帕金森病患者智能障碍及其相关因素分析

目的 研究帕金森病（ＰＤ）患者智能障碍与年龄、性别、病程、脑萎缩、脑功能和了局部血流量（ｒＣＢＦ）的相关性。方法 采用长谷川简易智能评价分度表（ＨＤＳ）测试７６例ＰＤ患者智能,并检查其头颅ＣＴ,脑电地形图（ＢＥＡＭ）和＾１３３Ｘｅ吸入法测定ｒＣＢＦ。结果 智能障碍ＰＤ患者,ＨＤＳ值与年龄呈负相关（ｒ＝－０．７１,Ｐ〈０．０１）,与大脑平均血流量呈正相关（ｒ＝０．６７,Ｐ〈０．０１）;而与性别和病程     

脑动脉硬化的脑电图,脑电地形图经颅多普勒超声的对照研究

目的 探讨脑电图（ＥＥＧ）、脑电地形图（ＢＥＡＭ）及经颅多普勒超声（ＴＣＤ）三项检查联合应用对脑动脉硬化的诊断价值。方法 ２０８例临床诊断为脑动脉硬化的病人,均在发病一月内行ＥＥＧ、ＢＥＡＭ及ＴＣＤ检查。结果 ＥＥＧ异常７４例,ＢＥＡＭ异常１２５例住院ＴＣＤ异常率为１００％。ＥＥＧ与ＢＥＡＭ比较（Ｘ＾２＝２５．０６,Ｐ〈０．０１）。有非常显著差异;ＢＥＡＭ与ＴＣＤ比较（Ｘ＾２＝４．１２,Ｐ〈０．０     

十八维度人格测定量表的信度和效度

目的 检测十八维度人格测定量表（ＤＡＰＰ－ＢＱ）的信度与效度。 方法 以２０名２０￣２１岁的苏州医学院临床医学系九五级大学生为测试对象，以ＤＡＰＰ－ＢＱ进行测试，一月后再测试，进行相关分析。 结果 重测相关系数〉０．５６１（Ｐ〈０．０１），条目与所属维度条目总分间的相关系数〉０．４４４（Ｐ〈０．０５）。 结论 ＤＡＰＰ－ＢＱ中译本具良好的信度及效度，值得推广使用。     

急性闭合性颅脑损伤患者血清髓鞘碱性蛋白及其抗体含量的…

用酶联免疫吸附法（ＥＬＩＳＡ）测定３６例急性闭合性颅脑损伤（ＡＣＨＴ）患者、４０例其它神经系统疾病（ＯＮＤ）患者及３２名正常人的血清髓鞘碱性蛋白（ＭＢＰ）及其抗体（Ａｎｔｉ－ＭＢＰ）含量。结果表明：ＡＣＨＴ组患者血清ＭＢＰ含量显著高于ＯＮＤ组与正常人组（均Ｐ〈０．０１），ＡＣＨＴ患者中脑挫裂伤组和脑内血肿组血清ＭＢＰ含量较脑震荡组明显增高（均Ｐ〈０．０１）；而ＯＮＤ组与正常人组比较则无明显差异（Ｐ     

茶色素加β—七叶皂甙钠治疗缺血性脑血管病的临床研究

采用茶色素加β－七叶皂甙钠联合治疗缺血性脑血管病８０例,观察其对缺血性脑血管病的疗效。结果表明在血脂改善率（ＴＣ、ＴＧ、ＬＤＬ、ＨＤＬ）均有显著性差异（Ｐ〈０．０１）。临床疗效：Ａ组（治疗组）８７．５％;Ｂ组（β－七叶皂甙钠组）８１．６７％;Ｃ组（对照组）６６．６７％。Ａ组与Ｂ组比较,无显著差异（Ｐ〉０．０５）,Ａ组与Ｃ组比较、Ｂ组与Ｂ组比较均有显著性差异（Ｐ〈０．０１）。认为茶色素加β－七叶皂甙     

