高血压,年龄与Ⅱ型糖尿病患病率的关系研究

对湖北省部分地区２５岁及以上的９４５０名居民进行了高血压、年龄与Ⅱ型糖尿病——非胰岛素依赖型糖尿病（ＮＩＤＤＭ）及糖耐量低减（ＩＧＴ）患病率关系的流行病学研究。结果表明：２５岁及以上的ＮＩＤＤＭ患病率为２．６２％，ＩＧＴ患病率为４．４８％，男女性的ＮＩＤＤＭ与ＩＧＴ患病率差别无统计学意义（Ｐ＞０．０５），高血压患者中，ＮＩＤＤＭ和ＩＧＴ患病率分别为６．７５３％和９．６３３％，非高血压者ＮＩＤＤＭ和ＩＧＴ患病率仅为２．３４８％和３．７９０％，前者分别为后者的２．９倍和２．５倍，二者的标准化患病率差别仍有统计学意义。     

糖尿病母亲的婴儿随访及家系调查

目的 为观察糖尿病母亲的婴儿（ＩＤＭＳ）生长发育状况及探讨ＩＤＭＳ与糖尿病的相关性。方法 对３３例ＩＤＭＳ进行定期体格发育随访和智商（ＩＱ）测定及家系调查，结果 （１）体格发育及ＩＱ处于正常范围；（２）检出糖尿病患儿（女，９．９岁）１例，患病率为３．０３％；（３）３１个家系中糖尿病家族史阳性家系２１个，占６６．７％。结论ＩＤＭＳ糖尿病患病风险高于群体，其遗传背景与糖尿病患儿显示一致性。强调对ＩＤＭ     

天津市部分居民老年期痴呆的流行病学调查

目的：了解天津居民老年期痴呆的患病情况,为其预防提供科学依据。方法：采用ＭＭＳＥ,ＨＤＳ,ＦＡＱ三种痴呆评量表的得分,用时情况,对天津干部疗养院和河西居民区老年人群进行抽样调查。结果;干疗组与河西组痴呆患病率分别为１２．１％,４０．９％,血管性痴呆多于老年性痴呆,并发现痴呆患病率受多种因素影响。结论痴呆患病率增高与高龄,文化程度低,女性,患多种老年病等危险因素存在密切关系,提示预防老年期痴呆的发生     

山东省糖尿病患病现况与流行因素研究

以分层整群随机抽样方法对２０２２８人糖尿病患病情况进行了流行病学调查，结果发现：总患病率为１０．９３‰，ＩＤＤＭ占４．５％，ＮＩＤＤＭ占９５．５％；总患病率随年龄递增，≥６０岁达５５．６‰；城市患病率（２３．５‰）最高，其次为海岛、沿海居民（２１．４‰），农村最低（４．２２‰）；男、女患病率差异无显著性；调查中新诊断的病人占病人总数３３．５％。对２１１例ＮＩＤＤＭ患者进行的流行因素的病例对照分析发现：最终进入多因素Ｌｏｇｉｓｔｉｃ回归模型有意义的因素有家族史系数、ＢＭＩ、喜素食和高血压，ＯＲ值分别为３．３２、２．８９、０．３８和１．６７。交互作用分析表明，阳性家族史与体重超重或不良饮食习惯二因素并存者，特别是该三因素并存者为ＮＩＤＤＭ社区干预的重点人群     

平顶山煤矿区人群糖尿病流行病学研究

１９９６年５－８月对平顶山煤矿区２０－７４岁人群进行了糖尿病（ＤＭ）流行病学抽样调查，共调查３３８０人，发现ＤＭ１３７人，患病率为４．０５％，糖耐量低减（ＩＧＴ）１４３人，患病率为４．２３％，经１９９０年全国人口年龄标化后，ＤＭ患病率为４．８２％，ＩＧＴ患病率为３．８７％。ＤＭ、ＩＧＴ的患病率随年龄增加明显上升。男性ＤＭ年龄标化患病率为５．１１％，与女性（４．８９％）相比，无统计学差异，男性ＩＧＴ     

