块面积显著高于对照组,差异有统计学意义(P<0.05);两组斑块形态分布比较,差异无统计学意义(P>0.05)。观察组颈动脉狭窄程度显著高于对照组,差异有统计学意义(P<0.05);观察组重度狭窄的例数要高于对照组,秩和检验结果显示,两组不同狭窄程度的分布存在差异(P<0.05)。颈动脉内膜中层厚度与MMSE评分呈显著负相关(r=-0.881)。斑块面积与MMSE评分呈显著负相关(r=-0.890)。颈动脉狭窄程度与MMSE评分呈显著负相关(r=-0.903)。结论:认知功能障碍是脑梗死后的常见并发症,患者颈动脉粥样硬化斑块的面积、颈动脉IMT、颈动脉狭窄程度与认知功能障碍有显著的相关性。  相似文献   

4.
目的探究颈动脉血管超声及头颈电子计算机断层扫描血管造影(CTA)在脑梗死并颈动脉狭窄患者血流动力学状态评估中的应用。方法回顾性分析52例于我院接受颈动脉血管超声检查提示存在颈动脉狭窄的脑梗死患者临床资料,超声检查3d内均完成头颈CTA及CT灌注扫描检查(CTP),另选择30例健康体检者为对照组,进行CTA及CTP检查,分析患者和健康体检者检查结果及不同颈动脉狭窄患者血流动力学指标差异。结果52例患者经颈动脉血管超声、头颈CTA共检查119支颈内动脉,对应显示46支和43支颈内动脉正常,73支和76支颈内动脉狭窄,颈动脉狭窄对应包括轻度11支和16支、中度13支和11支、重度29支和25支、闭塞20支和24支,颈动脉血管超声与头颈TCA评价颈动脉狭窄程度的一致性评价Kappa=0.788,具有极高一致性(P<0.05);颈动脉血管超声显示,轻、中、重度狭窄及闭塞患者颈内动脉收缩期峰值流速(PSV)、舒张期末流速(EDV)水平均显著高于对照组(P<0.05),重度狭窄和闭塞患者大脑中动脉搏动指数(PI)、平均血流速度(Vm)水平显著低于对照组(P<0.05);脑梗死并颈动脉狭窄患者颈内动脉PSV、EDV水平由低到高依次为轻度、中度、重度狭窄和闭塞(P<0.05),重度狭窄及闭塞患者大脑中动脉PI、Vm水平显著低于轻度和中度狭窄患者(P<0.05),重度狭窄及闭塞患者侧肢循环开放率大于轻、中度狭窄患者(P<0.05),闭塞患者侧肢循环开放率大于重度狭窄患者(P<0.05);对照组和轻度、中度狭窄患者额叶、颞叶、基底节区脑血流动力学参数比较差异无统计学意义(P>0.05);重度狭窄、闭塞患者额叶、颞叶、基底节区脑血流量低于对照组体检者及轻度、中度狭窄患者(P<0.05),脑血容量、平均通过时间、达峰时间高于对照组体检者及轻度、中度狭窄患者(P<0.05)。结论颈动脉血管超声配合头颈CTA及CTP检查能够了解脑梗死伴颈动脉狭窄患者血流动力学状态,评价患者颈动脉狭窄程度,为临床诊疗提供有效的影像学信息。  相似文献   

5.
目的 探讨短暂性脑缺血发作(TIA)患者血清肝细胞生长因子(HGF)水平与颈动脉狭窄程度的关系.方法 选择TIA患者64例和28例健康对照者,采用数字减影血管造影(DSA)判断TIA患者颈动脉狭窄程度,分为颈动脉轻度、中度和重度狭窄组,测定3组患者的血清HGF水平并进行比较.结果 各狭窄组患者血清HGF水平均显著高于正常对照组(P<0.01),重度狭窄组患者的血清HGF水平高于中度狭窄组(P<0.05),中度狭窄组患者的血清HGF水平高于轻度狭窄组(P<0.05) .结论 血清HGF水平与颈动脉狭窄程度相关,可作为判断早期动脉粥样硬化性病变的指标.  相似文献   

