纳洛酮治疗椎—基底动脉供血不足45例观察

目的 探讨纳洛酮对椎基底动脉供血不足的治疗作用。方法 将符合入组标准的椎基底动脉供血不足９５例患者随机分为纳洛酮治疗组（４５例）和对照组（５０例），逐日观察疗效。结果 纳洛酮治疗组，临床效果显著，用药７２小时后总有效率为９５．５６％。结论纳洛酮治疗椎基底动脉供血不足疗效好，起效快，具有临床应用价值。     

电刺激小脑顶核治疗核—基底动脉供血不足性眩晕的临床研究

目的：研究电刺激小脑顶核治疗核－基底动脉供血不足性眩晕的临床疗效。方法：62例椎－基底动脉供血不足性眩晕患者，随机分为治疗组和对照组，治疗组患者在常规内科治疗的基础上，同时接受电刺激小脑顶核治疗。观察其临床疗效及血液流变学各项指标。结果：治疗组患临床总有效率为88．2％，对照组患者总有效率为67．9％，两组比较有显著差异（P＜0．01），同时治疗组治疗前后血液流变学指标（红细胞压积，全血比粘度和血浆粘度）比较，均有显著性差异（P＜0．05），观察组与对照组治疗比较有显著性差异（P＜0．05）。结论：电刺激小脑顶核治疗椎－基底动脉供血不足性眩晕有显著疗效。     

赛莱乐治疗椎—基底动脉供血不足的疗效观察

目的：临床观察赛莱乐治疗椎－基底动脉供血不足。方法：选椎－基底动脉供血不足病人90例，男58例，女42例，年龄40－86岁。分两组，治疗组50例用赛莱乐150mg；对照组40例用维脑路通0.6g，加液体静滴，每日一次，10天为一疗程。结果：在椎－基底动脉供血不足病人中，眩晕症状消失时间治疗组比对照组早，10天后评定整体疗效，治疗组的有效高于对照组，显效率明显高于对照组。结论：赛莱乐对椎－基底动脉供血不足有效。     

赛莱乐在椎基底动脉供血不足中的应用

目的：观察赛莱乐治疗以眩晕为主要症状的椎基底动脉供血不足疗效及副作用。方法：选择椎基底动脉供血不足患者45例，应用赛莱乐（盐酸丁咯地尔）200mg溶于生理盐水200ml静滴，10天一疗程。对照组40例，应用丹参注射液20ml溶于5％葡萄糖200ml静滴，10天一疗程。结果：治疗组有效率明显高于对照组（P＜0．01）。结论：赛莱乐能迅速有效地控制椎基底动脉供血不足所致的眩晕症状。     

丁咯地尔治疗椎基底动脉供血不足32例疗效观察

目的观察丁咯地尔治疗椎基底动脉供血不足(VBI)的疗效。方法将确诊的椎基底动脉供血不足患者62例，随机分为治疗组(32例)和对照组(30例)进行观察。结果丁咯地尔治疗组临床效果显著，72h总有效率93．7％。结论丁咯地尔治疗椎基底动脉供血不足疗效好，起效快，不良反应少。     

赛莱乐治疗椎—基底动脉供血不足的疗效观察

目的：观察赛莱乐对椎－基底动脉供血不足疗效。方法：１００例患者随机分为两组。治疗组用赛莱乐１５０ｍｇ（５２例），用盐酸培地啶治疗对比（４８例）。结果：治疗组痊愈８例（３４．６％）。观察组痊愈例（１４．５％），两组有显著性差异（Ｐ〈０．０５）。结论：赛莱乐治疗椎－基底动脉供血不足与盐酸培他啶相比具有起效更快，缓解病情迅速的特点，值得推广应用。     

盐酸丁咯地尔治疗椎基底动脉供血不足的疗效观察

应用丁咯地尔共7d。结果床应用。目的观察丁咯地尔治疗椎基底动脉供血不足的疗效。方法选择椎基底动脉供血不足性眩晕患者102例，治疗组0．1g加入盐酸培他啶500ml中静滴，1次／d，共7d。对照组用复方丹参10ml加入盐酸培他啶500ml中静滴，1次／d，治疗组疗效明显高于对照组（P〈0．05）。结论丁咯地尔治疗椎基底动脉供血不足起效快，效果好，疗程短，值得临床应用。     

