急性缺血性卒中重组组织型纤溶酶原激活剂静脉溶栓致出血性转化及其预后的危险因素分析

目的 探讨急性缺血性卒中重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后发生出血性转化(HT)的可能危险因素以及这些危险因素对患者预后的影响.方法 128例急性缺血性卒中患者发病6h内接受rt-PA静脉溶栓治疗,选取溶栓前临床和实验室资料,通过比较HT组与非HT组之间的差异,筛选与HT相关的可能危险因素,并进一步通过Logistic回归分析影响HT及其预后的独立危险因素.结果 128例溶栓患者有29例继发HT(22.66％),其中16例为症状性脑出血(12.50％),死亡2例,占HT的6.90％.Logistic回归分析表明房颤(OR=1.293,95％ CIl.224 ～1.589,P=0.00l)、早期CT改变(OR=2.452,95％ CI 1.132～3.309,P=0.034)、基线舒张压≥100 mm Hg(1 mm Hg=0.133 kPa,OR=9.265,95％ CI 1.435 ～ 59.836,P=0.019)、基线血糖≥11.1 mmol/L(OR=3.037,95％ CI0.252 ～ 57.593,P=0.047)、NIHSS评分＞15分(OR=8.752,95％CI 1.035 ～30.285,P=0.023)和溶栓时间窗＞3h(OR=98.74,95％CI 5.067 ～ 186.120,P=0.002)6项为HT独立危险因素,其中基线血糖≥11.1 mmol/L(OR=3.265,95％ CI 0.435 ～ 59.863,P=0.045)、NIHSS评分＞15分(OR=10.453,95％ CI 5.647～38.185,P=0.003)和溶栓时间窗＞3h(OR =2.541,95％CI 1.098 ～51.086,P=0.017)影响了HT患者的预后.结论 溶栓前的舒张压、血糖水平、神经功能缺损程度、CT低密度改变或水肿占位效应、房颤和溶栓时间窗是HT的独立危险因素,其中基线血糖水平、神经功能缺损程度和溶栓时间窗影响了溶栓后HT患者的预后.     

静脉内溶栓治疗急性缺血性卒中病人的神经功能改善观察

目的观察急性缺血性卒中患者静脉溶栓后24 h对神经功能改善的预测因素及其与1年后预后的关系。方法急性缺血性卒中患者经静脉rt-PA溶栓治疗,根据NIHSS记分评价神经功能及患者1年后的预后。结果 72例患者23例在治疗后24 h神经功能得到改善。年龄<60岁(OR1.9,95%CI 1.7 to 3.2)、入院时血糖水平<8 mmol/L(OR3.87,95%CI 1.9 to 9.2)与神经功能改善相关。结论年龄<60岁、入院时血糖水平<8 mmol/L及轻中度卒中是静脉内溶栓后神经功能恢复相关,治疗后24 h神经功能恢复是1年后良好结局的独立预测因素。     

心房颤动与急性缺血性卒中静脉溶栓致出血转化的相关性及危险因素分析

目的探讨心房颤动与急性缺血性卒中重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓致出血转化的相关性,分析房颤患者溶栓后出血转化的危险因素。方法回顾性分析接受rt-PA静脉溶栓治疗的147例急性缺血性卒中患者,将入选病例分为非房颤组与房颤组,比较两组患者溶栓后出血转化(HT)的差异,采用单因素和logistic回归分析房颤患者溶栓后出血转化的危险因素。结果 147例入组患者中房颤患者66例,非房颤患者81例,房颤组HT与非房颤组比较差异有统计学意义[27.27%(18/66)与14.81%(12/81),χ2=3.071,P=0.028],房颤组症状性HT与非房颤组比较差异亦有统计学意义[12.12%(8/66)与3.70%(3/81),χ2=3.798,P=0.015],logistic回归分析表明伴发房颤的患者基线收缩压高(OR=11.285,95%CI 1.576-68.377,P=0.035)、基线NIHSS评分较高(OR=2.608,95%CI 1.072-4.380,P=0.013)、早期头部CT有缺血改变(OR=1.595,95%CI 1.164-3.258,P=0.023)、起病-溶栓时间(OTT)较长(OR=93.114,95%CI 7.385-177.972,P=0.006)、溶栓24h内血压变异性大(收缩压变异性OR=18.638,95%CI 1.433-65.634,P=0.004;舒张压变异性OR=21.449,95%CI 1.528-56.420,P=0.003)与溶栓后发生HT显著相关。结论房颤与静脉溶栓后HT具有相关性。基线收缩压高、基线NIHSS评分较高、早期头部CT有缺血改变、OTT较长、溶栓24h内血压变异性大是房颤患者静脉溶栓后发生HT的危险因素。     