6.
目的 探讨精神分裂症患者共情能力及其与执行功能的关系.方法 采用人际指针量表(IRI-C)对74例精神分裂症患者进行测试,与69名正常对照者比较,同时作威斯康星卡片分类测验(WCST)、Stroop色词干扰测验和空间n-back测验评估.结果 与对照组相比,患者组IRI-C总分[(46.8±10.0)分,(51.5±9.7)分,(P<0.01)]及观点采择[(9.5±4.2)分,(12.2±3.9)分,(P<0.01]、想象力[(12.5±4.2)分,(15.5±3.8)分,(P<0.01]、共情性关心[(15.9±4.2)分,(17.3±3.4)分,(P<0.05]均显著较低,而个人痛苦[(8.8±5.1)分,(6.5±3.7)分,(P<0.01]则显著较高.WCST、Stroop测验和空间n-back测验各项评分,2组间差异具有显著性意义(均P<0.01).Pearson相关分析显示,IRI-C总分与WCST卡片分类测验的总应答数(r=-0.293)、错误应答数(r=-0.253)和非持续性错误数(r=-0.272)呈负相关(均P<0.05),共情关心分与WCST总应答数(r=-0.326,P<0.01)、错误应答数(r=-0.300,P<0.01)、持续性应答数(r=-0.294,P<0.01)和持续性错误数(r=-0.287,P<0.05)呈负相关,而与概念化水平数呈正相关(r=0.279,P<0.05);IRI-C的幻想力分与Stroop测验的B项(r=-0.299)和C项(r=-0.322)反应时存在负相关(均P<0.01).结论 精神分裂症患者存在广泛共情和执行功能障碍,情感共情水平与执行功能存在某种关联,提示执行功能障碍可能构成患者共情缺陷的病理机制之一.  相似文献   

7.
目的:探究并分析颈动脉内膜剥脱术及颈动脉支架置入术对脑缺血患者血流动力学及认知功能的影响.方法:选取2017年2月—2020年2月收治的91例颈动脉狭窄引起的脑缺血患者,按照随机数字表法将其分为观察组(45例)和对照组(46例).对照组患者采用颈动脉内膜剥脱术,观察组采用颈动脉支架置入术.观察并记录两组患者一般资料(包括年龄、病程、收缩压、颈动脉内膜厚度等),手术前后脑血流指标(包括Vmean、Qmean、Wv、R),手术前后MMSE评分,血清γ-GGT、IL-6水平.结果:术前两组患者各脑血流指标比较,差异无统计学意义(P>0.05);两组患者术后脑血流指标均较术前明显改善(P<0.05),术后观察组脑血流指标明显优于对照组(P<0.05).两组患者MMSE评分比较差异显著(F=12.31,P=0.000;F=8.65,P=0.012;F=10.59,P=0.003),术后6 h、24 h两组患者MMSE评分均较术前显著降低(P<0.05),观察组术后6 h、24 h MMSE评分显著高于对照组(P<0.05).经重复方差分析,术前两组患者γ-GGT比较无明显差异(P>0.05),术后两组患者γ-GGT浓度均较术前显著降低(P<0.05),观察组患者术后6 h、术后24 h、术后48 hγ-GGT水平显著低于对照组(P<0.05);术前两组患者IL-6浓度比较差异无统计学意义(P>0.05),术后两组患者IL-6浓度均较术前显著升高(P<0.05),观察组患者术后6 h、术后24 h、术后48 h IL-6浓度显著低于对照组(P<0.05).结论:颈动脉支架置入术较颈动脉内膜剥脱术更能有效改善患者脑动脉血流及术后认知功能,减轻患者氧化应激反应,降低炎症因子水平,值得临床推广.  相似文献   

