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1.
为探讨小量氯氮平(25mg)对精神分裂症患者脑电活动的影响与近期疗效之间的关系,对60例精神分裂症患者进行BEAM检测。将服药前后脑电活动变化明显者和变化不明显著分成反应良好组和反应不良组,应用单一氯氮平(200-400mg/日)治疗6周,用BPRS评定疗效。结果(1)服药后患者双侧枕区(o1,o2)α1频段的绝对功率值逐渐增高,α2、α3频段的绝对功率值逐渐降低,且在第4、5小时时最明显;(2)反应良好者52例(87%),反应不良者8例(13%);(3)反应良好组(52例)近期疗效好者48例(92%)、差者4例(8%),反应不良组(8例)近期疗效好者1例(12%)、差者7例(88%)。提示,小量氯氮平可致精神分裂症患者脑电活动基本节律的改变(α波慢化),而这种改变显著者应用氯氮平近期疗效好,反之疗效差。  相似文献   

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氯氮平和利培酮对首发精神分裂症患者糖代谢影响的研究   总被引:34,自引:5,他引:29  
目的 探讨氯氮平和利培酮对首发精神分裂症患者糖代谢的影响。方法  6 8例首发精神分裂症患者随机分为两组 ,分别给予氯氮平治疗 ( 34例 ,氯氮平组 )和利培酮治疗 ( 34例 ,利培酮组 )。两组患者治疗前和治疗后第 4周末做糖耐量试验 ,测定空腹胰岛素、C肽、甘油三酯、胆固醇、瘦素 ,并测量身高、体重 ,计算体重指数 [BMI,体重 (kg) /身高 (m2 ) ]。共观察 4周。结果 治疗第 4周末 ,氯氮平组餐后 1h、2h的血糖值 [分别为 ( 8 6± 1 8)mmol/L和 ( 6 7± 1 1)mmol/L]比治疗前 [分别为( 7 4± 2 2 )mmol/L和 ( 5 8± 1 4 )mmol/L]明显升高 (P <0 0 5 ,P <0 0 1) ,而利培酮组无明显变化。治疗后氯氮平组 ( 2 0 % ,7例 )患者糖耐量减低的发生率高于利培酮组 ( 3% ,1例 ) ,差异有显著性 ( χ2 =3 972 ,P <0 0 5 )。结论 氯氮平对首发精神分裂症患者餐后血糖值的影响大于利培酮  相似文献   

3.
为探讨氯氮平民致首发精神分裂症患和健康成人之间脑电能量变化的差异及自身用药前后脑电能量变化,对22例健康受试和19例首发精神分裂症患服用一次量25mg氯氮平前后0.5、1、2、3、4、5、6、8、12、24小时脑电能量变化进行两因素方差分析。结果,α1频段Fp1、F3、F4、F7、F8导联,α3频段O2导联,β联频01导联,精神分裂症患和健康成人之间比较及自身前后比较,差异均有显性(P<0.05);α1频段Fp2、T3、T4、T5、T6、P3、O1导联,α2频段F4导联,α3频段C4、P3导联,δ频段Fp1、Fp2、F3、F4、F8、T3、C3、T5、O1、O2导联,精神分裂症患与健康成人之间比较差异有显性(P<0.05);β频段O2导联,δ、θ频段F7、T4导联,自身前后比较差异有显性(P<0.05)。说明氯氮平致健康成人与首发精神分裂症患脑电能量变化除θ频段外,各频段两组间比较均有显性差异,除α2频段外,各频段自身前后变化比较均有显性改变。  相似文献   

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目的:探讨氯氮平所致首发精神分裂症患者和健康成人之间脑电能量变化的差异及自身用药前后脑电能量变化。方法:对22例健康受试者和19例首发精神分裂症患者服用一次量25mg氯氮平前及后0.5、1、2、3、4、5、6、8、12、24h脑电能量变化进行单因素和两因素方差分析。结果 :某些频段的部分导联在患者或健康人自身对照时有显著改变;有些在患者与健康人比较时有显著差异。结论;氯氮平所致健康成人与首发精神分裂症患者某些脑电能量变化有显著差异。  相似文献   

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为探讨氯氮平所致首发精神分裂症患和健康成人之间脑电能量变化的差异及自身用药前后脑电能量变化,对22例健康受试和19例首发精神分裂症患服用一次量25mg氯氮平前及后0.5,1,2,3,4,5,6,8,12,24小时脑电能量变化进行单因素和两因素方差分析。结果,α1频段Fp1,Fp2,F3,F4,F8,3,T4,T5,T6,P3,O1导联,α2频段F4导联,α3频段C4,T4,P3,O2导联,β频段O1导联,δ频段Fp1,Fp2,F3,F4,F8,T3,C3,T5,O1,O2导联,精神分裂症患和健康成人之间比较差异具有显性(P<0.05)。除健康成人α2频段,精神分裂症患α1频段变化不明显外,两组受试对象各频段脑电能量变化趋势基本一致,但显变化部位均有不同。提示,氯氮平致健康成人与首发精神分裂症患脑电能量变化除θ频段外,各频段两组间比较均有显性差异,两组受试对象各频段脑电能量变化趋势大致一致。  相似文献   