河北省糖尿病流行病学研究

为探索河北省城乡非胰岛素依赖型糖尿病（ＮＩＤＤＭ）流行趋势和患病的危险因素，对６个城乡进行了抽样调查和分析。结果表明，抽样人口ＮＩＤＤＭ患病率为２．７９％，标化率２．３４％；城市人口患病率３．０３％，农村为２．５６％；人均收入高的城乡，ＮＩＤＤＭ患病率亦高。高龄、肥胖、阳性家族史者是ＮＩＤＤＭ的高危人群。经多因素分析，人均收入高及饮食开支大、家族史、肥胖及肉、蛋、油、奶类的大量摄入是ＮＩＤＤＭ高发的危险因素，玉米等粗粮摄入、体育锻练和职业体力劳动是保护因素。提示营养过剩、运动缺乏、教育不足是ＮＩＤＤＭ发病的主要原因。     

HIV-1感染与AIDS痴呆综合征

ＨＩＶ－１在中枢神经系统的感染是ＡＩＤＳ痴呆综合征（ＡＩＤＳＤｅｍｅｎｔｉａＣｏｍｐｌｅｘ，ＡＤＣ）形成的直接原因［１］。ＡＤＣ在临床上表现为认知，运动和行为机能障碍；在病理上表现为大脑萎缩及包括基底神经节在内的白质和深灰质结构异常。因此，了解ＨＩＶ...     

Ⅱ型糖尿病伴发冠心病患者血清脂质与丙二醛变化的临床观察

观察了４０例Ⅱ型糖尿病（ＮＩＤＤＭ）伴发冠心病（ＣＨＤ）患者及３２例ＮＩＤＤＭ无心脑肾并发症患者（对照组）血脂水平及丙二醛（ＭＤＡ）和超氧化物歧化酶（ＳＯＤ）的血清含量，结果显示，除胆固醇外，其余各指标两组间均有显著差异。ＣＨＤ组ＭＤＡ明显高于对照组，而ＳＯＤ则明显低于对照组。多元线性相关分析表明，低密度脂蛋白胆固醇与ＭＤＡ呈显著正相关（ｒ＝０．５７１２；Ｐ＜０．００１）。高密度脂蛋白胆固醇与ＳＯＤ呈显著正相关（（ｒ＝０．５１１２；Ｐ＜０．００１）。提示ＮＩＤＤＭ患者伴发冠心病高脂血症与脂质过氧化间有一定的关系。     

耐甲氧西林葡萄球菌感染基因诊断的实验研究

目的探明沈阳地区ＭＲＳＡ感染状况及耐药机理。方法采用酶标－多聚酶链式反应（ＥＤ－ＰＣＲ）方法对沈阳地区３所医院分离的７６株葡萄球菌耐甲氧西林（ＭｅｃＡ）基因进行检测。结果ＭｅｃＡ基因阳性２３株，耐甲氧西林葡萄球菌（ＭＲＳ）的检出率为３０．３％，其中耐甲氧西林金黄色葡萄球菌（ＭＲＳＡ）检出率占金黄色葡萄球菌总数的２１．７％。采用微量液体稀释法、琼脂稀释法以及ＭＲＳＡ鉴别培养法等３种方法与之相比较，经统计学处理ＥＤ－ＰＣＲ法与其它３种方法的一致性非常有意义（Ｐ＜０．０１）。以ＭＲＳＡ鉴别培养法作为诊断ＭＲＳ的参考标准，ＥＤ－ＰＣＲ法敏感性为９５．５％，特异性为９６．３％。结论ＥＤ－ＰＣＲ法与其它３种方法相比，具有简便、快速、敏感性高、特异性强等优点     