赛莱乐治疗椎基底动脉供血不足50例疗效观察

目的 探讨赛莱乐对椎基底动脉供血不足的治疗作用。方法 将确诊的椎基底动脉供血不足患者98例，随机分为治疗组(50例)和对照组(48例)进行观察。结果 赛莱乐治疗组临床效果显著，72h总有效率为96．0％。结论 赛莱乐治疗椎基底动脉供血不足疗效好，起效快，具有临床应用价值。     

大剂量利多卡因治疗椎—基底动脉供血不足性眩晕86例疗效分析

目的：观察利多卡因治疗椎－基底动脉供血不足性眩晕的疗效。方法：选择椎－基底动脉供血不足性眩晕患者１５６例。治疗组８６例,应用利多卡因０．２－０．４ｇ加入５％葡萄糖内静滴１４天,一日１次,对照组７０例,应用维生素、苯海拉明,并用低分子右旋糖酐＋复方丹参注射液静滴,一日１次,１４天一疗程。结果：治疗组疗效明显高于对照组（Ｐ〈０．０５）。结论：大剂量利多卡因治疗椎－基底动脉供血不足性眩晕疗效佳。     

丁咯地尔治疗椎基底动脉供血不足32例疗效观察

目的 观察丁咯地尔治疗椎基底动脉供血不足(VBI)的疗效。方法 将确诊的椎基底动脉供血不足患者62例, 随机分为治疗组(32例)和对照组(30例)进行观察。结果 丁咯地尔治疗组临床效果显著,72h总有效率93.7％。结论 丁咯 地尔治疗椎基底动脉供血不足疗效好,起效快,不良反应少。     

钙拮抗剂防治蛛网膜下腔出血后的迟发性脑血管痉挛的观察

目的 :观察钙拮抗剂对蛛网膜下腔出血后迟发性脑血管痉挛 (DCVS)的疗效。方法 :对 66例蛛网膜下腔出血 (SAH)患者将其分为钙拮抗剂治疗组 ( 32例 )和常规治疗对照组 ( 34例 )。结果 :32例治疗组中发生DCVS的 5例 ,34例对照组中发生DCVS2 1例 (P <0 0 5) ;死亡人数治疗组 4例 ,对照组 7例 ,无显著差异 (P >0 0 5)。结论 :钙拮抗剂在DCVS的防治中有显著疗效。     

小组心理护理对躯体形式障碍患者述情障碍的影响

目的:研究小组心理护理对躯体形式障碍患者述情障碍的疗效. 方法:将符合入组标准的躯体形式障碍患者63例随机分为试验组32例和对照组31例,分别对两组患者进行常规药物治疗和护理,且对试验组进行小组心理护理.对完成研究的试验组30例患者和对照组30例患者进行多伦多述情障碍量表(TAS)和临床疗效总评量表(CGI)的测试. 结果:①重复测量的方差分析发现干预因素对TAS因子Ⅰ、因子Ⅱ和因子Ⅳ存在主效应(F=4.291 ～5.844,P＜0.05);时间因素对TAS因子Ⅰ、因子Ⅱ、因子Ⅲ和因子Ⅳ均存在主效应(F=31.283～99.974,P＜0.01);干预因素和时间因素对TAS因子Ⅰ、因子Ⅱ和因子Ⅳ存在交互作用(F =7.815～12.541,P＜0.01).②逐步回归分析显示干预前TAS各因子分数和小组心理护理对TAS因子Ⅰ、因子Ⅱ、因子Ⅳ减少值具有显著的预测作用(Beta值=4.572～13.199,P＜0.01).③试验组疗效(76.7％)优于对照组(50％);多因素Logistic回归分析显示,对躯体形式障碍患者临床疗效影响从大到小的因素分别是:小组心理护理、TAS因子Ⅰ、TAS因子Ⅱ和TAS因子Ⅳ(OR =9.721～1.237). 结论:小组心理护理能够改善躯体形式障碍患者的述情障碍和临床疗效.     

