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1.
正缺血性卒中占所有卒中的80%以上[1]。颅外颈动脉粥样硬化被认为是缺血性卒中的危险因素,约20%的缺血性卒中是由颈动脉粥样硬化性斑块引起[2],颈动脉斑块破裂形成栓子或者引起颈动脉狭窄均可导致缺血性卒中,颈动脉高分辨磁共振成像(high resolution magnetic resonance imaging,HRMRI)检查对预测早期缺血性卒中患者的预后,选择恰当的治疗方案,具有十分重要的意义。颈动脉的影像学检查有多种,包括超声  相似文献   

2.
氧化应激、微炎症反应、血流切应力与颈动脉斑块稳定性   总被引:1,自引:0,他引:1  
颈动脉粥样硬化是缺血性卒中的常见病因.在西方国家,因颈动脉粥样硬化造成的缺血性卒中占19% ~ 35%[1].  相似文献   

3.
颈动脉粥样硬化与缺血性脑卒中   总被引:13,自引:6,他引:7  
198 9年美国国立神经疾病和卒中研究所的资料中将 2 3%的脑梗死归因于颈动脉病变[1] ,近年来随着多普勒超声与磁共振血管造影的临床应用 ,颈动脉粥样硬化与缺血性卒中之间的密切关系越来越受到人们的重视。颈动脉粥样硬化对缺血性卒中病因学方面的重要意义主要在于它可能是脑栓子的一个重要来源以及它对脑血流动力学的影响。本文就近年来有关颈动脉粥样硬化的研究进展及其与缺血性卒中的关系综述如下 :1 颈动脉粥样硬化的危险因素动脉粥样硬化是一种全身慢性疾病 ,其病变主要累及体循环的大中型动脉 ,以主动脉、冠状动脉及脑动脉罹患最多。…  相似文献   

4.
目的探讨颈动脉粥样硬化性缺血性卒中患者外周血辅助性T细胞1、2和17(Th1、Th2和Th17)的分布特点。方法共180例颈动脉粥样硬化性缺血性卒中患者,根据颈动脉狭窄程度分为颈动脉轻度狭窄亚组、中度狭窄亚组和重度狭窄亚组(各60例),流式细胞术检测患者外周血Th1、Th2和Th17细胞比例。结果缺血性卒中组患者外周血Th1和Th17细胞比例均高于对照组[(5.76±1.81)%对(3.54±0.29)%,P=0.000;(0.36±0.13)%对(0.18±0.03)%,P=0.000]。颈动脉狭窄不同程度亚组患者外周血Th1[(4.56±0.55)%、(4.88±0.42)%和(7.83±1.69)%,P=0.000]和Th17[(0.23±0.04)%、(0.34±0.02)%和(0.50±0.09)%,P=0.000]细胞比例差异均有统计学意义,其中,重度狭窄亚组Th1(P=0.001,0.001)和Th17(P=0.000,0.001)细胞比例高于轻度狭窄亚组和中度狭窄亚组,中度狭窄亚组仅Th17细胞比例高于轻度狭窄亚组(P=0.000)。结论 Th1和Th17细胞与颈动脉粥样硬化狭窄程度密切相关,随着颈动脉狭窄程度的加重,外周血Th17细胞比例升高,表明细胞免疫机制参与颈动脉粥样硬化的发生与发展,为颈动脉粥样硬化性缺血性卒中的免疫治疗提供理论依据。  相似文献   

5.
颈动脉硬化性狭窄大多数是由于颈动脉的粥样斑块导致的颈动脉管腔的狭窄,其发病率较高。颈动脉粥样硬化不仅是全身动脉硬化的标志,而且是缺血性卒中最重要的病因及危险因素之一。本文就颈动脉狭窄的流行状况及其导致缺血性卒中的危险性作一综述。  相似文献   

6.
颈动脉粥样硬化的研究大约经历了对其病因和临床的认识、外科治疗、药物治疗和对卒中的特殊预防4个主要阶段。颈动脉与脑梗塞关系的研究虽然已有20多年的历史,但仍然是临床病理学探讨的重要课题。随着脑血管病检查新技术的不断开展,颈动脉粥样硬化的研究也日渐广泛和深入。本文就颈动脉粥样硬化与缺血性卒中关系的几个问题作如下综述。颈动脉粥样硬化与缺血性卒中的关系颈动脉粥样硬化是脑实质缺血性病变的主要原因之一。颈动脉粥样硬化是否引起脑的缺血性病变与其病变类型、狭窄程度、有无伴随血栓、栓塞及血液动力学改变等因素有关。颈动脉内膜溃疡及狭窄:颈动脉粥样斑块和内膜溃疡是TIA和卒中的潜在病因。临床病理学结果  相似文献   

