急性脑出血患者血清肌酶的监测及意义

目的 探讨急性脑出血患者血清心肌酶谱改变的临床意义。方法 对５８例脑出血患者血清心肌酶进行监测。结果 ①血清心肌酶与脑出血的部位有关，与出血量呈正相关。②急性发病死亡患者血清心肌酶高于存活者。③脑出血患者于病初３天心肌酶水平最高，１４天恢复正常。结论 对急性脑出血患者心肌酶进行监测有助于判断患者的心功能，病情严重程度和预后。     

急性脑出血患者血清心肌酶谱血糖水平的变化及与预后的关系

目的：观察急性脑出血患者血清心肌酶谱、血糖水平的变化,探讨其与预后的相关性。方法收集急性脑出血患者120例作为观察组,纳入同时期健康志愿者60例作为对照组,比较2组患者间血清心肌酶谱、血糖水平;再将120例急性脑出血患者分别按心肌酶水平和血糖水平分为心肌酶正常组和心肌酶升高组、血糖正常组和血糖升高组,比较入组时和治疗3、6个月后组间神经功能缺损评分（NIHSS）。结果急性脑出血患者血清AST、LDH、CK及CK-MB水平显著高于正常人群,其空腹血糖水平也显著高于正常人群（ P＜0.05）。心肌酶升高和血糖升高的急性脑出血患者入组时和治疗3、6个月后NIHSS评分显著高于心肌酶和血糖正常者。结论急性脑出血患者血清心肌酶谱、血糖水平高于正常人群,其水平高低与预后呈正相关。     

急性一氧化碳中毒血清心肌酶的变化及临床意义

目的 初步探讨急性一氧化碳中毒患者血清心肌酶的变化及其临床意义.方法 回顾性分析77例急性一氧化碳中毒患者血清心肌酶变化情况.结果 急性一氧化碳中毒患者血清心肌酶在急性期有明显改变,中-重度中毒心肌酶升高发生率明显较轻度中毒组高.结论 急性一氧化碳中毒患者除出现神经系统受损外,还可出现血清心肌酶升高,心脏受损.     

急性脑血管病患者的心肌酶谱分析

目的:探讨急性脑血管病患者的心脏损害。方法:对50例急性脑血病患者和25例健康体检者静脉血清天门冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、α羟丁酸脱氢酶(α-HBDH)于病后2天内进行检测。结果:血清AST、LDH、cK、α-HBDH水平,急性脑血病组高于对照组(P<0.01).而脑出血组与脑梗死组的患者血清心肌酶水平无明显差异(P>0.05).有意识障碍与无意识障碍患者血清心肌酶谱有显著性差异(P<0.05),CK有非常显著性差异(P<0.01)。结论:急性脑血病患者有心肌酶谱变化,其程度与病变范围及意识障碍程度相一致,与病变的性质无关。     

急性脑梗死患者血清心肌酶学改变及危险因素分析

目的观察急性脑梗死(ACI)患者血清心肌酶学的改变,并分析其危险因素。方法选取115例ACI患者,入院确诊后均给予相应的治疗措施,收集患者一般资料,内容包括性别、年龄、主要病史(高血压、糖尿病、脑血管病),对相关因素进行Logistic分析,在患者入院后72h内进行标准12导联心电图检查,并采血进行心肌酶学检测(检测指标:CK、CK-MB、AST、LDH)。同时对2组患者神经功能缺损程度及短期预后进行比较,并对其与患者心肌酶水平之间的关系进行分析,神经功能缺损程度采用NIHSS评分进行评定,短期预后采用mRS(自我生活自理能力)评定。结果 115例患者中,血清心肌酶升高20例,正常95例;血清心肌酶升高组CK、CK-MB、AST、LDH均明显高于正常组(P0.05)。单因素Logistic分析显示,高血压史、糖尿病史、TC、TC、LDL-C、纤维蛋白原是ACI患者血清心肌酶学改变的危险因素(P0.05),其中以高血压史、LDL-C升高、HDL-C降低影响更为显著。将ACI患者血清心肌酶学改变的危险因素进一步校正,结果显示高血压史(OR=2.56,P0.05)、LDL-C升高(OR=2.68,P0.05)是ACI患者心肌酶学改变的独立危险因素。心肌酶升高组发病后第1、3、7天NIHSS评分、mRS评分均明显高于正常组(P0.05)。结论 ACI患者血清心肌酶升高的危险因素包括高血压史、高血脂史、糖尿病史等,而心肌酶越高,预后越差,应对采取必要的干预措施。     

