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1.
目的观察类风湿关节炎(RA)患者焦虑抑郁情绪及其与主要症状体征、生活质量(QOL)的相关性,探讨RA患者抑郁情绪的机制。方法采用焦虑自评量表(SAS)和抑郁自评量表(SDS)、主要症状体征积分、生活质量量表对100例RA患者进行观察并做相关分析。结果(1)100例RA患者中,SAS标准分为(46.33±7.69),有焦虑症状者为37%;SDS标准分为(51.36±9.10),抑郁情绪的发生率为53%;两者均高于正常人;(2)SAS标准分与关节疼痛、关节压痛、关节重着、症状体征总积分呈正相关;SDS标准分与食欲减退、少气懒言、倦怠乏力、关节重着、症状体征总积分呈正相关,两者均与年龄、病程无关。(3)SAS、SDS标准分均与生理功能、社会功能、心理功能、健康自我认识能力及生活质量总积分呈正相关。结论类风湿关节炎患者存在一定程度的焦虑抑郁情绪,以抑郁情绪为主,RA患者的焦虑、抑郁情绪与病情及生活质量存在一定的相关性,提示其发生机制与生活质量下降有关。  相似文献   

2.
目的:调查2型糖尿病(T2DM)患者焦虑、抑郁发生情况并分析其与生活质量的相关性。方法:采用Zung焦虑自评量表(SAS)、抑郁自评量表(SDS)、中文版健康调查简表(SF-36)对天津4家三级甲等医院的234例T2DM患者的心理健康和生活质量进行横断面调查。结果:T2DM患者焦虑、抑郁的发生率分别为14.5%和18.4%。焦虑、抑郁评分高于国内常模,差异有统计学意义(P0.01)。SAS和SDS评分与SF-36量表8个维度均呈负相关(P0.01)。结论:T2DM患者存在焦虑、抑郁情绪障碍,且焦虑、抑郁情绪与生活质量存在相关性。  相似文献   

3.
目的探讨负性情绪对慢性病患者自我概念的影响。方法采用抑郁自评量表( SDS)、焦虑自评量表( SAS)及田纳西自我概念量表( TSCS)对100例慢性病患者进行测评,并与100例健康人群进行比较。结果慢性病患者SDS、SAS评分均明显高于健康人群(均P<0.01),慢性病患者TSCS评分明显低于健康人群( P<0.01),TSCS值与SDS、SAS值均呈负相关性(均P<0.01)。结论慢性病患者自我概念水平较差,焦虑抑郁情绪能够降低自我评价,临床治疗中应帮助患者消除负性情绪,提高心理健康水平。  相似文献   

4.
目的:观察强直性脊柱炎(AS)患者焦虑、抑郁情绪的变化情况,探讨影响AS患者焦虑、抑郁情绪的相关机制.方法:采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、健康状况调查问卷(WHOQOL-BREF表)和流式细胞仪检测CD4+CD25nt/hiCD12710调节性T细胞表达频率,观察57例AS患者,并进行相关分析.结果:94例AS患者中有55.3%的患者生活质量受到影响,有焦虑、抑郁情绪分别占44.7%和占76.5%;其急性时相反应物指标ESR、CRP、а1-AGP升高和调节T细胞表达频率水平降低.SAS标准分和SDS标准分与总体评分、生活质量(P<0.01)、疾病活动性指标、CD4+CD25nt/hiCD12710调节性T细胞的表达频率呈负相关;与BASDAI、BASFI、BAS-GS和症状总积分呈正相关(P<0.05或P<0.01).结论:AS患者存在一定程度的焦虑、抑郁情绪,以抑郁情绪为主,与生活质量、疾病活动性指标和CD4+Cd25nt/hiCD12710调节性T细胞的表达频率相关.  相似文献   

5.
目的:探讨护理干预对膀胱癌(BC)患者焦虑、抑郁状态的影响。方法:采用Zung焦虑自评量表(SAS)、抑郁自评量表(SDS)对46例BC患者护理干预前后的焦虑和抑郁状态进行调查分析并比较。结果:46例BC患者护理干预前SAS评分和SDS评分与国内常模比较差异有统计学意义(P<0.01);护理干预后患者焦虑、抑郁发生率及SAS评分、SDS评分均低于护理干预前(P<0.05,P<0.01)。结论:BC患者存在明显的焦虑、抑郁状态,在临床治疗过程中给予积极护理干预可有效缓解其焦虑、抑郁情绪。  相似文献   

