三种非典型抗精神病药对精神分裂症首发患者代谢影响的临床研究简

目前非典型抗精神病药已经成为我国治疗精神分裂症的主流药物, 反映出精神分裂症治疗理念和治疗技术的进展[1].然而,非典型抗精神病药引起的肥胖及体质量增加、糖脂代谢异常等不良反应日益引起关注.现有资料显示,抗精神病药对个体代谢有着不同影响[2],不同的抗精神病药对体质量和糖脂代谢等影响不同[3].本研究比较3 种非典型抗精神病药对精神分裂症首发患者代谢的影响,旨在为临床合理用药提供参考依据.     

阿立哌唑与氯氮平治疗难治性精神分裂症对照研究

我国难治性精神分裂症(refractory schizophrenia,RS)患者约占所有精神分裂症患者的25%～33%[1]。目前国内外对RS治疗一线用药为氯氮平,可考虑为首选,但其毒副作用和不良反应影响了其在临床上的推广[2]。近年来,也有非典型抗精神病药物奥氮平、喹硫平、利培酮、阿立哌唑等治疗RS的报道[3]。为提供RS更多的治疗策略,笔者以氯氮平为对照,探讨阿立哌唑对RS的疗效及安全性。     

支气管镜下气道炎症状态评估在慢性咳嗽患儿中应用

目的探讨支气管镜下气道炎症评估对慢性咳痰患儿的临床价值。方法回顾性分析58例慢性咳嗽患儿临床资料,按照支气管镜检查气道炎症状态评估结果将患儿分为脓性支气管炎组19例,非脓性支气管炎组39例;记录患儿一般情况以及肺泡灌洗液(bronchoalveolar lavage fluid,BALF)细菌培养结果和BALF细胞计数等,观察有无喉软骨软化症等发生。结果脓性支气管炎组患儿BALF细菌培养阳性率(42.1%)高于非脓性支气管炎组(12.8%)(P0.05),BALF细胞总数[(5.49±3.02)×106/mL]、中性粒细胞比率[(40.2±22.2)%]高于非脓性支气管炎[(3.98±1.53)×106/mL、(25.1±19.0)%)(P0.05);脓性支气管炎组喉软骨软化症发生率(42.1%)与非脓性支气管炎组(35.9%)比较差异无统计学意义(P0.05)。结论支气管镜下气管炎症状态评估在预测慢性咳嗽患儿气道细菌感染方面有一定价值。     

蛋白激酶B1基因多态性与重性抑郁障碍事件相关电位的关联性研究

Objective To explore the relationship of protein kinase B1 ( PKB1 ) gene polymorphisms in PI3-K pathway of BDNF and event-related potentials in depression.Methods The design of case-control research was used ,and 91 major depressive patients and 65 normal controls who were made in age and gender matched with patients were measured auditory event-related potential P300 and contingent negative variation ( CNV ) in the day when two groups were collected.Polymerase chain reaction (PCR) and direct DNA sequencing technology were used to detect PKB1 gene polymorphisms.Three SNPs that named rs3001371 ,rs2494738 ,rs1130214 were selected from 3 representative BLOCK Districts of PKB1.Two independent samples t test was used to analysis P300 and CNV between two groups,and the same way to analysis the average level of P300 and CNV and PKB1 SNP genolatency of P2(P＜0.05) and lower amplitude of P3a(P＜0.01 ) ,P3b(P＜0.01 ) and P3 (P＜0.01 ) ;CNV had der had statistical difference (P＜ 0.05 )in PKB1 rs3001371 gene between C/C and C/T genotype combined which included C allele, and T/T genotype.The amplitude of P3a( (5.93 ± 2.35 ) μV, P3b(6.51 ± 3.00) μV, P3 (6.27±2.43) μV) were lower than TT Genotype ( (7.45 ±2.19)μV, (8.63 ±3.57)μV,(8.04 ±2.57)μV,respectively).The mean of CNV indicators were not found different in statistics among the rs3001371 genotypes.Conclusions PKB1 gene rs3001371 polymorphism is associated with the principal component of P300 amplitude in patients with Major depressive disorder which suggest that genetic factors may have a certain impact on cognitive function in the patients with Major depressive disorder.     

