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1.
目的 探讨腔隙性脑梗死患者介入治疗术后认知的功能变化特点.方法 43例伴颈动脉狭窄的腔隙性脑梗死患者分别于术前及术后1个月、6个月、12个月进行神经心理学测验,并与41例正常人比较.结果 与对照组比较,治疗组患者术前简易智能状态检查量表( MMSE)评分[(26.33±1.94)分]、记忆力、执行能力均降低,差异有统计学意义(P<0.05或P<0.01).与术前比较,治疗组患者MMSE评分术后1月[(27.17 ±2.15)分]、术后6月[(27.78±2.12)分]、术后12月[(28.15±1.98)分],及记忆力、执行能力大都明显改善,差异有统计学意义(P<0.05或P<0.01).结论 腔隙性脑梗死患者急性期(发病1周内)大部分认知功能损害较重,介入治疗12月后大都恢复正常,其机制可能与慢性脑供血不足的改善有关.  相似文献   

2.
危薇  徐志彬 《海南医学》2012,23(2):29-31
目的 探讨癫痫患者的MMSE和MoCA评估的特点,研究两者的相关性,并评价其临床价值.方法 选择69例癫痫患者作为癫痫组,35例正常人为对照组,均进行简易精神状态检查量表(Mini mental state examination,MMSE)测查,排除得分低于正常值者,再进行蒙特利尔认知评估(Montreal cognitive assessment,MoCA),记录各项得分.结果 癫痫组的MMSE总分低于对照组(P<0.05),计算力和回忆认知功能水平下降(P<0.05);MoCA总分低于对照组(P<0.05),执行、注意和延迟回忆认知功能水平下降(P<0.05).癫痫组和对照组的MoCA与MMSE总得分成正相关(r=0.626,P<0.05),MoCA对MMSE达到正常值范围内的癫痫组的认知功能障碍检出率是49.3%.结论 癫痫患者的MMSE和MoCA评分均有降低,但MoCA相对MMSE敏感性较高,对评价其认知功能损害程度相对更为全面和客观.  相似文献   

3.
《中国现代医生》2020,58(7):40-43
目的 比较颈动脉支架植入(Carotid artery stent,CAS)与颈动脉内膜切除手术(Carotid endarterectomy,CEA)效果及血清基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)及选择性抑制剂-1(Tissue inhibitor of metalloproteinase-1,TIMP-1)变化。方法 选择我院于2016年1月~2019年1月收治的颈动脉狭窄患者86例,按照不同手术方法分为CAS组43例与CEA组43例,CEA组采用颈动脉内膜切除术,CAS组采用颈动脉支架植入,比较两组术后并发症,术前、术后1个月和术后3个月蒙特利尔认知评估(Montreal cognitive assessment,MoCA)量表和简易智力状态量表(Mini-Mental state examinatlon, MMSE)、血清MMP-9和TIMP-1水平变化。结果 CEA组并发症发生率(9.30%)低于CAS组(25.58%)(P0.05)。两组术后1个月和术后3个月MoCA评分和MMSE评分较术前增加(P0.05);两组术后1个月和术后3个月MoCA评分和MMSE评分比较差异无统计学意义(P0.05)。两组术后1个月和术后3个月血清MMP-9和TIMP-1水平较术前降低(P0.05);CEA组术后1个月和术后3个月血清MMP-9和TIMP-1水平低于CAS组(P0.05)。结论 颈动脉内膜切除手术治疗颈动脉狭窄患者效果优于颈动脉支架植入,术后并发症少,且减低MMP-9和TIMP-1水平明显,值得临床借鉴。  相似文献   

4.
  目的 比较简易精神状态(MMSE)量表与蒙特利尔认知评估(MoCA)量表(中文版)在腔隙性脑梗死患者认知障碍评估中的应用价值。方法 首先采用中文版MMSE量表对确诊为腔隙性脑梗死患者进行筛选,然后对经过受教育程度矫正后MMSE得分正常的患者采用中文版MoCA量表进行评分,以26分作为分界值。MoCA<26分者纳入腔隙性脑梗死认知功能障碍 (LI-CI) 组,MoCA≥26分者纳入腔隙性脑梗死认知功能正常 (LI-NC) 组,另选50例健康体检者作为对照(NC)组。比较3组患者MoCA总分及各个认知领域的得分情况。结果 MMSE得分正常的患者中53%(50/94)为MoCA评分<26分,其认知功能与MoCA评分≥26分的患者比较,差异有统计学意义﹙P<0.01﹚。LI-CI组在视空间与执行能力、命名、延迟记忆、抽象等认知领域得分低于LI-NC组(P<0.05)。结论 MMSE评分正常、MoCA评测异常的患者认知损害主要表现在视空间与执行功能、命名、延迟记忆、抽象等方面。MoCA量表在筛查腔隙性脑梗死患者认知障碍方面可能比MMSE量表更敏感。  相似文献   