6.
目的:探讨空巢老年糖尿病住院患者焦虑、抑郁与生存质量的现状及相关性,为制定相应的干预方案提供参考依据。方法:采用自评焦虑量表(SAS)、自评抑郁量表(SDS)和中国糖尿病患者生存质量特异性量表(DSQL)对43例空巢老年糖尿病住院患者进行问卷调查。结果:空巢老年糖尿病住院患者的焦虑得分(46.16±9.95)分,抑郁得分(57.12±8.81)分,生存质量得分(53.91±8.91)分,95.3%的患者为中等水平的生存质量状况;相关性分析显示,焦虑与生存质量呈正相关(P0.01),抑郁与生存质量不相关(P0.05)。结论:空巢老年糖尿病住院患者的焦虑、抑郁发生率高,生活质量状况堪忧,空巢老年糖尿病患者焦虑抑郁的负性情绪降低患者的生活质量,护理人员应加强对空巢老年糖尿病住院患者的心理干预,进而改善并提高患者的生存质量。  相似文献   

7.
目的:探讨心理干预对缓解膀胱癌患者膀胱全切加回肠膀胱术(Bricker)术后患者焦虑抑郁状态的影响,为临床治疗提供客观依据.方法:对27例膀胱癌患者行Bricker手术,并在常规护理基础上给予系统的心理干预,于心理干预前后应用Zung焦虑自评量表(SAS)和抑郁自评量表(SDS)进行评分.结果:心理干预前患者平均SAS、SDS评分与国内常模比较,差异有统计学意义(P<0.01,P<0.05);心理干预后患者焦虑抑郁发生率及评分均低于干预前(P<0.01,P<0.05).结论:对膀胱癌Bricker手术患者实行心理干预能减轻其焦虑抑郁情绪,提高患者生活质量.  相似文献   

8.
目的:调查分析糖尿病患者焦虑、抑郁共病情况,为制定有效预防、干预措施提供临床依据。方法:将93例住院糖尿病患者作为观察组,将77例健康体检者作为对照组,应用抑郁自评量表(SDS)和焦虑自评量表(SAS)评估比较两组焦虑、抑郁情况。结果:观察组SDS、SAS分值及抑郁、焦虑发生率均显著高于对照组(P<0.01)。结论:糖尿病与抑郁、焦虑具有高相关性,对糖尿病患者实行心理干预有利于改善其负性情绪,减轻临床症状,提高治疗依从性和生活质量。  相似文献   

9.
目的 初步探讨心理应激性失眠患者焦虑抑郁情绪特征及其与个性行为的相关性.方法 采用焦虑自评量表(SAS)与抑郁自评量表(SDS)及A型行为类型问卷(TABP)对56例心理应激性失眠患者的焦虑抑郁情绪及个性行为进行评估.结果 心理应激性失眠患者的SAS及SDS评分明显高于常模(P<0.01);按SAS、SDS分级标准,中度以下焦虑患者54例(96.4%),中度以下抑郁患者50例(89.3%),但焦虑抑郁情绪严重程度总体分布情况无统计学意义(P0.05);56例患者中属于A-型人格22例,明显多于A型(8例)、M型(5例)、B-型(13例)及B型(8例).结论 心理应激性失眠患者存在明显的焦虑抑郁情绪.  相似文献   

10.
《中华现代护理杂志》2005,11(20):1685-1687
目的调查类风湿关节炎(Rheumatoid Arthritis,RA)患者抑郁焦虑情绪发生率及其相关因素.方法采用Zung抑郁自评量表(SDS)及焦虑自评量表(SAS)和肖水源的社会支持量表调查58例RA患者,以压痛关节数多少分组,进行对照比较.结果类风湿关节炎患者抑郁、焦虑情绪发生率分别为46.55%(27/58)和39.66%(23/58).其中抑郁症状以晨重晚轻、能力减退、易激怒、疲乏、性兴趣减退列前五位.而焦虑以静坐不能、乏力、睡眠障碍、不幸预感、多汗等症状常见.抑郁、焦虑情绪与RA患者关节压痛数(P<0.01)、关节肿胀数(P<0.01)呈正相关,与握力(P<0.01)呈负相关,与晨僵、年龄、病程、社会支持(P>0.05)无明显相关性.结论RA患者存在焦虑、抑郁情绪,焦虑、抑郁与患者的关节压痛数、关节肿胀数、握力有关.  相似文献   

