帕金森病患者60例血液流变学变化分析

目的探讨帕金森病(PD)患者血液流变学主要指标的变化情况。方法采用NE-WLEADBV-100全自动悬丝血流变仪对60例PD患者和65例健康者进行血液流变学检测,而后进行比较。结果PD患者全血(高、中、低切)黏度、血浆黏度、纤维蛋白原均高于健康对照组,差异有统计学意义(P<0.05);而红细胞比容无明显差异(P>0.05)。结论血液流变学检测对PD的早期诊断、预防、治疗和判断预后有一定价值。     

经颅磁刺激对帕金森病小鼠黑质区多巴胺能神经元及脑源性神经营养因子表达的影响

目的:观察重复经颅磁刺激(rTMS)对帕金森病(PD)小鼠黑质多巴胺能神经元及脑源性神经营养因子(BDNF)表达的影响,探讨其可能的作用机制.方法:32只雄性C57BL/6J小鼠随机分为生理盐水(NS)、PD模型(PD)、假刺激(s-rTMS)及磁刺激(rTMS)组,每组8只.后3组采用1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)皮下注射建立PD小鼠模型.rTMS组鼠每天接受1 Hz、1 T 的rTMS治疗(共5个序列,25脉冲/序列),疗程为2周.经rTMS干预后,免疫组织化学检测黑质(SN)区酪氨酸羟化酶(TH)和BDNF的表达变化,并借助图像分析系统进行定量分析.结果:PD组酪氨酸羟化酶免疫组化阳性(TH-ir)和BDNF免疫组化阳性(BDNF-ir)细胞计数、校正光密度值(CD)较NS组减少(P<0.01);rTMS组TH-ir和BDNF-ir、CD值较PD组和s-rTMS组增加(P<0.05);s-rTMS组与PD组间以上指标无统计学差异.相关分析显示黑质区TH-ir与BDNF-ir细胞计数呈正相关(r=0.949,P<0.01),相应的CD值比较亦呈正相关(r=0.880,P<0.01).结论:rTMS对PD小鼠模型黑质多巴胺能神经元具有保护作用,而上调黑质区BDNF的表达可能是其作用机制之一.     

40例帕金森病肛门括约肌肌电图分析

帕金森病(pakinson disease，PD)是中老年常见疾病，以震颤、肌强直、运动减少、面具脸为主要表现，其诊断主要根据临床表现。易与多系统萎缩(multiple system atrophy，MSA)相混淆。MSA是一组散发的、进行性的神经系统变性疾病，主要包括散发的橄榄桥脑小脑萎缩、Shy-Drager综合征和纹状体变性3种亚型。临床症状复杂，尤其在发病早期，与PD     

帕金森病运动并发症的临床表现与治疗研究进展

运动并发症是帕金森病(PD)后期最常见的、棘手的临床问题,是晚期PD患者致残的主要原因。运动并发症主要包括症状波动及异动症两种,其发生与年龄、性别、病程及左旋多巴的应用等有关,且常合并存在,临床治疗前首先要识别运动并发症的类型,并进行个体化治疗。本文围绕PD运动并发症的类型、特点及常见运动并发症的治疗等内容进行综述,为临床诊断及针对性治疗提供参考。     

低频重复经颅磁刺激对帕金森病大鼠行为学的影响

目的探讨0.5Hz重复经颅磁刺激(rTMS)对帕金森病大鼠行为学的影响。方法取健康SD大鼠45只,用6-OHDA毁损右侧黑质致密部(SNc)与中脑腹侧背盖(VTA)制备偏侧帕金森病模型。用阿扑吗啡(APO)腹腔注射筛选,将成功的20只帕金森病鼠随机分为治疗组和对照组,每组10只。治疗组给予rTMS治疗,频率为0.5Hz,刺激强度为阈上30%,连续20个刺激,每天1次,连续刺激2周。对照组予以假刺激。在治疗前、治疗结束后第1天、14天、28天分别测定APO诱导的大鼠旋转圈数、启动潜伏期的变化。结果(1)大鼠旋转圈数(r/min):治疗组与对照组在治疗结束后第14天为(9.7±3.0vs14.6±2.6)、28天为(9.2±2.7vs14.2±2.6),治疗组旋转圈数减少,与对照组比较差异有统计学意义(P<0.05);治疗组在治疗结束后第14天、28天与治疗前比较差异有统计学意义(P<0.05);对照组各时间点比较差异无统计学意义(P>0.05)。(2)启动潜伏期(s):治疗组与对照组rTMS治疗结束后第1天(25±9vs39±16)、第14天(18±7vs42±16)、第28天(17±7vs42±16)比较,治疗组启动潜伏期明显缩短,差异有统计学意义(P<0.05);治疗组各时间点与治疗前比较差异有统计学意义(P<0.05);对照组各时间点比较差异无统计学意义(P>0.05)。结论0.5Hz、阈上30%刺激强度的rTMS可改善PD大鼠的行为学异常。     

低频重复经颅磁刺激对帕金森病运动功能和情感障碍的疗效观察

Objective To investigate the therapeutic effects of low frequency repetitive transcranial magnetic stimulation (rTMS) on motor function and affective disorder in patients with Parkinson's disease (PD). Methods Twenty PD patients were performed by 1 Hz rTMS therapy for 15 days and 10 matched patients were performed sham stimulation. Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Unified Parkinson' s Disease Rating Scale (UPDRS) were assessed before and 15 days after rTMS treatment. Results After treatment with rTMS, the motor function was improved, and UPDRS total score and UPDRS-Ⅰ , UPDRS-Ⅱ, UPDRS-Ⅲ scores were decreased. UPDRS score was decreased from (38.45±17.33) to (30.95± 17.00) (t=6.780,P<0.01). At the same time, HAMD score was decreased from (12.15±7.62) to (8.75±7.31 ) (t = 5.101, P<0.01 ). The scores of somatization, blockage and sleep disorders were lowered after treatment, but the HAMA score had no significant change(t=1.757, P>0.05). The rigidity of PD patients was improved obviously. All indexes had no improvement in sham stimulation group. Conclusions Low frequency rTMS may improve motor dysfunction and affective disorder in PD patients .     