桂林市儿童Ⅰ型糖尿病发病率调查

为研究桂林市儿童Ⅰ型糖尿病（ＩＤＤＭ）发病情况,按照ＷＨＯ儿童糖尿病多国计划（ＷＨＯ ＤＩＡＭＯＮＤ计划）登记方法,采用捕获－ 再捕获方法进行调查。结果显示,１９８９～１９９８ 年间１５ 岁以下儿童发病率为：男性０．５８／１０ 万,女性０．６２／１０ 万,总发病率为０．６０／１０ 万;桂林市ＩＤ－ＤＭ 发病率与ＷＨＯ ＤＩＡＭＯＮＤ计划获得的多国发病率情况相一致,与东方及中国其他地区的情况也相近     

社区老年人痴呆流行病学调查

目的 :了解社区老年人痴呆的流行现状。方法 :采用整群抽样 ,以简易精神状态量表 (MMSE)法 ,对南海市桂城社区 14 18名 6 0岁以上老年人进行痴呆的流行病学调查。结果 :符合美国精神障碍诊断统计手册第 4版 (DSM- IV)和美国国立神经和语言障碍和卒中——老年性痴呆及相关疾病学会 (NINCDS- ADRDA)痴呆诊断标准者 6 5例 ,痴呆患病率 4 .5 8%。其中 Alzheim er病痴呆 (AD) 5 1例 ,患病率 3.6 0 % ,占 78.4 6 % ;血管性痴呆 (VD) 14例 ,患病率 0 .99% ,占2 1.5 4 %。痴呆及 AD患病率女性明显高于男性 (P<0 .0 1) ,而 VD患病率男女间差异无显著性 (P>0 .0 5 )。痴呆、 AD及 VD的患病率均随年龄的增长而增高 (P<0 .0 1)。文化程度越低 ,痴呆、 AD及 VD的患病率越高 (P<0 .0 5 )。结论 :社区痴呆患病率与世界各国报道相似 ;AD为主要类别 ;高龄、女性、低文化水平可能是痴呆的危险因素。     

泰安市老年人痴呆患病情况调查

目的 了解山东省泰安市老年人群痴呆的流行现状,为建立该病的预防与控制及制定老年健康服务措施提参考依据.方法 第1阶段采用整群抽样调查方法,以简易智能状态量表(MMSE)和问卷调查为测查工具,第2阶段临床诊断,由神经科医师对筛查阳性者进行临床检查,根据美国精神病学会的精神障碍诊断和统计手册第四版(DSM-IV)、美国神经病学、语言障碍和卒中-老年性痴呆和相关疾病学会(NINCDS-ADRDA)、美国神经病学、语言障碍和卒中-国际神经科学学会(NINCDS-AJREN)标准作出阿尔茨海默痴呆(AD)和血管性痴呆(VaD)的临床诊断.结果 对泰安市区5个居委会618名60岁～老年人进行调查,查出各类痴呆者52例,患病率为8.41%,其中阿尔茨海默病(AD)42例,血管性痴呆(VD)10例,二者患病率分别为6.79%和1.62%.结论 泰安市区老年期痴呆较我国以往报道的患病率为高.AD为主要类别,高龄、文化程度低和女性是痴呆患病的危险因素.     

Lewy body disease: first figures on its frequency in Spain

Lewy body disease (LBD) as a separate nosologic entity causing dementia in the elderly is being firmly established. To know its prevalence and characterization, we reviewed 549 consecutive autopsied brains in our Department. The age of death was 60 years or older in 391 subjects. Immunohistochemical staining with ubiquitin antibodies facilitated the identification of LB. Their specific density was measured (number per 100xfield) following a protocol in the predilection neocortical sites, entorhinal cortex, hippocampal gyrus, diencephalon and brainstem. We assessed the clinical features according to LB findings. Twelve brains (2.1%) had neocortical LB. Nine of them were diagnosed as diffuse Lewy body disease (DLBD). One more brain had nigral and neocortical LB leading to a pathological diagnosis of PD. In the remaining 2 cases, the finding of neocortical LB seems to be either incidental or asymptomatic or preclinical. Cognitive decline was mild to moderate in all subjects which had neocortical LB in 4 or more areas. However, the density of these LB does not correlate with the severity of dementia. Dementia was associated with minor parkinsonian symptoms and psychiatric features in the most of patients with DLBD. Thirty eight cases of the 391 (9.7%) older than 60 years in these series had been clinically diagnosed as senile dementia. Using accepted neuropathologic criteria, diagnoses were AD (63.1%), DLBD (21.05%) and vascular dementia (13.1%). These observation suggest that on consultant diagnosis of senile dementia, DLBD must be taken in account.     