rt-PA 静脉溶栓后颅内出血转化相关机制的研究进展

急性缺血性脑卒中是最常见的脑卒中类型,重组组织型纤溶酶原激活剂(Recombinant Tissue Plasminogen Activator,rt-PA)静脉溶栓是急性缺血性脑卒中有效的治疗方法,具有明确的循证学依据,美国国立神经疾病与卒中研究所(NINDS)、欧洲急性卒中协作研究(ECASS)及中国2014中国急性缺血性脑卒中诊治相关指南均加以推荐使用.rt-PA静脉溶栓后部分类型颅内出血,严重影响患者预后,增加患者的死亡及伤残率,是阻碍静脉溶栓实施的重要因素.因此,探讨rt-PA静脉溶栓后颅内出血转化的发病机制,具有重要意义.本文就溶栓后颅内出血转化的分类、rt-PA药理作用、不同类型出血转化发病机制加以综述.     

尿酸与缺血性脑卒中rt-PA静脉溶栓预后:前瞻性研究

目的探讨血清尿酸水平与rt-PA静脉溶栓急性缺血脑卒中临床预后的相关性。方法对108例急性缺血性脑卒中rt-PA静脉溶栓患者为研究对象,收集一般基线资料,并进行为期6 m的随访,评估神经功能恢复情况。结果 rt-PA溶栓前正常尿酸组平均尿酸为(285.5±49.6)μmol/L,高尿酸组为(460.3±58.5)μmol/L;溶栓前NIHSS评分正常尿酸组为(12±6),高尿酸组为(11±5.25)(P=0.41),无明显统计学意义。病程2 w时正常尿酸组评分为(9±4),高尿酸组为(7±4.25)(P=0.022)、高尿酸组中早期神经功能好转人数比例(24例,75.0%)明显高于正常尿酸组(40例,52.6%)(P=0.034);病程6 m时,高尿酸组神经功能预后不良(mRS 3~6)人数比例低于正常尿酸组(P=0.035)。多因素Logistic回归分析提示高尿酸水平(P=0.037,OR=0.467,95.0%CI:0.250~0.873)是rt-PA溶栓后远期预后的保护因素。结论高尿酸水平有助于rt-PA静脉溶栓治疗缺血性脑卒中早期及远期神经功能恢复,提示高尿酸水平是其近期及远期预后的保护性因素。     