Cognitive function and anticonvulsant therapy: effect of monotherapy in epilepsy

Introduction – The effect of antiepileptic drugs (AED) on cognitive function was studied in 87 patients with epilepsy. Material and methods – Group A: (n = 52) started AED treatment (carbamazepine, oxcarbazepine, sodium-valproate, phenobarbital or phenytoin). Group B: (n = 27) had AED monotherapy withdrawn (carbamazepine or sodium-valproate). Group C: (n = 8) was switched from phenytoin to carbamazepine monotherapy. The patients were tested before and 4 months after change of the treatment. Results – In group A the test performances were in general unchanged. Patients who had their drug treatment withdrawn (group B) and the patients who were switched from phenytoin to carbamazepine (group C) improved in single tests. The predominant changes in performance seem to be due to practice effect. Conclusion – Cognitive functions are only minimally influenced by AEDs after short-term treatment whereas there is a slight improvement after discontinuation of long-term administration of carbamazepine and valproate. A lack of practice effect might be the first indicator of a negative effect of AED on cognitive function.     

心理行为干预联合帕罗西汀治疗惊恐障碍患者的临床疗效

目的:观察心理行为干预联合帕罗西汀对惊恐障碍的治疗效果。方法:60例住院惊恐障碍患者随机分为,研究组和对照组各30例。研究组给予心理行为干预联合帕罗西汀治疗,对照组单用帕罗西汀治疗。观察12周。采用汉密尔顿焦虑量表(HAMA)、临床疗效总评量表-病情严重程度(CGI-SI)在治疗前及治疗2、4、8和12周评定疗效;以治疗中出现的症状量表(TESS)评定不良反应。结果:两组治疗后HAMA及CGI-SI评分较治疗前均显著降低(P<0.05),两组比较,研究组下降更为明显(P<0.05)。结论:心理行为干预联合帕罗西汀治疗惊恐障碍效果优于单用帕罗西汀治疗。     

奎硫平与氟哌啶醇治疗脑血管病所致精神障碍患者对照研究

目的:探讨奎硫平与氟哌啶治疗脑血管病所致精神障碍的临床疗效与不良反应. 方法:脑血管病所致精神障碍患者各30例,分别以奎硫平与氟哌啶醇治疗4周.采用简明精神病评定量表(BPRS)评定疗效,简明智能状况检查表(MMSE)评定认知状况,治疗中出现的症状量表(TESS)评定不良反应. 结果:治疗结束时两组BPRS评分较入组时显著减低(P＜0.01);奎硫平组有效率86.7％,氟哌啶醇有效率80.0％,两组疗效差异无统计学意义(P＞0.05),奎硫平组MMSE减分率显著低于氟哌啶醇组,奎硫平组无明显锥外系反应. 结论:奎硫平治疗脑血管病所致精神障碍患者疗效与氟哌啶醇相似,但奎硫平不良反应较氟哌啶醇轻而少.     

阿立哌唑与氟哌啶醇治疗精神分裂症对照研究

目的:评价阿立哌唑与氟哌啶醇治疗精神分裂症的疗效及安全性。方法:阿立哌唑组50例,氟哌啶醇组48例,以阳性与阴性症状量表(PANSS)、临床疗效总评量表疾病严重程度(CGI-SI)、治疗中出现的症状量表(TESS)、锥体外系反应量表(RSESE)评定疗效及不良反应。疗程6周。结果:两组疗效相仿。阿立哌唑组PANSS阴性症状因子减分在治疗后4及6周显著优于氟哌啶醇组。阿立哌唑组不良反应显著较少。结论:阿立哌唑是一有效安全的抗精神病药。     

Intelligence quotient and neuropsychological profiles in patients with schizophrenia and in normal volunteers.

BACKGROUND: The objective of this study was to examine neuropsychological performance at different intelligence quotient (IQ) levels in schizophrenia. METHODS: Thirty-six patients with schizophrenia were matched with 36 normal control subjects in two IQ groups: low average (81-94) and average (95-119). Performance level (IQ group main effects) and profile shape (IQ group x function interactions) were compared. RESULTS: Current IQ was lower than estimated premorbid intellectual ability in both patient groups. Patients also displayed poorer neuropsychological function than same-IQ control subjects, suggesting neuropsychological dysfunction beyond their already compromised IQ. Patients had different profile shapes than control subjects, but profile shapes were consistent within patients and control subjects at each IQ level. Patients at both levels had higher verbal and lower performance IQ than control subjects. Abstraction-executive function was one of the lowest neuropsychological scores in both patient groups. Average IQ patients had nonsignificantly better overall neuropsychological performance than low average control subjects, but the effect size (.43) was quite small relative to the IQ difference (effect size = 2.57). CONCLUSIONS: Neuropsychological patterns in schizophrenia tend to be consistent at different IQ levels. Even schizophrenia patients with normal current IQs manifest substantial neuropsychological compromise relative to their level of general intellectual ability. The results strengthen the argument that neurocognitive deficits are core deficits of schizophrenic illness.     