蛋白激酶B1基因多态性与重性抑郁障碍事件相关电位的关联性研究

目的 探讨重性抑郁障碍患者脑源性神经营养因子(BDNF)磷酸肌醇3-激酶(PI3-K)途径中蛋白激酶B1(PKB1)基因多态性与事件相关电位P300、CNV检测指标的关联性.方法 采用病例对照研究,选取重性抑郁障碍患者91例和与之性别、年龄相匹配的正常对照组65例.2组均于入组当日检测其P300及CNV数据.应用聚合酶链反应(PCR)和DNA直接测序技术,检测样本的PKB1基因多态性.分析重性抑郁障碍及正常对照组间P300、CNV均数差异.比较PKB1 SNP基因型间P300及CNV指标均数的差异.结果 ①与对照组比较,重性抑郁障碍患者的P300为P2潜伏期延长(P＜0.05);P3a、P3b及P3波幅均明显减低(P＜0.01);CNV则为B波幅明显减低(P＜0.01)、RT反应时间明显延长(P＜0.01).②重性抑郁障碍患者P300指标在PKB1基因rs3001371含C等位基因的C/C及C/T合并组与TT组间有统计学差别.C/C及C/T合并组P3a、P3b及P3波幅[分别为(5.93±2.35)μV,(6.51±3.00)μV,(6.27±2.43)μV],低于TT基因型组[(分别为(7.45±2.19)μV,(8.63±3.57)μV,(8.04±2.57)μV],均差异有显著性(P＜0.05).未发现rs3001371基因型间CNV的指标均数差异有显著性(P＞0.05).结论 重性抑郁障碍患者PKB1基因rs3001371多态性与P300主成分波幅相关联,提示遗传因素对重性抑郁障碍记忆及认知功能可能有一定的影响.     

蛋白激酶B1基因多态性与重性抑郁障碍事件相关电位的关联性研究

Objective To explore the relationship of protein kinase B1 ( PKB1 ) gene polymorphisms in PI3-K pathway of BDNF and event-related potentials in depression.Methods The design of case-control research was used ,and 91 major depressive patients and 65 normal controls who were made in age and gender matched with patients were measured auditory event-related potential P300 and contingent negative variation ( CNV ) in the day when two groups were collected.Polymerase chain reaction (PCR) and direct DNA sequencing technology were used to detect PKB1 gene polymorphisms.Three SNPs that named rs3001371 ,rs2494738 ,rs1130214 were selected from 3 representative BLOCK Districts of PKB1.Two independent samples t test was used to analysis P300 and CNV between two groups,and the same way to analysis the average level of P300 and CNV and PKB1 SNP genolatency of P2(P＜0.05) and lower amplitude of P3a(P＜0.01 ) ,P3b(P＜0.01 ) and P3 (P＜0.01 ) ;CNV had der had statistical difference (P＜ 0.05 )in PKB1 rs3001371 gene between C/C and C/T genotype combined which included C allele, and T/T genotype.The amplitude of P3a( (5.93 ± 2.35 ) μV, P3b(6.51 ± 3.00) μV, P3 (6.27±2.43) μV) were lower than TT Genotype ( (7.45 ±2.19)μV, (8.63 ±3.57)μV,(8.04 ±2.57)μV,respectively).The mean of CNV indicators were not found different in statistics among the rs3001371 genotypes.Conclusions PKB1 gene rs3001371 polymorphism is associated with the principal component of P300 amplitude in patients with Major depressive disorder which suggest that genetic factors may have a certain impact on cognitive function in the patients with Major depressive disorder.     

米氨平与帕罗西汀治疗抑郁症的对照研究

目的:对米氮平和帕罗西汀治疗抑郁症的疗效和不良反应进行对比.方法:将74例抑郁症患者随机分为两组,分别给予米氮平和帕罗西汀口服,疗程8周.采用汉密顿抑郁量表(HAMD)和副反应量表(TESS)评定疗效及不良反应.结果:治疗8 周末,两组的疗效减分率比较差异无显著性(P>0.05).结论:米氮平与帕罗西汀治疗抑郁症的疗效相似,但米氮平起效快,不良反应少,依从性好,是一种安全、有效的新一代抗抑郁药物.     

高血压病时间治疗学的理论探讨

原发性高血压 (ＥＨ)不仅是血流动力学异常性疾病 ,而且也是代谢性疾病 ,常伴有糖、脂类代谢紊乱 ,电解质紊乱及心、脑、肾、血管等靶器官损伤 (ＴＯＤ) ,由于动态血压 (ＡＢＰＭ )的节律性波动 ,促使治疗观念发生改变[1] 。本文就其时间治疗学的有关问题 ,报告如下。1　血压波动模式1.1　季节差异性　ＡＢＰＭ显示 ,壮年组平均血压 (ＭＢＰ)春、秋高于冬、夏季 ;老年组则冬季高于夏季 ,而春、秋居中。就ＭＢＰ波动而言 ,前者以舒张压 (ＤＢＰ)为主 ,后者以收缩压(ＳＢＰ)为主。原因为 :老年组由于气温改变 ,壮年组由于情志所伤。1.2　昼夜…