造影显示的卒中患者颅内外动脉狭窄的分布

目的分析缺血性卒中患者颅内外动脉狭窄的分布.方法收集我院缺血性卒中患者306例,所有患者均进行颈动脉彩超、经颅多普勒超声（TCD）、磁共振血管造影术（MRA）和数字减影血管造影（DSA）检查,狭窄程度按北美症状性颈动脉内膜切除试验（NASCET）测量标准分为5个等级.结果（1）颅内动脉狭窄149例（48.6%）,颅外动脉狭窄25例（8.2%）,颅内外动脉均见狭窄33例（10.8%）;（2）207例动脉狭窄患者中,单支狭窄129例（62.3%）,多支狭窄78例（37.7%）;（3）动脉狭窄的常见部位依次为：大脑中动脉＞椎动脉远端及基底动脉＞颈内动脉颅外段＞大脑前动脉＞大脑后动脉＞颈内动脉虹吸段＞椎动脉起始段;（4）DSA所示狭窄程度：207例316条狭窄血管中,重度狭窄或闭塞87条（27.5%）;（5）157/164例（95.7%）脑卒中病灶与血管狭窄的部位相对应.结论缺血性卒中患者以颅内血管狭窄为多见,大脑中动脉主干狭窄的发生率最高,其次是椎动脉远端及基底动脉.     

循证护理指导脑血管病介入术后护理的研究

目的探讨运用循证护理思维指导经皮股动脉穿刺脑血管介入治疗术后患者的护理效果。方法回顾性分析病例120例,58例作为对照组,给予常规护理。观察组62例,采用循证护理方案,提出护理问题,针对问题查阅相关资料和文献的直接和间接实证,并进行分析、归纳、结合临床实践,制定出护理方案并实施。结果观察组24 h腰背酸痛、腹胀、入睡困难、尿潴留发生率显著低于对照组(P<0.01),两组均未发生并发症。结论运用循证护理可提高脑血管介入治疗术后患者的舒适度,预防并发症,提高护理质量。     

New and future developments in cerebrovascular ultrasound,magnetic resonance angiography,and related techniques

Four-dimensional (4D) analysis of atherosclerotic plaque and wall motion, the application of 4D ultrasound to the study of atherogenesis, and the incorporation of ultrasound data into flow models for simulation of cerebrovascular hemodynamics are new frontiers in diagnostic ultrasound that use computer vision and optical flow techniques to exploit the full potential of real-time imaging and Doppler studies. New approaches to improve blood vessel delineation with ultrasound include application of contrast agents, harmonic imaging, and red blood cell density imaging. An assessment of the potential clinical utility of these new developments in cerebrovascular ultrasound requires an analysis of comparable trends in magnetic resonance (MR) technology, eg, rapid advances in the fields of MR angiography, dynamic contrast-enhanced MR, and MR diffusion imaging. Likewise, the value of ultrasound techniques for the measurement of blood flow to evaluate cerebrovascular hemodynamics must be compared to related methods in magnetic resonance, such as dynamic MR inflow tracking. This article addresses several new and future developments in cerebrovascular ultrasound and discusses their relative merits in terms of ongoing research in the field of magnetic resonance angiography, imaging, and related techniques. © 1995 John Wiley & Sons, Inc.     

5-HT-containing nerves to major cerebral arteries of the gerbil originate in the superior cervical ganglia

This study has shown that over 95% of the 5-hydroxytryptamine (5-HT)-containing nerves to major cerebral arteries in the gerbil share a common origin with noradrenergic cerebrovascular nerves in the superior cervical ganglia. A small group of 5-HT-containing and noradrenergic nerves to the vessels of the posterior brain circulation had a different origin, which may be either central or peripheral. The pial blood vessels of the gerbil appeared to have no 5-HT-containing nerve supply. The effects of unilateral superior cervical ganglionectomy on 5-HT-containing and noradrenergic nerves to the arteries of the circle of Willis were different. Our results showed total loss of 5-HT-containing nerves on the vessels ipsilateral to the ganglionectomy combined with ca. 50% reductions of nerve density on the vessels of the contralateral side. There were no contralateral reductions of noradrenergic nerve density in parallel experiments although again the ipsilateral side was totally denervated. We suggest that 5-HT-containing cerebrovascular nerves are differently distributed as well as being in some way more sensitive to nerve damage compared to noradrenergic cerebrovascular nerves. The relationship between a combined serotonergic and noradrenergic vasoconstrictor control of large cerebral blood vessels and serotonergic vasodilation of small pial blood vessels is discussed.     