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为探讨氯氮平对首发精神分裂症患脑电活动的影响,采用自身前后对照方法,比较首发精神分裂症患服用一次量25mg氯氮平前及后0.5、1、2、3、4、5、6、8、12、24小时脑电能量变化。结果,服用一次量25mg氯氮平后,α1频段Fp2、F8导联,α3频段F4、F8导联,β频段F8、O1导联脑电能量在第5-6小时较服药前显降低(P<0.05),第24小时基本恢复用药前水平;α2频段Fp1、F4导联,α3频段Fp1、Fp2、T4导联,β频段T4、T5、O2导联能量呈降低趋势,但未达显水平(P<0.05);θ频段Fp1、F7导联,δ频段F3、F4、F7、C3导联能量在第5-6小时较服药前显增高(P<0.05),第24小时基本恢复用药前水平,δ频段Fp2、F8、T3、T4、T6、P3、O2导联,θ频段C3、T5、P3、O1、O2导联,α1频段C3、O2导联能量有增高趋势,但未达显水平(P>0.05)。提示,氯氮平对首发精神分裂症患脑电图的影响为α1、θ、δ频段能量增加,α2、α3、β频段能量降低。  相似文献   

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氯丙嗪和氯氮平对首发精神分裂症血糖影响的随访观察   总被引:3,自引:0,他引:3  
目的:探讨氯丙嗪和氯氮平对首发精神分裂症血糖水平的影响。方法:对160例首发精神分裂症患者随机给予氯丙嗪或氯氮平治疗,于治疗前及治疗12周、26周、52周末分别测定一次空腹血糖。结果:首发精神分裂症患者治疗前合并高血糖者占8.75%,氯丙嗪治疗52周末时血糖水平增高,而氯氮平治疗12周后血糖水平即增高,治疗26周时,氯氮平组合并高血糖者显著高于氯丙嗪组(χ^2=4.81,P=0.03)。结论:氯氮平治疗期间应定期监测血糖。  相似文献   

8.
利培酮维持治疗2年随访对照研究   总被引:1,自引:1,他引:0  
目的 比较利培酮、氯氮平、利培酮合用氯氮平对精神分裂症维持治疗的效果和安全性。方法 选择符合CCMD 2 R入组标准的住院精神分裂症病人共 73例 ,其中 2 7例利培酮治疗 ,2 7例氯氮平治疗 ,19例利培酮合用氯氮平 (简称合并组 )疗程 2年 ,均用PANSS、SSPI、TESS量表于入组后、治疗 1年、治疗 2年进行疗效评定 ,并进行氯氮平血浓度、血常规、EKG等测定。结果 每组在治疗始、治疗 1年、治疗 2年PANSS减分率有显著差异 (P =0 .0 2 5 ,P =0 .0 3,P =0 .0 2 9) ,SSPI的减分率也有显著差异 (P =0 .0 0 ,P =0 .0 0 ,P =0 .0 1) ,在副反应方面利培酮以锥外系反应为主 ,氯氮平以粒细胞下降、流涎、心血管副反应为主 ,两者小剂量合用并未明显增加毒副反应 (P >0 .0 5 )。结论 维持剂量的利培酮、氯氮平对精神分裂症病人的长期治疗均有良好效果 ,而利培酮安全性较高 ,更适于维持治疗。  相似文献   

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氯氮平的早期反应可预测后期疗效   总被引:5,自引:0,他引:5  
目的 研究氯氮平的 2周症状改善是否能预测 4周疗效。方法 给 40例精神分裂症病人予氯氮平治疗 ,在治疗 2~ 4周末剂量固定为 (30 9± 83)mg/d ,治疗 2和 4周末分别评定阳性和阴性症状量表 (PANSS)。结果 2与 4周末的PANSS总分减分率之间有极显著相关性 (r =0 .7334 ,df=39,P <0 .0 1) ,2周末PANSS总分减分率≥2 0 %的病人其 4周显效率 (12 / 2 3)比 <2 0 %的病人其 4周显效率 (0 / 17)显著为高 (P =0 .0 0 0 2 42 )。结论 氯氮平治疗 2周末症状改善 2 0 %以上者 ,到 4周末约 5 0 %的病人显效 ,而治疗 2周末症状改善不足 2 0 %者 ,到 4周末几乎无显效的可能性。  相似文献   

10.
奎硫平与氯氮平治疗精神分裂症的比较研究   总被引:21,自引:2,他引:19  
目的 探索奎硫平治疗精神分裂症的疗效及安全性。方法 对 6 3例精神分裂症患者分别给予奎硫平、氯氮平治疗 ,其中奎硫平组 32例 ,剂量为 (330± 5 8)mg d ;氯氮平组 31例 ,剂量 (30 0±4 3)mg d ;疗程共 8周。采用阳性和阴性症状量表 (PANSS)及副反应量表 (TESS)在治疗前及治疗后 1、2、4、8周末分别评定疗效和副反应。结果  (1)两组治疗后第 1,2 ,4 ,8周的PANSS分与治疗前比较 ,差异具有显著性 (P <0 0 1)。 (2 )奎硫平与氯氮平有效率分别为 83 3%和 85 7% ,两者有效治疗剂量分别为 2 75~ 4 5 0mg d ,2 5 0~ 4 0 0mg d。 (3)TESS评定奎硫平组副作用少于氯氮平组 (P <0 0 1)。 结论 奎硫平治疗精神分裂症阳性、阴性症状与氯氮平同样有效 ,但不良反应更少。  相似文献   

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Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.  相似文献   

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A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.  相似文献   

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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   

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Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.  相似文献   

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After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.  相似文献   

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