5.
目的 探讨不同麻醉方式对老年腔隙性梗死患者术后认知功能的影响.方法 选择接受手术治疗的腔隙性脑梗死患者46例作为研究对象,按照手术麻醉方式分为硬膜外麻醉组与全身麻醉组.观察并比较两组患者术后认知功能障碍(POCD)的发生率、采用MMSE(简易智能状态检测法)评分以及中文版蒙特利尔认知估量表(MoCA)对患者术后短期认知功能进行评估.结果 与术前相比,两组患者MMSE及MoCA评分均显著降低,且具有统计学意义(P<0.05);与接受静吸复合全身麻醉的患者相比,接受硬膜外麻醉患者的术后6h、1d以及3d的POCD发生率、MMSE及MoCA评分均显著改善.结论 手术麻醉对老年腔梗患者认知功能会造成一定程度的损伤,但硬膜外麻醉方式较静吸复合麻醉带来的损伤小,可作为需进行手术治疗的老年腔梗患者的首选麻醉方式.  相似文献   

6.
目的:探究颈动脉狭窄(CAS)合并认知功能障碍(CI)患者支架植入后脑血流动力学(CHD)变化,以及CHD改善与CI的关系。方法选择江门市中心医院神经内科一区2012年1月至2013年6月入院的CAS合并CI患者26例,所有患者均行颈动脉支架植入术,分别在术前和术后采用蒙特利尔认知估量表(Montreal cognitive assessment,MoCA)、简易精神评估量表(MMSE)评价患者的认知功能,同时以64排螺旋CT进行灌注成像显影(CTP),统计患者狭窄血管供血区和非供血区(大脑后动脉供血区,一般选取狭窄血管同侧的枕叶)的相对脑血流量(rCBF)、相对脑血容量(rCBV)和相对达峰时间(rTTP)等CHD指标。结果患者MoCA、MMSE得分术前分别为(15.3±3.9)分、(21.0±3.4)分,术后3个月分别为(20.6±3.4)分、(25.2±3.0)分,术前术后MoCA、MMSE得分比较差异具有统计学意义(P〈0.05);狭窄血管供血区术前rCBF、rCBV和rTTP得分分别为(0.98±0.15)分、(0.97±0.12)分和(1.05±0.11)分,而术后分别为(0.96±0.11)分、(0.97±0.14)分和(1.00±0.06)分,rCBF和rTTP术前术后差异具有统计学意义(P〈0.05)。结论支架植入手术能显著改善CAS合并CI患者的CHD,同时也能改善患者的认知功能。  相似文献   

7.
目的 探讨简易精神状态测验量表(Mini-Mental Status Examination,MMSE)、蒙特利尔认知量表(Montreal CognitiveAssessment,MoCA)筛查急性脑梗死后患者发生认知异常的能力及认知损害情况;探讨脑白质损伤、脑白质内胆碱能通路损伤情况与认知损害间的相关性.方法 对88 例急性脑梗死患者予MMSE、MoCA 进行认知功能评定;完成颅脑磁共振成像(magneticresonance imaging,MRI)者予Fazekas 量表、胆碱能通路高信号评分量表(cholinergic pathways hyperintensities scale,CHIPS)测评.结果 MoCA 测评出认知异常者为83 例(94.32%),而MMSE 仅为22 例(25.00%);MoCA 测评两组间总分及各认知域比较在总分及视空间/ 执行功能、命名、语言、抽象、延迟记忆方面差异,且差异有统计学意义(P<0.05);MoCA 评分与Fazekas 量表评分、CHIPS 评分间存在相关性(r=-0.340,P=0.001;r=-0.343,P=0.001).结论 MoCA 较MMSE 筛查急性脑梗死后认知功能损害发生率敏感性高;脑白质损伤、脑白质内的胆碱能通路损伤程度与认知功能间存在可能的相关性.  相似文献   

