HD诱发癫痫2例

常规抗精神病药诱发癫痫已为精神科医生所熟知,但使用长效抗精神病药,尤其是肌注氟哌啶醇癸酸脂(HD)诱发癫痫较为罕见,现将本院遇到的使用 HD 治疗慢性精神分裂症诱发癫痫发作的2例报告如下:例1,徐某,男,34岁,未婚,农民,于1985年8月17日入院。因精神失常十七年,兴奋多言、生活懒散、外出乱跑,用斧头砍死农妇被拘审入院,经精神病司法医学鉴定为精神分裂症。入院后用氯丙嗪100～200毫克,氯氮平200～300毫克约五年。1990年11     

HD与精神病的维持治疗

如何防止和减少精神病的复发是精神卫生工作者必须重视的课题。现就精神病的维持治疗以及氟哌啶醇癸酸酯(以下称 HD)在维持治疗中的地位综述如下:一、精神病的维持治疗不论是精神分裂症,还是躁郁症的复发都会给病人及家属带来痛苦。而且研究表明,     

HD与FD治疗慢性精神分裂症的双盲对照试验

我们于1988年10月～1989年5月应用有关量表对比利时Janssen药厂生产的氟哌啶醇癸酸酯(Haloperidol Decanoate,简称HD)和国产的氟奋乃静癸酸酯(Fluphenazine Decanoate,简称FD)治疗慢性精神分裂症的疗效和锥体外系副作用进行了双盲对照研究。     

Old people reporting childhood AD/HD symptoms: Retrospectively self-rated AD/HD symptoms in a population-based Swedish sample aged 65–80

Our knowledge of attention deficit/hyperactivity disorder (AD/HD) has increased in recent years. Little is still known about the course and manifestations in later parts of life and whether elderly persons who once presented childhood AD/HD symptoms can be identified. The aim of the study was to explore the occurrence to which elderly individuals retrospectively report symptoms that may indicate childhood AD/HD. The 25-item Wender Utah Rating Scale (WURS) was administered in a population-based sample of 2500 persons aged 65–80. Demographics, self-ratings of problems in childhood, current health and memory were also investigated. A total of 1599 individuals participated, which corresponds to a response rate of 64%. The prevalence of self-rated childhood AD/HD symptoms was 3.3% using a cut-off score of 36 or more in the WURS. Men rated significantly more AD/HD symptoms. Those who reported more childhood AD/HD symptoms also claimed general problems in childhood as well as worse current health. The proportion of individuals among 65–80-year-olds, who report childhood AD/HD symptoms is slightly lower but comparable with recent prevalence rates of childhood AD/HD. The study encourages further studies of AD/HD using a lifespan perspective.     

HD基因和UCHL-1基因多态性与Huntington病关系的研究

目的探讨Huntington病患者发病年龄与HD基因和UCHL-1基因S18Y多态性相关情况。方法应用聚合酶链式反应(polymerase chain reaction,PCR)技术检测两个HD家系(53人)、6例非家系HD患者和51名正常对照组HD基因CAG重复次数;应用聚合酶链式反应-限制性内切酶分析(polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)技术检测UCHL-1基因S18Y多态性的分布情况。结果在两个家系中确诊了5例HD病人,在其有高度遗传风险的子女中发现4例症状前患者。UCHL-1基因S18Y多态性的基因型和等位基因分布频率在两个家系和正常对照组中无统计学差异(SY型基因型在三种基因型中最常见,频率>50%)。非家系患者中未见YY基因型,SS基因型多于SY型,S等位基因多于Y型,与正常对照组差别有统计学意义。多元线性回归研究显示11例病人发病年龄变异的15.6%是由其UCHL-1基因S18Y多态性造成的。CAG重复次数可解释发病年龄变异的71.4%。结论HD基因CAG重复次数是决定患者发病年龄变异的最主要因素,但不是唯一因素。UCHL-1基因S18Y多态性是HD的调节基因,对发病年龄有微弱的调节作用,提示UCHL-1可能参与HD的发病机制。     