7.
颈动脉粥样硬化与进展性缺血性脑卒中的关系   总被引:22,自引:0,他引:22  
目的探讨颈动脉粥样硬化与进展性缺血性脑卒中的关系。方法采用彩色多普勒超声仪对564例缺血性脑卒中患者的颈动脉进行评估,比较进展性缺血性脑卒中和非进展性缺血性脑卒中患者的颈动脉粥样硬化特征和程度。结果564例缺血性脑卒中患者有135例为进展性缺血性脑卒中(23.8%);在重度颈动脉粥样硬化110例中,有49例(44.5%)发展为进展性卒中;在重度颈动脉狭窄95例中,有48例(50.5%)发展为进展性卒中;在病理表现为溃疡斑86例中,有47例(54.7%)发展为进展性卒中:无颈动脉粥样硬化或伴轻度颈动脉粥样硬化的缺血性脑卒中患者,仅9%~10%发生进展性卒中。经Logistic回归分析发现,颈动脉粥样硬化程度、狭窄程度以及溃疡斑与进展性缺血性卒中的发生成正相关。结论颈动脉粥样硬化与进展性缺血性脑卒中的发生密切相关,颈动脉粥样硬化的严重程度可作为进展性缺血性脑卒中的预测指标。  相似文献   

8.
颈动脉超声与临床   总被引:3,自引:1,他引:2  
心脑血管疾病是危害人类健康的严重疾病,颈动脉粥样硬化与冠心病密切相关,同时也是造成颈动脉狭窄引起缺血性卒中或斑块脱落导致颅内动脉栓塞的常见病因。近年来,随着人口老龄化、人们生活水平的不断提高和生活方式的变化,颈动脉粥样硬化不仅与老年人缺血性卒中密切相关,  相似文献   

9.
颈动脉粥样硬化与缺血性卒中   总被引:14,自引:0,他引:14  
颈动脉粥样硬化是缺血性卒中的重要危险因素。研究颈动脉粥样硬化与缺血性卒中的关系对缺血性卒中发病机制的研究和缺血性卒中的预防都有重要意义。1 颈动脉粥样硬化引起缺血性卒中的机制颈动脉粥样硬化引起缺血性卒中的机制比较公认的有两种学说 ,即血栓 -栓塞学说和血流动力学性末梢低灌流学说。颈动脉粥样硬化斑块表面的微栓子受不稳定血流的冲击 ,可以被冲刷下来 ,形成微栓子阵雨 ,从而在颈动脉完全闭塞前发生分水岭性脑梗死或 TIA。栓子的另一来源是颈动脉血栓的扩散 ,血栓从颈内动脉起始部向远端扩展到第一条高流量旁支 (通常为眼…  相似文献   

10.
缺血性脑血管病是致残率和病死率较高的疾病之一,国内位居第三,其特点是反复发病.故对其病因探寻预防疾病发生突显重要.颈动脉粥样硬化是缺血性卒中常见病因,在西方国家,因颈动脉粥样硬化造成的缺血性卒中占19%~35%[1].颈动脉超声检查具有安全、无创、简便易行及准确的特点,在临床广泛应用.下面将40例均经CT或MRI确诊的脑梗死病例的颈动脉超声检查情况分析如下.  相似文献   

11.
Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005  相似文献   

12.
BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.  相似文献   

13.
2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。  相似文献   

14.
目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。  相似文献   

15.
《Clinical neurophysiology》2020,131(1):243-258
Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.  相似文献   

16.
目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。  相似文献   

17.
18.
Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.  相似文献   

19.
Introduction: An important consideration in treating acute mania is the promptness with which a chosen therapy can bring symptom amelioration. This article reviews the available published data from controlled, blinded studies regarding the latency of responses to antipsychotics in patients with acute mania.

Methods: Articles for this review were obtained from a search of the Medline database (1966–1999), using the following keywords and phrases: antipsychotic, atypical, bipolar disorder, mania, neuroleptic, typical. The bibliographic sections of articles gleaned from this search were used to direct further inquiries.

Results: Although information regarding the onset of action of antipsychotics is limited, we discovered data for four typical and three atypical antipsychotics. Drugs with the fastest onsets include haloperidol, risperidone, and olanzapine, with onsets appearing in 2–6 days. Chlorpromazine and thiothixene were at the slowest end of the continuum, with onsets of 2 weeks or longer. Data regarding pimozide are mixed, with some studies showing an onset equivalent to that of the 'fast' compounds and others showing one similar to that of the 'slow' compounds.

Conclusions: Choice of therapy should consider not only efficacy and safety, but also onset speed. Atypical antipsychotics appear to offer safer, faster, and more effective therapies.  相似文献   

20.
Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.  相似文献   

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