脑出血患者心肌酶谱与纤维蛋白原联合检测的临床价值

目的探讨急性脑出血后患者心肌酶谱及纤维蛋白原的早期预警作用。方法收集我院住院就诊的47例脑出血患者为病例组,另选50例健康体检者为对照组。用Roche-P800生化分析仪检测心肌酶谱,用ACL-TOP全自动凝血分析仪检测纤维蛋白原。观察病例组与对照组的心肌酶谱及纤维蛋白原的水平,并进行比较分析两者联合检测的临床意义。结果与对照组比较,病例组的心肌酶谱及纤维蛋白原明显升高(P<0.05)。结论急性脑出血患者的心肌酶谱和纤维蛋白原的异常升高对合并心肌受损有早期预测价值,联合监测心肌酶谱和纤维蛋白原可为临床早期采取治疗措施提供实验依据。     

脑出血并急性心肌梗死10例临床分析

目的 探讨脑出血并急性心肌梗死的机制及防治措施.方法 对我院近10年来诊断为脑出血并急性心肌梗死(AMI)10例患者的临床资料进行总结分析.结果 脑出血在3 d～1周内易合并急性心肌梗死,且病灶在基底节区,大量出血并破入脑室,既往有高血压、吸烟病史患者提示其心肌损伤较重,更易合并心肌病变.结论 脑出血患者动态监测心肌酶学、心电图及血浆肌钙蛋白I,为防治脑出血早期合并AMI具有重要的临床意义.     

140例脑出血患者心电图分析

目的：观察不同部位急性脑出血患者心电图的异常及其表现形式。方法：对１４０例不同部位急性脑出血患者心电图结果进行分析。结果：急性 血血患者心电图异常率７５．４％，心电图异常与出血部位有关，脑干、基底节及丘脑区出血心电图异常率高，多表现为心肌缺血性改变及心律失常，而心律失常又以传导阻滞、、窦带、室早多见。结论：急性脑出血患者并发心科异常率高，对脑出血患者治疗应重视，尤其是脑干丘脑、基底节区出血要重视心     

NIHSS量表和MMSE量表评价急性脑出血患者心肌酶变化的意义

目的：应用美国国立卫生院卒中量表（NIHSS）、简易精神状态量表（MMSE）评价急性脑出血患者心肌酶变化的意义。方法检测118例急性脑出血患者血清心肌酶水平,其中血清心肌酶增高组60例,血清心肌酶正常组58例。2组发病后1 d、30 d及3个月时行NIHSS、MMSE评分,并对生存率进行比较。结果2组患者在发病后第1天NIHSS、MMSE评分差异无统计学意义（P＞0.05）,但在发病后30 d及3个月时心肌酶正常组NIHSS、MMSE评分均优于心肌酶增高组（P＜0.05）。心肌酶正常组30 d内生存率也优于心肌酶增高组（P＜0.05）。结论通过NIHSS、MMSE的评价,更为全面客观地证实脑出血急性期血清心肌酶水平变化与病情恢复及预后有关,观察血清心肌酶水平有助于病情及预后的判断。     

出血性脑血管病与脑心综合征（附165例临床资料分析）

出血性脑血管病与脑心综合征（附１６５例临床资料分析）雷革胜作者单位：７１００３８西安第四军医大学唐都医院神经内科脑血管病是老年常见疾患之一。急性期易并发心脏功能改变加重病情，本文对１６５例急性脑出血病人进行血清心肌酶谱和心电图（ＥＣＧ）监测，探讨脑心...     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.