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1.
长期住院治疗的精神分裂症患者代谢综合征风险研究   总被引:3,自引:0,他引:3  
目的调查长期服用抗精神病药的精神分裂症患者在糖脂代谢相关变量的情况及相关风险的评估,以便为进一步研究抗精神病药与代谢综合征发生的因果关系提供初步的调查线索。方法以上海市精神卫生中心住院诊断为精神分裂症且持续服用治疗剂量抗精神病药至少6个月以上而以往无代谢障碍的患者为调查对象,在6个病房中进行筛选,符合条件共170人,调查包括人口学资料(身高,体重,腰围,用药时间,糖尿病家族史)、最近一月的血脂水平(HDL,TG)、空腹血糖和血压等情况。结果精神分裂症患者中男性较女性更易罹患代谢综合征(P<0.01);精神分裂症患者中的吸烟者较不吸烟者更易罹患代谢综合征(P<0.05);而药物之间的比较并无显著性差异(P>0.05)。结论经典和非典型抗精神病药可能会引起代谢综合征或加重其发生的风险。  相似文献
2.
目的探讨二甲双胍合并行为干预疗法对氯氮平治疗精神分裂症患者体重、血糖、血脂的影响。方法将60例开始单独服用氯氮平治疗的精神分裂症患者随机分为两组,研究组采用氯氮平(250~400mg/d)联合二甲双胍(750mg/d)及实施行为干预治疗,对照组则单用氯氮平(250~400mg/d),未实施任何干预措施,治疗12周。两组患者分别于入组时和治疗后第4、8及12周末测定空腹血糖(FBG)、血脂(TC、TG、HDL、LDL)、身高、体重、腰围,计算体重指数(BMI)以及治疗12周末体重增加大于7%的人数比率。用阴性与阳性症状量表(PANSS)于治疗前和治疗12周末评定疗效。结果治疗12周末,研究组与对照组体重较治疗前分别增加为(2.03±1.26)kg、(4.98±3.09)kg;BMI较治疗前分别增加为(0.54±0.62)kg/m2、(2.03±1.02)kg/m2,体重、BMI的升高程度对照组高于研究组(P〈0.05),体重增加大于7%的患者研究组为6例(20%)、对照组为16例(53%),对照组明显高于研究组(P〈0.05)。两组患者治疗后空腹血糖、血脂各项的升高程度对照组明显高于研究组(P〈0.05)。结论二甲双胍合并行为干预疗法能有效减轻氯氮平治疗精神分裂症患者所致的体重增加及血糖、血脂升高。  相似文献
3.
抗精神病药对代谢的影响比较   总被引:1,自引:1,他引:0  
目的:探讨抗精神病药对体质量、血糖、血脂、胰岛素、瘦素的影响。方法:首发住院精神分裂症患者94例随机分为3组,分别服用氯氮平、利培酮、奥氮平治疗,于治疗前和治疗6周测定体质量、血清瘦素、胰岛素、胰岛素抗体、空腹血糖、糖化血红蛋白(HbA1c)、血清胆固醇(TC)及三酰甘油(TG)。结果:3组治疗前后BMI变化分别为(2.37±2.11)kg/m2、(1.32±1.77)kg/m2、(2.07±1.38)kg/m2(F=10.783,P=0.000)。治疗前3组糖化血红蛋白差异显著(F=16.412,P<0.001),初始血糖、初始TC、TG、胰岛素、瘦素水平差异无显著性(P>0.05)。治疗6周后,3组间血糖、初始TC、TG、胰岛素、瘦素水平均有显著性差异。结论:氯氮平对体质量、血糖、血脂、瘦素及胰岛素的影响大;奥氮平不良反应较小,对体质量、血脂、血浆瘦素水平影响较大;利培酮对各项代谢指标及体质量的影响较小。  相似文献
4.
二甲双胍对奥氮平所致精神分裂症患者体质量增加的影响   总被引:1,自引:0,他引:1  
目的 验证二甲双胍预防奥氮平引起精神分裂症患者的体质量增加和糖代谢紊乱的效果.方法 将37例未服过抗精神病药的精神分裂症患者,随机分为奥氮平(15 mg/d)联合二甲双胍组(750 ms/d;A组,18例)和奥氮平(15 mg/d)联合安慰剂组(B组,19例),治疗12周.于治疗前和治疗第4周末、8周末及12周末测定空腹血糖、胰岛素(INS)、身高、体质量、腰围、臀围,计算体质量指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数(IRI)及治疗12周末体质量增加大于7%的比率.用阳性症状量表(SAPS)、阴性症状量表(SANS)于治疗前和治疗12周末评定疗效.结果 治疗12周末,A、B两组的体质量、BMI、WHR及B组患者的空腹INS和IRI较治疗前均升高(P<0.05).治疗第8,12周末,B组的体质量、BMI、空腹INS和IRI的变化值高于A组(P<0.05).B组体质量增加大于7%的比率(63%,12例)高于A组(17%,3例;P<0.01).A、B两组的SAPS及SANS评分均显著低于治疗前(均P<0.05),但组间差异均无统计学意义(P>0.05).结论 二甲双胍能有效减轻奥氮平引起的体质量增加和糖代谢紊乱.  相似文献
5.