11.
本文详细介绍了创伤后血糖应激适度理论,以及高血糖与感染和多器官功能不全综合征的关系;提出涉及胰岛B细胞功能不全的MODS实验诊断新方案和极化液个体化干预新措施,可早期发现创伤MODS、降低感染率及MODS发生率和病死率。  相似文献   

12.
目的:探讨腹膜后纤维化(RPF)导致肾积水的原因及诊治经验。方法:回顾分析2004年1月—2010年12月24例腹膜后纤维化致肾积水患者的诊治资料。结果:(1)RPF患者常见首发症状为腰背痛或腹痛(69.2%);(2)红细胞沉降率(ESR)增快和血清IgG4升高最常见。超声检查仅提示上尿路积水。RPF的静脉肾盂造影(IVP)和CT尿路成像(CTU)表现具有特征性。IVP肾盂输尿管显影不良时,CTU能较清晰的显示上尿路影像。CT扫描发现腹膜后软组织肿块9例(37.5%),优于超声检查;(3)输尿管松解和腹腔化手术治疗22例;行肾切除术1例;行输尿管置双J管术1例。最终确诊为继发性RPF8例,其中4例为术前诊断,3例为术中腹膜后软组织肿块冷冻活检证实,1例为术后病理证实;(4)特发性RPF手术后肾积水均获长期缓解,而继发性RPF的预后取决于原发疾病及其治疗方案。结论:影像学检查是诊断RPF的重要手段,CTU优于超声检查和IVP。输尿管松解和腹腔化手术可以使特发性RPF输尿管梗阻得到长期的缓解,术中对肿块进行冷冻活检有助于鉴别特发性和继发性RPF,及时调整治疗方案。  相似文献   

13.
It is remarkable that migraine is a prominent part of the phenotype of several genetic vasculopathies, including cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL), retinal vasculopathy with cerebral leukodystrophy (RVCL) and hereditary infantile hemiparessis, retinal arteriolar tortuosity and leukoencephalopahty (HIHRATL). The mechanisms by which these genetic vasculopathies give rise to migraine are still unclear. Common genetic susceptibility, increased susceptibility to cortical spreading depression (CSD) and vascular endothelial dysfunction are among the possible explanations. The relation between migraine and acquired vasculopathies such as ischaemic stroke and coronary heart disease has long been established, further supporting a role of the (cerebral) blood vessels in migraine. This review focuses on genetic and acquired vasculopathies associated with migraine. We speculate how genetic and acquired vascular mechanisms might be involved in migraine.  相似文献   

14.
Fibrinogen and fibrin structure and functions   总被引:12,自引:0,他引:12  
Fibrinogen molecules are comprised of two sets of disulfide-bridged Aalpha-, Bbeta-, and gamma-chains. Each molecule contains two outer D domains connected to a central E domain by a coiled-coil segment. Fibrin is formed after thrombin cleavage of fibrinopeptide A (FPA) from fibrinogen Aalpha-chains, thus initiating fibrin polymerization. Double-stranded fibrils form through end-to-middle domain (D:E) associations, and concomitant lateral fibril associations and branching create a clot network. Fibrin assembly facilitates intermolecular antiparallel C-terminal alignment of gamma-chain pairs, which are then covalently 'cross-linked' by factor XIII ('plasma protransglutaminase') or XIIIa to form 'gamma-dimers'. In addition to its primary role of providing scaffolding for the intravascular thrombus and also accounting for important clot viscoelastic properties, fibrin(ogen) participates in other biologic functions involving unique binding sites, some of which become exposed as a consequence of fibrin formation. This review provides details about fibrinogen and fibrin structure, and correlates this information with biological functions that include: (i) suppression of plasma factor XIII-mediated cross-linking activity in blood by binding the factor XIII A2B2 complex. (ii) Non-substrate thrombin binding to fibrin, termed antithrombin I (AT-I), which down-regulates thrombin generation in clotting blood. (iii) Tissue-type plasminogen activator (tPA)-stimulated plasminogen activation by fibrin that results from formation of a ternary tPA-plasminogen-fibrin complex. Binding of inhibitors such as alpha2-antiplasmin, plasminogen activator inhibitor-2, lipoprotein(a), or histidine-rich glycoprotein, impairs plasminogen activation. (iv) Enhanced interactions with the extracellular matrix by binding of fibronectin to fibrin(ogen). (v) Molecular and cellular interactions of fibrin beta15-42. This sequence binds to heparin and mediates platelet and endothelial cell spreading, fibroblast proliferation, and capillary tube formation. Interactions between beta15-42 and vascular endothelial (VE)-cadherin, an endothelial cell receptor, also promote capillary tube formation and angiogenesis. These activities are enhanced by binding of growth factors like fibroblast growth factor-2 (FGF-2) and vascular endothelial growth factor (VEGF), and cytokines like interleukin (IL)-1. (vi) Fibrinogen binding to the platelet alpha(IIb)beta3 receptor, which is important for incorporating platelets into a developing thrombus. (vii) Leukocyte binding to fibrin(ogen) via integrin alpha(M)beta2 (Mac-1), which is a high affinity receptor on stimulated monocytes and neutrophils.  相似文献   