八氢吲(口朶)并[2,3-a]喹嗪衍生物的合成

本文报道简化长春胺结构、寻找治疗脑血管疾病有较好疗效的药物。以烯胺Ⅰa,Ⅰb和Ⅰc为起始原料,在C₁位引进羟甲基和羟丙基以及进行酰化等反应,立体选择性地合成了17个结构比长春胺少一个E环的1,2,3,4,6,7,12,12b-八氢-吲哚并[2,3-a]喹嗪衍生物,并分离到3个五环稠合化合物。对于副产物Ⅱ,ⅩⅠⅩ和ⅩⅩ的生成机理作了推测。所合成的化合物进行了小白鼠耐缺氧初筛试验,发现有11个化合物有明显的生物活性,对其它动物的脑血流动力学试验尚在进行中。     

中国农村脑血管病的流行病学—患病率分析

我们采用回顾性现状调查的方法调查了中国农村1986年12月31日脑血管病的时点患病率。在从全国抽取的127个调查点调查了3478345人,发现当日患脑血管病例数为6025例,患病率为173.21/10万,患病率的95%置信区间为168.84～177.58/10万。用中国1982年人口标化后为143.25/10万,用世界标准人口标化后为193.56/10万。分析发现,中国农村脑血管病的时点患病率具有从南向北逐渐升高的趋势;居住地区的高度和脑中风患病率之间有负相关和线性回归关系,粗患病率和高度,r=0.9288,Y=196.58—0.0595x(P<0.01),标化患病率和高度,r=0.9744,Y=163.64—0.0386x(P<0.01)。城市的患病率比农村高,男性比女性高。     

血小板激活因子对大鼠脑血管通透性的影响及药物的保护作用

颈内动脉注射血小板激活因子(PAF),再给伊文思蓝,可见脑实质染色程度加深,而颈内动脉只注射伊文思蓝,脑实质未见染色。而我们合成的新药SZ-1可剂量依赖性地抑制PAF诱导的脑实质伊文思蓝染色程度的加深。在体外培养的脑微血管平滑肌细胞上,PAF能显著刺激~(14)-花生四烯酸的释放,而SZ-1能剂量依赖性地抑制这种释放,提示PAF在脑内产生的损害除与其他因素相关外,还与其刺激花生四烯酸释放有密切关系,SZ-1对PAF引起的脑部损害有保护作用。     

中国天津与美国人群心脑血管疾病主要危险因素的对比分析

与欧美国家相比天津脑血管病死亡率高而心肌梗塞死亡率却较低.通过对比两人群的主要危验因素,认为天津市人群比美国具备高吸烟率、高收缩期血压均值和高的原发性高血压病人现患率;低体块指数、低血清胆固醇和低密度脂蛋白;十分相近的舒张期血压均值和高密度脂蛋白胆固醇水平等特点.因此建议天津疾病的预防和控制.并开展有关脑血管疾病病因和预防措施的研究.     

脑血管病高危人群的筛选

脑血管病人的高危人群是高血患者并伴有脑血管病家族史的人群。对该人群采取综合防治措施，可以降低脑血管病的发病率。我们利用流行病学方法，在居民中筛选脑血管病的高危人群，方法简单易行。     

我国社区人群脑卒中危险因素干预试验——健康教育问卷的调查分析

健康教育是脑血管病危险因素干预措施之一.为了调查其实施效果,我们采用随机整群抽样法,对七城市3653人(其中干预组1843人,对照组1810人)进行统一问卷测试.结果表明,不论从性别、年龄、职业、文化程度等各方面分析,干预组得分均明显高于对照组.和七城市干预组脑卒中的发病率和死亡率有明显的下降相一致.说明健康教育可以提高人们对脑卒中的防治知识,增强人们的自我保健能力.在降低脑卒中“二率””面,无疑起着不容忽视的作用.