老年期痴呆患者的脑循环变化

目的 探讨老年期痴呆患者的脑循环变化。方法 采用单光子发射计算机断层显像（ＳＰＥＣＴ）,Ｅ＾９９ｍＴｃ－ＥＣＤ作为显像剂,定量测定１５例Ａｌｚｈｅｉｍｅｒ型痴呆（ＡＤＴ）、２４例血管性痴呆（ＶＤ）和１５名正常老年人的局部脑血流量（ｒＢＣＦ）。结果 ＤＮＴ、ＶＤ组大脑平均血流量（ｍＣＢＦ）均显著低于对照组（Ｐ〈０．０１）;ＤＡＴ组额、颞、顶叶皮质ｒＣＢＦ明显减少（Ｐ〈０．０１）;ＶＤ组各脑叶皮质及其     

高血压合并急性离出血管病的心率变异性改变

对原发性高血压（ＥＨ）合并急性脑血管病（ＡＣＶＤ）患者３０例进行２４小时动态心电图心率变异性（ＨＲＶ）测定，并与３０例无ＡＣＶＤ的ＥＨ患者进行对比。结果显示，合并ＡＣＶＤ组最小心率及平均心率明显高于对照组（Ｐ〈０．０１、〈０．００１）；ＳＤＮＮ、ｒＭＳＳＤ、ＰＮＮ５０比对照组明显减低（Ｐ〈０．００１、〈０．０１、〈０．００１）。提示合并ＡＣＶＤ的ＥＨ患者ＨＲＶ减低，其主要原因可能是自主神经中枢损害     

急性闭合性颅脑损伤患者血清髓鞘碱性蛋白及其抗体含量的研究

用酶联免疫吸附法（ＥＬＩＳＡ）测定３６例急性闭合性颅脑损伤（ＡＣＨＴ）患者、４０例其它神经系统疾病（ＯＮＤ）患者及３２名正常人的血清髓鞘碱性蛋白（ＭＢＰ）及其抗体（Ａｎｔｉ－ＭＢＰ）含量。结果表明：ＡＣＨＴ组患者血清ＭＢＰ含量显著高于ＯＮＤ组与正常人组（均Ｐ＜０．０１），ＡＣＨＴ患者中脑挫裂伤组和脑内血肿组血清ＭＢＰ含量较脑震荡组明显增高（均Ｐ＜０．０１）；而ＯＮＤ组与正常人组比较则无明显差异（Ｐ＞０．０５）。ＡＣＨＴ组患者血清Ａｎｔｉ－ＭＢＰ含量与ＯＮＤ组比较差别无显著性（Ｐ＞０．０５）。提示血清ＭＢＰ含量对判断颅脑损伤的病情有重要价值。     

血清ApoE对脑动脉硬化症的诊断价值

本文观察４２例脑动脉硬化症患者与正常对照组４４例，对其血清ＡｐｏＥ和ＨＤＬ－Ｃ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡｐｏＡＩ、ＡｐｏＢ１００２６含量进行测定，并将ＡｐｏＥ与ＨＤＬ－Ｃ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡｐｏＡＩ、ＡｐｏＢ１００逐一进行相关比较，结果发现：脑动脉硬化症病人血清ＡｐｏＥ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡｐｏＢ１００明显高于正常对照组（Ｐ〈０．０１），ＨＤＬ－Ｃ显著低于正常对照组（Ｐ〈０．０１）     