三七总皂苷对急性缺血性卒中患者重组组织型纤溶酶原激活物静脉溶栓疗效及出血性转化的影响

目的探讨三七总皂苷对急性缺血性卒中患者重组组织型纤溶酶原激活物(rt-PA)静脉溶栓疗效和出血性转化的影响。方法共200例急性(发病至入院时间4.50 h)缺血性卒中患者采用随机数字表法随机分为常规rt-PA静脉溶栓组(对照组,100例)和rt-PA静脉溶栓联合三七总皂苷治疗组(治疗组,100例),分别于治疗前、静脉溶栓后24 h和14 d检测缺血-再灌注损伤指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]、出血性转化指标[基质金属蛋白酶-9(MMP-9)、纤维连接蛋白(FN)]和神经功能指标[美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)],观察静脉溶栓后14 d药物不良反应和出血性转化发生率,评价静脉溶栓后12个月预后(病死率和BI评分)。结果治疗组患者血清SOD(P=0.000)和BI评分(P=0.000)高于,血清MDA(P=0.001)和MMP-9(P=0.001)、血浆FN(P=0.000)和NIHSS评分(P=0.006)低于对照组。rt-PA静脉溶栓联合三七总皂苷治疗后24 h,血清MDA(P=0.000)和MMP-9(P=0.000)、BI评分(P=0.000)升高,NIHSS评分降低(P=0.000);治疗后14 d,血清MDA(P=0.000)和MMP-9(P=0.000)反而降低,血清SOD(P=0.000)和BI评分(P=0.000)持续升高,血浆FN(P=0.000)和NIHSS评分(P=0.000)持续降低。静脉溶栓后14 d,治疗组患者出血性转化发生率低于对照组[9例(9%)对19例(19%);χ2=4.153,P=0.042)],药物不良反应发生率组间差异无统计学意义[14例(14%)对11例(11%);χ2=0.411,P=0.521]。静脉溶栓后12个月,两组病死率差异无统计学意义[5例(5%)对1例(1%);χ2=1.546,P=0.241],而治疗组生存患者BI评分高于对照组(88.51±11.49对84.47±9.83;t=2.451,P=0.015)。结论三七总皂苷可以减轻急性缺血性卒中患者rt-PA静脉溶栓后缺血-再灌注损伤,降低出血性转化发生率,改善患者预后,且安全性良好。     

重组组织型纤溶酶原激活物治疗合并大脑中动脉高密度征的急性缺血性卒中有效性和安全性的系统评价

目的系统评价合并大脑中动脉高密度征(HMCAS)的急性缺血性卒中患者重组组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗的有效性和安全性。方法以hyperdense middle cerebral arterysign/HMCAS/hyperdense artery sign/hyperdense cerebral artery sign、ischemic stroke/cerebral infarction/brain infraction/cerebral embolism、thrombolysis/thrombolytic therapy/rt-PA/recombinant tissue plasminogenactivator,以及大脑中动脉高密度征/致密动脉征/大脑中动脉致密征/脑动脉高密度征、缺血性脑卒中/缺血性卒中/脑梗死/脑梗塞/脑栓塞、溶栓治疗/rt-PA/重组组织型纤溶酶原激活剂等中英文词组为检索词,计算机检索1994年1月-2014年12月美国国立医学图书馆生物医学信息检索系统、荷兰医学文摘、Cochrane临床对照试验中心注册库,以及中国生物医学文献数据库等收录的关于rt-PA静脉溶栓治疗合并HMCAS的急性缺血性卒中随机或非随机对照临床试验;分别采用Newcastle-Ottawa量表和Rev Man5.2统计软件行文献质量评价和Meta分析。结果经剔除重复和不符合纳入标准者,166篇英文文献中最终纳入8项非随机对照临床试验共11 373例患者[2455例合并HMCAS(rt-PA静脉溶栓治疗2316例、安慰剂治疗139例)、8918例未合并HMCAS]。Meta分析显示:rt-PA静脉溶栓组患者不良预后风险低于安慰剂组(OR=0.360,95%CI:0.150~0.850;P=0.020),但症状性颅内出血发生率组间差异无统计学意义(OR=1.640,95%CI:0.380~7.040;P=0.500);合并HMCAS患者rt-PA静脉溶栓治疗不良预后风险高于未合并者(OR=2.830,95%CI:2.550~3.150;P=0.000),但症状性颅内出血发生率组间差异无统计学意义(OR=1.090,95%CI:0.500~2.410;P=0.820)。结论尽管rt-PA静脉溶栓治疗合并HMCAS的急性缺血性卒中患者安全、有效,但发病3个月时易出现不良预后,而发生症状性颅内出血风险较低。     