阿立哌唑与利培酮治疗精神分裂症对照研究

目的：比较阿立哌唑与利培酮对精神分裂症的疗效及安全性。方法：选取70例精神分裂症患者,随机分为阿立哌唑组36例,利培酮组34例,分别给予阿立哌唑和利培酮治疗,疗程8周。在治疗前及治疗1、2、4、6、8周末分别采用阳性与阴性症状量表（PANSS）、治疗中出现的症状量表（TESS）对两组进行评定。并于治疗前、中、后检查催乳素水平。结果：两组治疗后PANSS评分均有显著下降。阿立哌唑组的锥体外系不良反应、体质量增加及月经失调均较利培酮组少而轻,对催乳素水平没有影响。结论：2药对精神分裂症均有较好的疗效,起效快,不良反应小。     

盐酸托烷思琼预防脑动脉瘤栓塞术后恶心呕吐的观察

目的:观察盐酸托烷思琼对预防脑动脉瘤栓塞术患者术后恶心呕吐(PONV)的有效性和安全性。方法:选择行颅内动脉瘤栓塞术患者45例,随机分为3组,每组15例,于手术结束前30分钟A组患者缓慢静注盐酸托烷思琼5mg,B组患者缓慢静注盐酸托烷思琼3mg,C组患者给予生理盐水。术后观察并记录以下指标:(1)术后24h内恶心呕吐发生率及强度;(2)术后2、8h镇静评分(OAA/S);(3)术后2、8h平均动脉压(MAP),心率(HR);(4)各组不良反应的发生情况。结果:术后24h内两治疗组恶心呕吐发生率显著低于对照组,差异有统计学意义(P<0.05或P<0.01)。托烷思琼5mg组恶心呕吐发生率略低于3mg组,但差异无统计学意义(P>0.05)。结论:托烷思琼可降低脑动脉瘤栓塞术患者术后恶心呕吐的发生率。托烷思琼3mg不仅可以减少药物用量,而且能减少副作用的发生,是一种经济、有效、安全的止吐方法。     

Unilateral focal lesions in the rostrolateral medulla influence chemosensitivity and breathing measured during wakefulness, sleep, and exercise

OBJECTIVES: The rostrolateral medulla (RLM) has been identified in animals as an important site of chemosensitivity; in humans such site(s) have not been defined. The aim of this study was to investigate the physiological implications of unilateral lesions in the lower brainstem on the control of breathing. METHODS: In 15 patients breathing was measured awake at rest, asleep, during exercise, and during CO(2) stimulation. The lesions were located clinically and by MRI; in nine patients they involved the RLM (RLM group), in six they were in the pons, cerebellum, or medial medulla (Non-RLM group). All RLM group patients, and three non-RLM group patients had ipsilateral Horner's syndrome. RESULTS: Six of the RLM group had a ventilatory sensitivity to inhaled CO(2) (V/P(ET) CO(2)) below normal (group A: V/P(ET) CO(2), mean, 0.87; range 0.3-1.4 l. min(-1)/mm Hg). It was normal in all of the non-RLM group (group B: V/P(ET) CO(2), mean, 3.0; range, 2.6-3.9 min(-1)/mmHg). There was no significant difference in breathing between groups during relaxed wakefulness (V, group A: 7.44 (SD 2.5) l.min(-1); group B: 6.02 (SD 1.3) l.min(-1); P(ET) CO(2), group A: 41.0 (SD 4.2) mm g; group B: 38.3 (SD2.0) mm Hg) or during exercise (V/VO(2): group A: 21 (SD 6. 0) l.min(-1)/l.min(-1); group B: 24 (SD 7.3) l.min(-1)/l.min(-1)). During sleep, all group A had fragmented sleep compared with only one patient in group B (group A: arousals, range 13 to > 60 events/hour); moreover, in group A there was a high incidence of obstructive sleep apnoea associated with hypoxaemia. CONCLUSION: Patients with unilateral RLM lesions require monitoring during sleep to diagnose any sleep apnoea. The finding that unilateral RLM lesions reduce ventilatory sensitivity to inhaled CO(2) is consistent with animal studies. The reduced chemosensitivity had a minimal effect on breathing awake at rest or during exercise.