15.
16.
Summary. Telemedicine and teleradiology hold the key for improving future health care delivery. In this paper we first review current communication and computer technologies used in telemedicine and teleradiology. Five examples in teleradiology applications are given including hospital-integrated picture archiving and communication systems, tele-neuro-imaging, telemammography, university consortium teleradiology service, and teleradiology for second opinion. Parameters important to teleradiology applications like costs, image quality, system reliability, and turn around time are considered. Data security is discussed, including patient confidentiality and image authenticity-which will be a major issue in future teleradiology applications.  相似文献   

17.
目的探讨儿童慢性顽固性咳嗽与肺炎支原体(MP)感染的关系及临床疗效观察。方法采用回顾性研究方法对于现将2005年3月至2008年3月在我院的55例确诊慢性顽固性咳嗽患儿,主要表现为肺炎支原体感染为临床特点进行分析,并进一步临床治疗研究。结果①临床特点:在55例确诊慢性咳嗽的患儿中,以慢性顽固性咳嗽为主要症状。58%(32/55)的病例无肺部体征;②外周血:85%(47/55)的病例外周血变化不大,WBC(4—10)×10 9/L之间,嗜酸性粒细胞增多;③特别检查:47.27%(26/55)肺炎支原体IgM(MP—IgM)抗体阳性,83.64%(46/55)PeR技术检测肺炎支原体特异性DNA;④X光报告为多种形式。结论肺炎支原体(MP)感染是引起儿童慢性顽固性咳嗽的病因之一,对儿童慢性咳嗽,特别是顽固性咳嗽的诊治中应更加重视。  相似文献   

18.
Designing interprofessional primary care teams composed of physicians and nurse practitioners (NPs) is a national priority. We assessed how profession and gender affect teamwork and job satisfaction among primary care physicians and NPs by using survey data from 186 physicians and 398 NPs practicing in New York State. Our regression models show profession (NP vs physician) moderates the associations of gender with teamwork and job satisfaction. Among NPs, men had higher job satisfaction than women. Among physicians, women had higher job satisfaction than men. Our results can benefit interprofessional primary care teams to optimize their professional and gender mix.  相似文献   

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Abstract

Acetylcysteine has been utilized successfully in the treatment of acetaminophen overdose since the 1970s. Although prospective trials as to efficacy and safety of acetylcysteine were conducted, there were no randomized controlled trials. This commentary addresses the reasons for this, and the background to choice of dose of acetylcysteine utilized in the oral and IV dosing regimens. Nomograms to predict possible hepatotoxicity based upon time of ingestion of acetaminophen were developed from a relatively arbitrary definition of toxicity as an aspartate aminotransferase/alanine aminotransferase (ALT/AST) greater than 1000 IU/L. While these have proved generally useful, patients still continue to develop hepatic damage after acetaminophen overdose, particularly if they present late after ingestion. The optimum management of these patients remains unclear, and one area of uncertainty is the dose and duration of acetylcysteine in various circumstances. This article discusses the issues that need to be elucidated to better target changes in acetylcysteine dose. The potential for measurements of other markers to improve treatment selection is the subject of further research.  相似文献   

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