重组组织型纤溶酶原激活物静脉溶栓治疗超时间窗急性缺血性卒中的Meta分析

目的系统评价超时间窗(4.50~6.00 h)的急性缺血性卒中患者行重组组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗的有效性和安全性。方法分别以缺血性卒中/脑梗死/脑梗塞、溶栓治疗、延长时间窗,以及acute ischemic stroke、thrombolytic therapy、beyond 4.5 hours等中英文词组为检索词,计算机检索1980年1月-2015年8月美国国立医学图书馆生物医学信息检索系统、Cochrane图书馆、中国知网中国知识基础设施工程、万方数据库等收录的rt-PA静脉溶栓治疗超时间窗(4.50~6.00 h)急性缺血性卒中随机对照临床试验;Jadad量表和Rev Man 5.3统计软件进行文献质量评价和Meta分析。结果共获得681篇文献,经剔除重复和不符合纳入标准者,最终纳入3项随机对照临床试验计2033例急性缺血性卒中(发病6 h)患者(rt-PA静脉溶栓组1029例、安慰剂组1004例)。Meta分析显示:rt-PA静脉溶栓与安慰剂对改善患者神经功能(RR=1.070,95%CI:0.940~1.220;P=0.310)和日常生活活动能力(RR=1.040,95%CI:0.940~1.160;P=0.430)、降低病死率(RR=1.260,95%CI:0.990~1.610;P=0.060)差异无统计学意义,但rt-PA静脉溶栓组患者脑出血发生率高于安慰剂组(RR=1.550,95%CI:1.030~2.340;P=0.030)。结论 rt-PA静脉溶栓治疗超时间窗(4.50~6.00 h)急性缺血性卒中无明显疗效且可能增加脑出血风险,高质量证据尚待大样本多中心随机对照临床试验加以验证。     

伴有心房颤动的急性缺血性卒中患者重组组织型纤溶酶原激活剂静脉溶栓的疗效及预后

目的 探讨伴有心房颤动急性缺血性卒中患者重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓的疗效、安全性及影响预后不良的因素.方法 162例急性缺血性卒中患者在发病4.5h内接受rt-PA静脉溶栓治疗,根据患者既往史及入院时心电图结果将患者分为心房颤动组(45例)和非心房颤动组(117例),所有患者溶栓前行美国国立卫生研究院卒中量表(NIHSS)评分,溶栓后3个月行改良Rakin量表(mRS)评分.结果 (1)心房颤动组的平均年龄(岁)高于非心房颤动组(69.2±11.6与62.5±12.9,t=-3.050,P=0.003),吸烟比例低于非心房颤动组[6.7％ (3/45)与28.2％(33/117),x2=8.723,P=0.003],其他基线资料比较差异无统计学意义.(2)溶栓前心房颤动与非心房颤动组NIHSS评分差异无统计学意义,心房颤动与非心房颤动组溶栓后3个月mRS评分0～1分的患者比例差异无统计学意义,心房颤动组的颅内出血比例[31.1％ (14/45)与14.5％(17/117),x2=5.774,P=0.016]及病死率[26.7％ (12/45)与12.0％(14/117),x2=5.213,P=0.022]明显高于非心房颤动组,但心房颤动与非心房颤动组症状性颅内出血比例差异无统计学意义.(3)45例心房颤动患者中,18例患者预后良好(mRS评分0～1分),预后不良27例(mRS评分2～5分).预后不良组入院时NIHSS评分(分)明显高于预后良好组(17.70±5.87与11.22 ±5.14,t=3.809,P=0.000),收缩压(mm Hg,1 mm Hg=0.133 kPa)明显低于预后良好组(145.5±24.0与164.9 ±21.0,t=-2.788,P=0.008),其他基线资料比较差异无统计学意义.(4)多因素回归分析提示心房颤动(OR=1.380,95％ CI 0.217～7.017,P=0.698)不是溶栓后死亡的独立危险因素,心房颤动(OR=3.558,95％ CI1.246～10.158,P=0.018)是溶栓后颅内出血的独立危险因素.结论 心房颤动不影响急性缺血性卒中患者静脉溶栓治疗的远期疗效,心房颤动患者行静脉溶栓的颅内出血及死亡风险高于非心房颤动患者,但心房颤动不是溶栓后死亡的独立危险因素,不增加症状性颅内出血风险.入院时NIHSS评分高、收缩压低可能是心房颤动患者静脉溶栓治疗预后不良及死亡的危险因素.     