阿尔茨海默病患者早老素-1基因内含子多态性分布的研究

目的 探讨早老素－１（ＰＳ－１）基因第８外显子３’端内含子等位基因多态性在散发性阿尔茨海默病（ＳＡＤ）发病机制中的作用。方法 应用聚合酶链反应－限制性片段长度多态性（ＰＣＲ－ＲＦＬＰ）方法检测７５例ＳＡＤ患者（ＳＡＤ组）和７３例正常老年人（对照组）的ＰＳ－１基因第８外显子３’端内含子等位基因多态性分布。结果 ＳＡＤ组１等位基因频率明显高于对照组（Ｐ〈０．０１,ＲＲ＝１．８３）,２等位基因频率明显低于对照组（Ｐ〈０．０１,ＲＲ＝０．５５）;ＳＡＤ组２／２基因型频率低于对照组（Ｐ〈０．０５,ＲＲ＝０．３２）。结论 ＰＳ－１基因多态性与ＳＡＤ发病有关,ＳＡＤ发病与ＰＳ－１基因２等位基因呈明显负关联,与１等位基因呈明显正关联。ＰＳ－１基因２等位基因对ＳＡＤ发病可能有保护作用,１等位基因可能是ＳＡＤ发病的危险因素之一。     

Cornell痴呆抑郁量表的信度和效度检验

目的检测Cornell痴呆抑郁量表的信度和效度.方法对60例痴呆患者进行测试,由四位医生进行联合评定.结果Cornell痴呆抑郁量表具有良好的内部一致性,联合评定ICC=0.87、F=24.59,P＜0.01.与HAMD量表评分相比,相关系数r=0.833,P＜0.01.平行效度好,在判断抑郁程度方面F值为0.01,P＜0.01.结论Cornell痴呆抑郁量表具有良好的我信度和效度,值得在临床推广.     

暴力作案刑事责任能力评定量表的应用

目的 探索暴力作案刑事责任能力评定量表（CRRS—V）对暴力作案刑事责任能力鉴定的使用价值。方法 采用CRRS—V，对155例暴力作案被鉴定人进行刑事责任能力评分，将评分结果同专家鉴定意见以及使用Rogers刑事责任能力评定量表（R—CRAS）评定的结果进行比较，分析CRRS—V的信度与效度。结果 CRRS—V量表评分者问一致性高（ICC=0．970，P〈0．001）；Cronbach系数为0．916。CRRS—V与专家结论的一致性较高（Kappa=0．880，P〈0．001）。结论 CRRS—V具有良好的信度和效度，符合量表编制的要求，具有实际应用价值。     

A parent-child relationship scale derived from the child and adolescent psychiatric assessment (CAPA)

OBJECTIVE: To examine a measure of children's perception of their relationships with parents. METHOD: The Child and Adolescent Psychiatric Assessment (CAPA) was administered to 114 inpatients (aged 9-18 years) at a tertiary asthma center from 1991 to 1994. Ten items from the CAPA were developed as a separate scale, the Parent-Child Relationship Scale (PCRS). Some subjects (82) were given family and child assessments. RESULTS: The PCRS had good internal reliability (Cronbach alpha = .72). Construct validity was demonstrated by correlations with child and parent report on the Family Assessment Device (r= 0.46 and 0.35; p < .001) and high expressed emotion of the parent (t= 2.89; p < .01). Divergent validity may be evidenced by the fact that the PCRS was not significantly related to high emotional over-involvement. Predictive validity was shown by significant correlations with the total problem scores of parents' (r = 0.28; p < .01) and children's (r = 0.41; p < .001) Achenbach reports, and prediction of CAPA psychiatric diagnosis (OR = 5.83; 95% CI 1.80-22.63). CONCLUSION: The PCRS can potentially be used to assess the child's perspective of the parent-child relationship for research or clinical purposes and deserves further study.     

歧视与病耻感量表(DISC)中文版在精神障碍患者中的信度和效度研究

目的:评估歧视与病耻感量表(DISC)在中国精神障碍患者中的信度和效度。方法:引进Thornicroft团队研发的DISC,按初译、回译等步骤形成DISC中文版,以242例精神障碍患者作为受访对象,验证量表的信度和效度。结果:DISC的Cronbach'α系数为0.70,分半信度为0.85,总分重测信度为0.83;DISC分量表1总分与精神疾病内在病耻感调查表(ISMI)歧视经历因子分呈正相关(r=0.417,P0.01),分量表2总分与ISMI社会退缩因子分呈正相关(r=0.332,P0.01);分量表2总分与自尊量表(SES)总分呈正相关(r=0.250,P0.01),分量表3总分与SES总分呈负相关(r=-0.187,P0.01);分量表4总分与社会支持评定量表(SSRS)客观支持分以及对支持的利用度分均呈正相关(r=0.177,0.170,P均0.01)。结论:DISC中文版具有较好的信度和效度,可作为评估精神障碍患者歧视与病耻感的临床工具。     