8.
目的:观察应用MMSE量表和MoCA量表评估老年病人全麻术后的早期认知功能.方法:老年全麻手术病人66例,分别于术前ld和术后3h、6h、24h、48h应用MMSE量表和MoCA量表评估病人的认知功能.结果:病人术后3h、6h的MMSE、MoCA测试评分最低;术后各时间点的MoCA评分均明显低于MMSE评分(P<0.05).MMSE量表显示18.18%(12例)的病人术后出现认知功能障碍,MoCA量表显示25.76%(17例)的病人出现认知功能障碍,两种量表评估病人认知障碍发生率比较差异无统计学意义(P>0.05).结论:MoCA量表可作为评估老年病人全麻术后早期认知功能障碍的首选;MMSE和MoCA两种量表共同评估或MoCA量表较MMSE更适于评估老年病人术后早期的认知功能.  相似文献   

9.
目的探讨蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)(中文版)在腔隙性脑梗死患者认知功能障碍评估中的应用价值。方法首先采用中文版简易智能状态量表(Mini-Mental State Examination,MMSE)对确诊为腔隙性脑梗死患者进行筛选,然后对经过受教育程度矫正后MMSE得分正常的患者采用中文版MoCA进行评分,使用26分作为分界值。MoCA<26分者纳入腔隙性脑梗死认知功能障碍组(LI-CI组),MoCA≥26分者纳入腔隙性脑梗死认知功能正常组(LI-NC组)。比较两组患者MoCA评分、MMSE评分及MoCA各个认知领域得分情况。结果 MMSE得分正常的患者有53%(50/94)MoCA评分<26分,这些患者的认知功能与MoCA评分≥26分的患者比较,差异有统计学意义﹙P<0.01﹚;LI-CI组在视空间功能与执行功能、命名、抽象、延迟回忆认知领域方面得分低于LI-NC组,差异均有统计学意义(P<0.05)。结论 MoCA在筛查腔隙性脑梗死患者认知障碍方面可能比MMSE更为敏感,对于MMSE评分正常MoCA评测异常的患者认知损害主要表现在视空间与执行功能、命名、延迟记忆以及抽象等方面。  相似文献   

10.
目的 观察介入再通术对慢性闭塞性脑血管病变(chronic total cerebrovascular occlusion,CTO)患者认知功能的改善情况,并与未进行血管再通的CTO患者进行对比.方法 选择我院2013年5月至2016年5月收治的CTO患者55例,其中介入再通组(治疗组)21例,非再通组(对照组)34例,比较术后12、24个月认知功能情况,采用简易智能精神状态检查量表(mini-mental state examination,MMSE)、蒙特利尔认知功能评分表(Montreal cognitive assessment,MoCA)评估患者认知功能.结果 治疗组与对照组患者术前美国国立卫生研究院卒中评分量表(national institute of health stroke scale,NIHSS)评分差异有统计学意义(P<0.05),而性别、年龄、文化程度、脑血管危险因素、认知功能等基线资料差异没有统计学意义(P>0.05).随访期间,两组患者认知功能(12个月后MMSE、MoCA,24个月后MMSE、MoCA量表评分)比较差异有统计学意义(P <0.05,P<0.01).结论 介入再通术可以明显改善CTO患者的认知功能.  相似文献   

11.
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   

12.
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   

13.
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   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

20.
ANTI-PROLIFERATION EFFECT OF ORIDONIN ON HL-60 CELLS AND ITS MECHANISM   总被引:4,自引:0,他引:4  
Objcetive To investigate the anti-proliferation effect of oridonin on leukemic HL-60 cells and its mechanism. Methods HL-60 cells in vitro in culture medium were given different concentrations of oridonin. The inhibitory rate of cells were measured by microculture tetrazolium (MTT) assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by hoechst 33258 fluorescence staining, and the activity of telomerase was detected using telomere repeat amplification protocol (TRAP) PCR-ELISA before and after apoptosis occurred. Results Oridonin could decrease telomerase activity, inhibit growth of HL-60 cells, and cause apoptosis significantly. The suppression was both in time- and dose-dependent manner. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by hoechst 33258 fluorescence staining especially after cells were treated 48-60 hours by oridonin. Conclusions Oridonin has apparent anti-proliferation and apoptotic effects on HL-60 cells in vitro, decreasing telomerase activity of HL-60 cells may be one of its most important mechanisms. These results will provide strong laboratory evidence of oridonin for clinical treatment of acute leukemia.  相似文献   

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