新型FKBPs配体HD5-6对SAMP8小鼠的抗老化研究

目的观察FKBPs(FK506 blinding proteins)配体噻嗪酰胺衍生物(HD5-6)对SAMP8快速老化小鼠学习记忆能力和海马神经元的影响,以及对SAMP8小鼠海马神经元基因表达谱的影响。方法选用10月龄快速老化的SAMP8小鼠20只,随机分为痴呆组、HD5-6组;另选10月龄正常老化的SAMR1小鼠10只作为正常对照组。各组分别腹腔注射药物35 d,并于29 d采用Morris水迷宫实验评价各组小鼠学习记忆能力的变化。HE染色观察海马区神经元形态;TUNEL观察海马神经元凋亡情况,用基因芯片技术检测HD5-6组和痴呆组小鼠海马神经元基因表达谱的变化差异。结果与正常对照组相比,痴呆组在定位航行实验中表现出明显的学习记忆障碍,逃避潜伏期显著延长(P0.05),HD5-6组自3 d开始逃避潜伏期比痴呆组明显缩短(P0.05);空间探索实验中HD5-6组跨平台次数、原平台象限停留时间明显多于痴呆组(P0.05)。与正常对照组相比,痴呆组海马区神经元数量明显减少,细胞排列紊乱,大量的神经元细胞核固缩,深染、坏死,其神经元凋亡指数(51.73±4.48)%明显高于正常对照组(28.02±11.25)%(P0.05),HD5-6干预的SAMP8小鼠海马区神经元病理改变明显改善,海马神经元凋亡指数(20.47±2.25)%明显降低(P0.01)。HD5-6组与痴呆组海马神经元基因表达谱相比,表达差异在2倍以上的基因有118条,表达上调的为9条,表达下调的为109条。其中有功能的mRNA中,表达上调的有4条,表达下调的有21条。结论 HD5-6能够改善快速老化小鼠SAMP8的学习记忆能力和海马神经元病理改变,并可能通过对基因表达谱产生影响而发挥明显的抗衰老作用。     

Adults’ self-efficacy beliefs and referral attitudes for boys and girls with AD/HD

Males with Attention Deficit/Hyperactivity Disorder (AD/HD) are referred to specialists significantly more frequently than females. The aim of this study was to examine differences in mothers’ and prospective educators’ self-efficacy beliefs and severity perceptions towards boys and girls with AD/HD and to explore the inter-relationships between those perceptions and referral judgements. One hundred and fifteen female prospective preschool educators and 118 mothers of boys and girls aged 4–6, enrolled in kindergartens in Athens completed a questionnaire that: (a) presented a vignette describing a typical boy or girl with AD/HD, and (b) was followed by two scales exploring severity perceptions and self-efficacy beliefs with reference to the child described in the vignette. Mothers’ sense of self-efficacy was higher than educators’ and both samples had higher sense of self-efficacy towards girls with AD/HD than boys. Educators rated the boys’ behaviour as significantly more severe than girls’. Finally, perceived self-efficacy predicted severity perceptions and severity perceptions predicted referral decisions. To conclude, adults’ differentiated perceptions of severity of AD/HD in boys and girls, which might be influenced by their own limited self-efficacy beliefs, especially towards males, might account for a proportion of the differences in referral ratio of boys and girls with AD/HD.     

HD联合HP治疗尿毒症脑病对患者意识状态及不良事件发生的影响

目的观察血液透析(hemodialysis,HD)联合血液灌流(hemoperfusion,HP)治疗尿毒症脑病的临床效果,分析其对患者意识状态及不良事件发生的影响。方法于我院2013-01—2014-01接诊的76例尿毒症脑病患者,随机均分为对照组与观察组。对照组采用HD治疗;观察组同时使用HP治疗。统计2组患者治疗前后各生化指标、意识状态及神经功能评分,观察2组患者不良事件发生情况与治疗效果。结果观察组治疗总有效率89.5%显著高于对照组71.1%,不良事件发生率5.3%显著低于对照组21.1%,组间差异有统计学意义(P0.05)。治疗前,2组患者β2-MG、PTH水平及GCS、NIHSS评分均有明显改变(P0.05),观察组上述指标改变幅度均优于对照组(P0.05)。结论 HD联合HP治疗尿毒症脑病效果显著,能有效改善患者意识状态,恢复神经功能,且不良事件发生率低,适合于临床推广。     

MS vs. HD: can white matter and subcortical gray matter pathology be distinguished neuropsychologically?

This study was conducted to examine the neuropsychological effects of white matter and subcortical gray matter pathology. Nineteen patients with multiple sclerosis (MS), 16 with Huntington's disease (HD), and 17 normal controls (NC) participated. Participants completed the California Verbal Learning Test (CVLT), Rotary Pursuit (RP) and Mirror Tracing (MT) tasks, and the Symbol Digit Modalities Test (SDMT). The principal findings pertain to a dissociation in procedural memory: on RP, the HD group demonstrated impaired sequence learning compared to the MS group, which performed similarly to the NC group, yet on MT, the MS and HD groups demonstrated normal perceptual-motor integration learning. On the CVLT, both patient groups performed better on recognition than on recall. On the SDMT, both patient groups performed worse than the NC group, with the HD group performing more poorly than the MS and NC groups. These results suggest that involvement of white and subcortical gray matter may produce different neuropsychological effects.