Abstract– An analysis was made of weight changes during treatment with valproate in 63 adult epileptic patients.
36 patients (57%) gained more than 4 kg in weight during treatment, while 27 patients (43%) were stable in weight with weight changes of less than ± 4 kg.
There were no significant differences between weight gainers and weight-stable patients with regard to age, sex, pretreatment overweight, duration of treatment, dosage or serum levels of valproate. From structured patient interviews, it appeared that the 2 groups of patients differed only insignificantly with regard to appetite, thirst and familial predispositions to obesity and diabetes. Consequently, no factors predictive for weight gain could be outlined. Presumable pathogenic mechanisms of importance are discussed.  相似文献
6.
A new perspective on mechanisms involved in the regulation of a constant fat body mass and its relation to body energy balance is presented on the basis of a series of experiments. A study of the neuroendocrine conditions underlying the daily weight gain-weight loss cycle in rat and man and experimentally induced over and underweight, leads to the notion that lipogenesis and lipolysis above and below a range of physiological fluctuations of body fat develop a counter-regulatory tendency to correcting lipolysis and lipogenesis respectively. This development is attributed to a chronic central action of plasma insulin concentration on hypothalamic insulin receptors. This liporegulatory system which controls and regulates the filling and emptying of fat stores modulates the feeding system which controls and regulates the filling of a gastrointestinal store by eating and its emptying by metabolic food utilization.  相似文献
7.
A new perspective on mechanisms involved in the regulation of a constant fat body mass and its relation to body energy balance is presented on the basis of a series of experiments. A study of the neuroendocrine conditions underlying the daily weight gain-weight loss cycle in rat and man and experimentally induced over and underweight, leads to the notion that lipogenesis and lipolysis above and below a range of physiological fluctuations of body fat develop a counter-regulatory tendency to correcting lipolysis and lipogenesis respectively. This development is attributed to a chronic central action of plasma insulin concentration on hypothalamic insulin receptors. This liporegulatory system which controls and regulates the filling and emptying of fat stores modulates the feeding system which controls and regulates the filling of a gastrointestinal store by eating and its emptying by metabolic food utilization.  相似文献
8.
This paper reviews the literature on the role of dietary fat in calorie intake and body weight gain in humans and laboratory animals. An overview of 40 animal studies which compared growth on high-fat (HF) and high-carbohydrate (HC) solid/powdered diets indicated that the HF diet elicited greater weight gain in 33 out of 40 studies. Enhanced growth on the HF diet was often, but not exclusively, attributable to greater caloric intake. Additional evidence for the growth-enhancing effect of HF diets emerges from "diet option" and "supermarket" feeding studies in rats, and experimental and epidemiological studies in humans. Three principal factors that contribute to the different responses to HF and HC diets are (a) caloric density, (b) sensory properties and palatability, and (c) postabsorptive processing. It is concluded that both calorie intake and metabolic energy expenditure are biased towards weight gain when a HF diet is consumed, and that the high caloric density of high-fat diets plays a primary role in weight gain. Humans may be biologically predisposed to gain weight when a HF diet is consumed.  相似文献
9.
Effects of NGF and anti-NGF on estrogen-sensitive behaviors were examined in ovariectomized, estrogen-treated rats. Intracerebroventricular (i.c.v.) administration of NGF resulted in a significant decrease in body weight. Daily treatment with low levels of estradiol resulted in a steady increase in lordosis behavior as reflected by average lordosis quotient and lordosis score. No effects of NGF or anti-NGF on lordosis behavior were detected. Estrogen treatment also resulted in a significant increase in the number of vocalizations elicited from female controls by male contact during sex behavior. NGF-treatment enhanced this effect, resulting in significantly more vocalizations elicited earlier in the course of estrogen treatment than were elicited from non-NGF-treated controls. These effects were blocked by progesterone. An increase in the number of rejections elicited by male contact during sex behavior was also observed in NGF-treated animals relative to controls. In addition, i.c.v. infusions of anti-NGF prevented the estrogen-mediated increase in elicited vocalizations, suggesting that NGF may have a physiological role in regulating this behavior. These data implicate NGF in the regulation of specific defense-related behaviors in estrogen-treated rats. Effects of NGF and anti-NGF on immunocytochemical staining for p75NGFR- and ChAT-like immunoreactivity were also analyzed and are discussed.  相似文献
10.
Abstract A new refeeding program using only liquid formula was given to six anorexic inpatients (LF group) at the initial stage of hospitalization. These patients were compared with six other inpatients who regular meals (RM group). The LF group did not develop a phobia of gaining weight, while the RM group showed a vicious cycle of gastrointestinal discomforts leading to fat phobia and stagnation in weight gain. By comparison, the LF group had fewer gastrointestinal symptoms, which resulted in the disruption of this cycle and seemed to help motivate these patients to obtain a steady gain in bodyweight.  相似文献
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