建立中国急性缺血性卒中溶栓医疗质量持续改进体系

卒中是我国居民死亡的第一位杀手,也是成人致残的第一位原因。国内外发表的急性缺血性卒中临床指南均强调在时间窗内给予静脉重组组织型纤溶酶原激活剂(recombinanttissue plasminogen activator,rt-PA)溶栓是最有效的治疗方式,但由于溶栓意识匮乏、院前或院内延误等原因,许多急性缺血性卒中患者得不到rt-PA治疗或无法获得规范的溶栓治疗。对于急性缺血性卒中患者来说,在卒中症状发生后越早使用rt-PA溶栓治疗,其恢复良好神经功能的可能性越大(图1)。Lansberg     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Opiate and digitalis receptor assays distinguish between neuroexcitant and inactive organochlorines and between anesthetics and convulsants

Specific binding of [3H]naloxone to rat brain tissue in vitro was inhibited by the excitant organochlorinated insecticides (OCI), by ether (E) and octanol (OCT), and by the convulsant indoklon (IND) and its anesthetic isomer, isoindoklon (ISO). In the presence of 100 mM NaCl the inhibition of naloxone binding by E, OCT and ISO was greatly potentiated, whereas that by OCI and IND was attenuated. KCl (100 mM) was equally effective as NaCl on the action of anesthetics, but the effect of the excitant drugs was, in contrast to NaCl, unaffected by KCl. Specific binding of [3H]ouabain in the absence of Na, was depressed by anesthetics and enhanced by neuroexcitants. In the presence of NaCl, which by itself inhibits ouabain binding to brain, both anesthetics and excitants enhanced ouabain binding. DDE, a non-insecticidal analog of DDT, and the dimethyl derivative of the OCI, lindane, were inactive in the receptor assays. These observations point to a unique isolated system which responds consistently to anesthetic agents as a class and, in a different way, to neuroexcitant compounds.     

Learning and forgetting new names and objects in MCI and AD

We studied how subjects with mild cognitive impairment (MCI), early Alzheimer's disease (AD) and age-matched controls learned and maintained the names of unfamiliar objects that were trained with or without semantic support (object definitions). Naming performance, phonological cueing, incidental learning of the definitions and recognition of the objects were tested during follow-up. We found that word learning was significantly impaired in MCI and AD patients, whereas forgetting patterns were similar across groups. Semantic support showed a beneficial effect on object name retrieval in the MCI group 8 weeks after training, suggesting that the MCI patients’ preserved semantic memory can compensate for impaired episodic memory. The MCI group performed equally well as the controls in the tasks measuring incidental learning and recognition memory, whereas the AD group showed impairment in this respect. Both the MCI and the AD group benefited less from phonological cueing than the controls. Our findings indicate that word learning is compromised in both MCI and AD, whereas long-term retention of newly learned words is not affected to the same extent. Incidental learning and recognition memory seem to be well preserved in MCI.     

Necdin蛋白与神经元的生长分化

在神经系统 ,Necdin只在成熟神经元的细胞核中表达 ,可能与成熟神经元分裂静止状态的保持有关。近年的研究表明 ,Necdin是一种生长抑制蛋白 ,能与多种因子如SV4 0大T抗原 ,腺病毒E1A ,转录因子E2F1以及肿瘤抑制蛋白p5 3等结合 ,在功能上类似于成视网膜瘤蛋白Rb。necdin基因缺陷时 ,会引起脑内 ,特别是下丘脑神经元分化障碍。人类necdin基因位于PWS综合征的基因缺失区 ,可能与PWS的一些症状有关。本文从Necdin蛋白的基本概况 ,生物功能以及Necdin与疾病三个方面进行了综述     

Satellite cells and myonuclei in young and elderly women and men

The overall aim of this study was to assess the effects of aging on the satellite cell population. Muscle biopsies were taken from the tibialis anterior muscle of healthy, moderately active young (age range, 20-32 years; n = 31) and elderly (age range, 70-83 years; n = 27) women and men with comparable physical activity pattern. Satellite cells and myonuclei were visualized using a monoclonal antibody against neural cell adhesion molecule and counterstained with Mayer's hematoxylin. An average of 211 (range, 192-241) muscle fibers were examined for each individual. Compared with the young women and men, the elderly subjects had a significantly lower (P < 0.011) number of satellite cells per muscle fiber but a significantly higher (P < 0.004) number of myonuclei per muscle fiber. The number of satellite cells relative to the total number of nuclei [satellite cells/(myonuclei + satellite cells)] was significantly lower in the elderly than in the young women and men. These results imply that a reduction in the satellite cell population occurs as a result of increasing age in healthy men and women.     