The relationship between age and the prevalence of senile dementia: a meta-analysis of recent data.

A linear regression model derived from a meta-analysis of 13 epidemiological studies of senile dementia conducted since 1980, and employing internationally-known case-finding procedures, suggests a much lower general rate of dementia prevalence than has been previously estimated. An exponential increase with age is observed, with senile dementia prevalence diagnosed by Diagnostic and Statistical Manual (DSM-III) criteria doubling every 6 years and senile dementia of the Alzheimer's type (SDAT) every 4.2 years. Studies providing data for the oldest ages indicating a drop in the rate of increase after the age of 80 suggest that senile dementia may be age-related rather than ageing-related. Estimates derived from this model may provide a reasonably accurate means of estimating dementia prevalence in the general population. The limitations of this method for the purposes of prediction and studies of risk factors are discussed in relation to the hypothesized heterogeneity of senile dementia and possible cohort effects.     

河北省3632名城乡社区老年人慢性病及老年痴呆的现况调查

目的 了解河北省内城乡社区老年人群老年痴呆的流行现况.方法 采用多级分层整群抽样调查,利用简易智能状态检查表(MMSE)、日常生活能力量表(ADL)及相应的老年痴呆诊断标准,数据用SPSS 13.0软件进行统计学分析.结果 河北省城乡≥60岁老年人慢性病的总患病率为64.84%(2355/3632),男女性患病率和总患病率均随年龄增高而升高.老年痴呆总患病率为7.24%(263/3632),其中阿尔茨海默病(AD)为4.87%(177/3632),位于高血压(32.35%)、糖尿病(11.37%)、慢性阻塞性肺疾病(9.25%)、冠心病(8.84%)和脑卒中(7.16%)之后的第六位.AD 的患病率有随年龄增加而升高及随文化程度增高而降低的趋势.结论 河北省社区老年人包括AD在内的慢性病总患病率较高,AD已成为老年人主要慢性病,患病率随年龄增高而升高.     

老年性痴呆患者的记忆分析

目的：分析老年性痴呆患者的记忆等、各量表分。方法：应用修订韦氏记忆量表（ＷＭＳ）甲式,对３９例老年性痴呆患者的记忆等级、各量表分进行分析、比较。结果：本文显示且的１０个量表分和总量表分明显低于对照组,差异显著。记忆商数均低于平常水平,说明老年性痴呆患者记忆有不同程度的损害。讨论：老年性痴呆患者的记忆损害明显,因此应对老年性痴呆患者进行早期诊断、早期治疗、早期干预。     

贵阳市城区老年痴呆患病率调查

目的了解贵阳市城区老年痴呆的患病率及其流行特征。方法采用多级整群抽样方法。随机抽取贵阳市城区26个社区居委会的60岁及以上老年人群作为样本人群，采用二阶段调查方式进行研究。调查60岁及以上老年人3229名。资料比较用Y0检验或计算比值比（OR）。结果共发现痴呆患者64例，其中AD患者41例（占64．06％），VD患者18例（占28．13％），混合性痴呆2例（占3．13％），其他类型痴呆3例（占4．68％）。60岁以上人群痴呆及AD、VD的患病率分别为1．98％，1．27％和0．56％。痴呆、DA和VD的患病率随年龄的增加而显著增高，在男性和女性之间差异无统计学意义；随受教育程度的增高而显著降低；体力劳动者AD患病率显著高于脑力劳动者。丧偶者痴呆、AD的患病明显高于在婚者。结论贵阳市城区痴呆患病率水平接近全国城市人群平均水平。AD是痴呆患病的主要类型，高龄、低教育程度、丧偶的老年人群是痴呆患病的高危人群。     