The Spanish version of the FibroFatigue Scale: validation of a questionnaire for the observer's assessment of fibromyalgia and chronic fatigue syndrome

OBJECTIVE: To examine some of the psychometric properties of the Spanish version of the FibroFatigue Scale (FFS). METHODS: FFS was administered to 120 patients diagnosed with fibromyalgia and chronic fatigue syndrome. Internal consistency was evaluated by using Cronbach's alpha, test-retest reliability with weighted kappa and construct validity by correlations among FFS, the Fibromyalgia Impact Questionnaire (FIQ), the EuroQol 5D (EQ-5D) and the Hospital Anxiety and Depression Scale (HADS). The interrater reliability was tested using analysis of variance with patients and raters as independent factors. RESULTS: Internal consistency (alpha) was .88, test-retest reliability was .91, and interrater reliability was .93. Significant correlations were obtained between overall FFS and the FIQ (.55, P<.01), the EQ-5D (-.48, P<.01) and the HADS depression subscale (.25, P<.01), but not with the HADS anxiety subscale. CONCLUSION: These results support the reliability and validity of the data obtained with the Spanish version of the FSS.     

健康状况调查问卷应用于精神分裂症患者中的信度和效度

目的 评价健康状况调查问卷(SF-36)在住院精神分裂症病人中的信度和效度。方法 通过面对面访谈方式调查90例住院精神分裂症患者,信度采用重测法、内部条目一致性分析(Cronbach’sα系数)。效度采用平行效度,用生活满意度指数A(LSIA)和简明精神病量表(BPRS)作为效标,与SF-36作相关分析。结果 整个测量的重测相关系数均大于0.469(P<0.01),内部一致性(Cronbach’s α系数)在0.73～0.96。平行效度:SF-36中的躯体功能、总体健康、生命活力、精神健康4个分量表与LSIA有较好相关性;总体健康、生命活力、社交功能、情感问题所致的角色受限、精神健康5个分量表与BPRS呈显著性负相关。 结论 SF-36是全面评价精神分裂症病人生命质量有效和可靠的量表之一。     

Spanish version of the Delirium Rating Scale-Revised-98: reliability and validity

OBJECTIVE: The aim of this study was to investigate the reliability and validity of the Spanish translation of the Delirium Rating Scale-Revised-98 (DRS-R-98). METHODS: Thirty patients diagnosed of delirium (DSM-IV) by a variety of general hospital medical wards criteria were assessed using the DRS-R-98, MiniMental State Examination (MMSE), Mini Examen Cognoscitivo (MEC; Spanish version of the MMSE) and the Orientation Scale (OS). Independent ratings between two psychiatrists were used to calculate intraclass correlation coefficients (ICCs) for interrater reliability. RESULTS: The DRS-R-98 had high interrater reliability for both total and severity scale scores (ICC=.96 for each). The DRS-R-98 severity score significantly correlated (P<.001) with MMSE (r=-.67), MEC (r=-.62) and OS (r=.73). Cronbach's alpha (r=.78 ) indicated high internal consistency of the DRS-R-98. CONCLUSION: The Spanish translation of the DRS-R-98 has high interrater reliability for both total and severity scale scores, high internal consistency, and very good concurrent validity in relation to other cognitive measures and therefore can be administered to delirious patients.     