Necdin蛋白与神经元的生长分化

在神经系统,Necdin只在成熟神经元的细胞核中表达,可能与成熟神经元分裂静止状态的保持有关.近年的研究表明,Necdin是一种生长抑制蛋白,能与多种因子如SV40大T抗原,腺病毒E1A,转录因子E2F1以及肿瘤抑制蛋白p53等结合,在功能上类似于成视网膜瘤蛋白Rb.necdin基因缺陷时,会引起脑内,特别是下丘脑神经元分化障碍.人类necdin基因位于PWS综合征的基因缺失区,可能与PWS的一些症状有关.本文从Necdin蛋白的基本概况,生物功能以及Necdin与疾病三个方面进行了综述.     

Retrospective and prospective design and data

The study of the presentation, symptomatology and family characteristics of an exclusively adolescent sample of patients with borderline personality disorder (BPD) was undertaken. Twenty-four cases of borderline personality disorder, 20 females, 4 males, identified using chart review and meeting the criteria of the Diagnostic Interview for Borderlines (DIB) and DSM III-R, were matched with psychiatric controls. Adolescents with borderline personality disorder were found to have high rates of affective symptomatology with Axis I diagnosis of major depressive disorder - MDD (DSM-III-R), and high rates of interpersonal psychopathology, i.e., manipulation, devaluation, and a pervasive sense of boredom. The latter seem to be characteristic as for adults with borderline personality disorder. The families were particularly angry and volatile.     

Cortisol levels and depression in men and women using heroin and cocaine

Abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis are well documented in men using illicit drugs and/or infected with HIV; however, less is known about HPA function, or the health consequence of HPA dysfunction, in their female counterparts. People with depression exhibit hypercortisolemia, and depression is common in people with HIV or substance use problems. The current study investigated cortisol secretion in 209 demographically matched men and women, stratified by their HIV and drug use status. Self-reported depressive symptoms were evaluated using a standardized, validated questionnaire (CES-D). Women reported more depressive symptoms than men (p=.01). Male and female drug users exhibited higher cortisol concentrations (p=.03), and were more likely to report depressive symptoms (p=.04), than non-users. Depression was related to elevated cortisol concentrations for the study population (p=.03), and women with elevated cortisol concentrations were significantly more depressed than all other participants (p=.05). While it is unknown whether high cortisol concentrations precede depressive symptoms or vice versa, these data indicate that higher cortisol concentrations are associated with depressive symptoms in heroin and cocaine users, and that this association is more pronounced in women than men. HIV status did not act in an additive or synergistic way with drug use for either cortisol or CES-D measures in the current study. Unique therapies to treat the endocrine and mental health consequences of illicit drug use in men and women deserve consideration as depressive symptoms, and high cortisol concentrations associated with depressive symptoms, differ by gender.     

相关性和一致性：这对相仿概念和测量方法的回顾与阐明

概述：一致性(agreement)和相关性(correlation)是两个广泛使用的概念,用来评估变量之间的关联。虽然二者相似且相关,但是它们代表关联完全不同的概念。评估变量之间的一致性假设变量测量的是相同的结构,而在变量测量完全不同的结构时也可以评估它们之间的相关性。这种概念上的差异就要求使用不同的统计方法,并且当评估一致性或相关性时,统计方法根据数据的分布和研究者的兴趣可能会有所不同。例如, Pearson相关性,作为评估连续变量之间相关性的一种普遍测量方法,只有用于符合线性关系的变量时才能提供有用的信息;当用于不符合线性关系的变量时就无法提供准确信息甚至会产生误导。同样地,内部相关性,作为一种评估连续变量之间一致性的常用方法,如果一致性不好的实质正好是研究兴趣所在,那么该测量就不能为研究者提供充分的信息。本报告回顾了一致性和相关性的概念,并讨论了几种常用方法在应用中的差异。