The PREMAP Study: Prevalence and risk factors of dementia and clinically diagnosed Alzheimer's disease in Provence, France

The PREMAP Study investigated the prevalence and risk factors of dementia and Alzheimer's Disease (AD) in a random sample of 1062 residents 70 year old or more, living in south-eastern France (private homes and institutions). All persons living in institutions for the elderly (n = 258) and community dwellers (n = 804) scoring less than 24 points on the MMSE (18.4%) were invited to undergo a medical evaluation at home by a qualified neurologist using the CERAD battery. We found 177 cases of dementia (9.2%), including 82 cases of AD (5.5%). Prevalence of AD increased significantly with age and was higher among women (OR: 4.24) and persons with no formal educational level (OR: 2.47). While a MMS score less than 24 was more frequent among persons with a foreign native language (OR: 3.05), the OR of AD was not significantly associated with native language. The proportion of AD among persons suffering from senile dementia was 45% among elderly living in institutions and 69% among those living in the community. Prevalence rates in south-eastern France are similar to the average rates for Europe. This study underlines the need to investigate the relationships between native language, MMSE and AD on the one hand, and the link between a low MMSE score and institutionalisation of patients suffering from AD on the other.     

Apolipoprotein E, methylenetetrahydrofolate reductase (MTHFR) mutation and the risk of senile dementia--an epidemiological study using the polymerase chain reaction (PCR) method

We examined apolipoprotein E (Apo E) polymorphism and methylenetetrahydrofolate reductase (MTHFR) 677 C to T mutation by using the polymerase chain reaction (PCR) method in 100 elderly Japanese aged 60 or more, and assessed whether these genetic factors are associated with an increased risk for the clinical phenotypes of senile dementia, Alzheimer's disease (AD) and vascular dementia (VD) by cross-sectional survey. It was found that the Apo E epsilon 4 allele were associated with an increased prevalence of AD as previously reported. Although, it was not strongly related to the severity of senile dementia, a weak association between the ApoE genotype and the severity of dementia was suggested. The proportion of patients with senile dementia was higher in the group of carriers of MTHFR mutation than in the group of noncarriers. Furthermore, the proportion of male patients with senile dementia was higher in the group of homozygous for the mutation (+/+) than the group without the mutation (-/-). Notably in VD patients, 5 of 7 males had the +/+ genotype. The results suggest that the ApoE epsilon 4 genotype and the MTHFR mutation are associated with the clinical phenotype and the clinical onset of senile dementia.     

上海城乡老年期痴呆患者死亡率和生存预示因素研究

目的研究老年期痴呆的死亡率和影响患者生存的因素。方法在上海地区基线患病率调查的基础上随机选择5个居委会和4个村委会的居民为研究对象。通过简易精神筛查量表,按文化程度划分的分界值进行初筛。分界值以下和正常人的4%进入第二阶段细查。细查项目包括详细病史记录、体格检查和神经心理学检查。6个月后对所有进入细查的对象进行上述内容的复查。根据NINCDSADRDA和NINDAAIREN标准诊断阿尔茨海默病(AD)和血管性痴呆(VaD)。结果老年期痴呆患者的死亡率是6.06/1000人年。与非痴呆组相比,在随访40个月后,痴呆组的生存概率急剧下降57%,两者相比差异有统计学意义(P<0.05)。但AD和VaD间的生存率无统计学差异(P>0.05)。由痴呆、AD和VaD导致的死亡相对危险度(RR)值分别为1.63(95%CI:1.42～1.86)、1.71(95%CI:1.44～2.03)和1.45(95%CI:1.16～1.82)。增加患者死亡危险性的因素有年龄(RR=1.0685)、疾病程度(RR=1.5733)、高社会生活功能量表(ADL)值(RR=1.0368)。结论上海地区老年期痴呆的死亡率为6.06/1000人年。AD和VaD患者的生存概率没有明显差别。增加患者死亡危险性的因素有年龄、疾病程度和高ADL值。