8.
目的:探讨血清S100B蛋白水平在早发精神分裂症患儿中的表达及意义。方法方便选择2015年5月—2016年1月间河南省精神病医院收治的90例早发精神分裂症患儿为观察组,同期72名健康儿童为对照组。采用Elisa法对两组儿童血清S100B水平进行检测。并采用威斯康星卡片分类测验(WCST)评估两组的认知功能指标(完成分数、错误应答数、完成第一个分类所需应答数、持续性错误数、持续性应答、非持续错误数)情况。结果观察组血清S100B水平为(0.163±0.040)μg/L显著性高于对照组的(0.129±0.033)μg/L(P<0.05)。观察组WCST各指标评分分别为(4.52±1.44)分、(44.37±12.46)分、(23.94±12.05)分、(8.86±3.14)分、(18.62±6.38)分、(35.17±14.33)分,均显著低于对照组的(5.49±1.27)分、(30.28±15.03)分、(16.07±9.17)分、(6.15±1.33)分、(12.65±5.34)分、(26.84±12.76)分(P<0.05)。血清S100B与WCST的非持续性错误、持续性应答、数错误应答数呈正相关性(r=0.403、0.368、0.364; P<0.05)。结论早发精神分裂症患儿血清S100B水平明显高于正常儿童,并与认知功能障碍呈正相关。  相似文献   

9.
《中国现代医生》2021,59(19):22-25
目的 探讨重复经颅磁刺激对精神分裂症患者认知功能的影响。方法 选择2019年7月至2020年5月在本院治疗的60例精神分裂症患者进行研究。所有患者随机分组,观察组30例,对照组30例。对照组给予氯氮平治疗,观察组给予氯氮平与rTMS治疗。比较两组治疗前后PANSS评分,智力状况(MMSE)以及认知功能水平(MMSE,BACS SC,HVLT-R,BVMT-R,WMS-ⅢSST,Stroop色-词测验,WCST)。结果 (1)治疗后,两组PANSS评分较治疗前显著下降,MMSE评分较治疗前高,差异有统计学意义(P0.05);观察组治疗后PANSS评分显著低于对照组,MMSE评分显著较对照组高,差异有统计学意义(P0.05)。(2)两组治疗后BACS SC、HVLT-R、BVET-R、WMS-ⅢSST、Stroop-词、Stroop-色、Stroop-色词、WCST总正确数、完成分类数较治疗前均较治疗前显著提高,差异有统计学意义(P0.05);两组WCST总错误数、持续错误数、持续应答数治疗后低于治疗前,差异有统计学意义(P0.05)。治疗后观察组BACS SC、HVLT-R、BVET-R、WMS-ⅢSST、Stroop-词、Stroop-色、Stroop-色词、WCST总正确数、完成分类数显著高于对照组,WCST总错误数、持续错误数、持续应答数较对照组低,差异有统计学意义(P0.05)。结论 在药物治疗基础上给予重复经颅磁刺激治疗,可显著改善患者精神分裂症评分以及认知功能。  相似文献   

10.
目的:探讨脑血管造影血流动力学改变对早期急性脑梗死患者临床神经功能的影响。方法:选取2019年1-9月本院收治的50例脑梗死患者,根据患者颈动脉狭窄情况将其分为轻度狭窄组10例、中度狭窄组15例、重度狭窄组15例、完全闭塞组10例。并选取同期于本院接受健康体检的健康者20例为对照组。对其进行数字减影全脑血管造影术检查,观察其血流动力学改变情况,对不同狭窄患者神经功能进行评估。结果:轻度、中度、重度狭窄组以及完全闭塞组的额叶CBV、MTT、TTP均高于对照组,CBF均低于对照组(P0.05);重度狭窄组以及完全闭塞组的额叶CBV、MTT、TTP均高于轻度狭窄和中度狭窄组,CBF均低于轻度狭窄和中度狭窄组(P0.05)。对照组、轻度狭窄组以及中度狭窄组的颞叶及基底节CBV、MTT、TTP均低于重度狭窄组和完全闭塞组,CBF均高于重度狭窄组和完全闭塞组,差异均有统计学意义(P0.05)。重度狭窄组和完全闭塞组的NIHSS评分以及CNFDS评分均高于轻度狭窄组和中度狭窄组,差异均有统计学意义(P0.05)。结论:对患者进行数字减影血管造影检查,可以准确评估患者血流动力学改变情况,患者血流动力学改变情况越明显,患者神经功能损伤越严重,可将数字减影血管造影作为早期急性脑梗死患者神经功能损伤评估指标。  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

14.
Shock wave lithotripsy (SWL) is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it's difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.  相似文献   

15.
Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.  相似文献   

16.
INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5  相似文献   

17.
People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.  相似文献   

18.
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…  相似文献   

19.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

20.
Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and > 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.  相似文献   

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