Validation of the Spanish version of the Perceived Stress Questionnaire

OBJECTIVE: To validate in Spanish the Perceived Stress Questionnaire (PSQ), a questionnaire to assess stress for research purposes in psychosomatic patients. METHOD: The test was administered to a healthy population (N=174) of nursing students and health workers and to a clinical sample (N=80) of patients attending a psychiatric outpatient consultation. RESULTS: Concurrent validity: General and Recent PSQ scores correlated high with trait anxiety (r=.65), moderate with depression (r=.46) and psychological disturbance (r=.51) and poor with state anxiety (r=.22). Predictive validity: PSQ scores were higher in "psychiatric cases" than in "psychiatric noncases" (P<.01), and correlated highly with somatic symptoms of psychological origin (r=.62) in the clinical subsample. Internal consistency was 0.9 for the General and 0.87 for the Recent PSQ. Test-retest reliability of the General PSQ was 0.80. DISCUSSION: The Spanish version of PSQ presents good psychometric properties and it seems to be a valuable instrument for psychosomatic researchers.     

The development and validation of a carer questionnaire to assess cognitive function in neuropsychiatric patients

OBJECTIVES: The carer history is an integral part of the assessment of patients with cognitive impairment. We aimed to develop a comprehensive yet concise carer questionnaire, the CogRisk, which captures actuarial risk variables for cognitive impairment in addition to key symptoms suggestive of cognitive decline in a number of cognitive domains, and to then assess its validity and reliability in a neuropsychiatric population. METHOD: Carers of patients assessed for cognitive impairment completed the CogRisk, and patients were clinically assessed using the Mini-Mental State Examination (MMSE) and Neuropsychiatry Unit COGnitive assessment tool (NUCOG). Reliability was assessed using test-retest and interrater measures and measures of internal consistency. Construct and concurrent validity was assessed using correlation between total and subscale scores on the CogRisk, total scores on the NUCOG and MMSE, and subscale scores on the NUCOG. Predictive validity was determined using measures of sensitivity and specificity and using receiver operating characteristic (ROC) methods. RESULTS: The CogRisk was completed by all carers in less than 10 min. The total CogRisk score correlated significantly with total MMSE and NUCOG scores (r=-0.511 and -0.563, respectively) and remained highly significant when age and education were controlled for. Internal consistency of CogRisk items was high (alpha=0.943). Intrarater reliability of the CogRisk was high with an intraclass correlation coefficient of .978 (P<.001), and interrater reliability between carers was also high at 0.868 (P<.05). Sensitivity and specificity for the detection of dementia were .70 and .73, respectively, with area under the ROC curve not significantly different from that of the MMSE or NUCOG. CONCLUSION: The CogRisk is a brief carer-rated tool of a patient's cognitive functioning developed for use within a neuropsychiatric setting. It exhibited good concurrent validity, internal consistency, and interrater and intrarater reliability. The CogRisk also demonstrated good sensitivity and specificity for dementia. The CogRisk provides carer information, which complements the clinical assessment and can be used to focus on direct carer interview.     

Fatigue after stroke: the development and evaluation of a case definition

OBJECTIVE: While fatigue after stroke is a common problem, it has no generally accepted definition. Our aim was to develop a case definition for post-stroke fatigue and to test its psychometric properties. METHODS: A case definition with face validity and an associated structured interview was constructed. After initial piloting, the feasibility, reliability (test-retest and inter-rater) and concurrent validity (in relation to four fatigue severity scales) were determined in 55 patients with stroke. RESULTS: All participating patients provided satisfactory answers to all the case definition probe questions demonstrating its feasibility For test-retest reliability, kappa was 0.78 (95% CI, 0.57-0.94, P<.01) and for inter-rater reliability kappa was 0.80 (95% CI, 0.62-0.99, P<.01). Patients fulfilling the case definition also had substantially higher fatigue scores on four fatigue severity scales (P<.001) indicating concurrent validity. CONCLUSION: The proposed case definition is feasible to administer and reliable in practice, and there is evidence of concurrent validity. It requires further evaluation in different settings.