低频重复经颅磁刺激对帕金森病运动功能和情感障碍的疗效观察

目的 从运动功能、情感障碍方面观察低频重复经颅磁刺激(rTMS)对帕金森病(PD)患者的治疗作用.方法 rTMS组用1HzrTMS技术治疗20例PD患者共15d.10例与rTMS组相匹配的PD患者接受假刺激治疗15d.rTMS、假刺激治疗前后观察统一PD评定量表(UPDRS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)的变化.结果 rTMS治疗后20例患者运动功能症状改善良好,UPDRS评分由治疗前的(38.45±17.33)分降至(30.95±17.00)分,降低19.51%,(t=6.780,P<0.01),UPDRS各项评分下降;HAMD总分由治疗前的(12.15±7.62)分下降到治疗后的(8.75±7.31)分,降低27.98%,(t=5.101,P<0.01),躯体化、睡眠障碍和阻滞的因子分低于治疗前;HAMA评分无明显改变(t=1.757,P>0.05).强直型患者症状改善更为明显.假刺激组治疗前后各项指标差异无统计学意义.结论 1HzrTMS可以改善运动功能和抑郁症状,对焦虑无明显作用.     

低频重复经颅磁刺激治疗帕金森叠加综合征疗效初探

Objective To study the effects of repeated transcranial magnetic stimulation(rTMS)on Parkinson's plus syndrome(PPS).Methods Fifteen in-patients with PPS were studied between 2005 and 2008.The patients received 1 Hz rTMS at an intensity 30%over the threshold.The rTMS was applied on the hand representive area of the bilateral first motor cortex,50 stimulations on each side,5 arrays,for 5 min,once daily for 15 d.Hamilton's depression scale(HAMD),Hamilton's anxiety scale(HAMA),the unified Parkinson's disease rating scale(UPDRS,which can be subdivided into UPDRS Ⅰ,UPDRS Ⅱ and UPDRS Ⅲ),an activities of daily living scale(ADL),the mini-mental state examination(MMSE)and motor evoked potential(MEP)were assessed before and immediately after 15 d of rTMS treatment. Results Average HAMD,HAMA,UPDRS,UPDRS Ⅱ and UPDRS Ⅲ scores all decreased,and ADL scores increased significantly after treatment,while UPDRSⅠand MMSE scores were unchanged before and after treatment.No significant changes in resting motor threshold or central motor conduction time of the MEP were observed after rTMS treatment. Conclusion Clinical symptoms of PPS patients improved after rTMS treatment and side effects were few.Depression,anxiety,motor function and ability in the activities of daily living improved greatly.Repeated transcranial magnetic stimulation is a potential treatment for PPS patients.There may be no correlation between the effective mechanism of rTMS and cortex excitation.     

低频磁刺激对PC12细胞分化的影响

目的探讨磁刺激对大鼠肾上腺嗜铬细胞瘤细胞株（PC12）分化及功能的影响。方法应用Magstim220型磁刺激仪分别刺激单纯PC12细胞组（M组）和PC12＋神经生长因子（NGF）组（MN组），刺激强度为0．38T、1．14T、1．9T（总强度1．9T），频率为1Hz，每天于10s内连续刺激10次，连续刺激9d。每隔1d观察细胞增殖和突起生长的情况，于倒置显微镜下随机取20个视野拍照并计数，于第3天、第6天、第9天留取细胞培养液检测多巴胺水平。结果在1．14T刺激强度下细胞突起显著增加；多巴胺水平在刺激强度为0．38T时达高峰。结论低频磁刺激可促进PC12细胞的分化及多巴胺分泌；1．14T、1．9T刺激强度时联合应用NGF可提高PCI2细胞的分化。     

颞叶癫痫患者43例的临床特征和睡眠脑电图特点分析

目的探讨颞叶癫痫临床特征及睡眠脑电图特点。方法对颞叶癫痫患者43例的临床特征、睡眠脑电图进行回顾性分析。结果43例中,仅表现为全身性强直－阵挛发作23例,复杂部分性发作15例,合并单纯部分性发作5例。患者睡眠脑电图和24h脑电监测中,除5例正常外,双侧颞叶癫痫样波9例,左侧颞叶癫痫样波10例,右侧颞叶癫痫样波8例,左额、颞癫痫样波2例,右额、颞癫痫样波3例,双额、颞癫痫样渡6例。颞叶癫痫继发全身强直－阵挛发作最多,颞叶癫痫强直．阵挛发作患者不容易与全身性强直．阵挛性癫痫相区别。部分性和全身性癫痫用药不同,区别是部分性癫痫还是全面性癫痫非常重要。结论睡眠脑电图对颞叶癫痫的定位及其放电机制的了解有着重要意义。