74例精神分裂症脑电地形图研究

对74例首次入院的精神分裂症或分裂样精神病患者脑电地形图(BEAM)的结果进行分析,发现占33.8％的患者,脑电地形图出现阳性结果,这说明精神分裂症患者大脑电生理功能发生了明显的变化,证实了脑电地形图对精神分裂症的辅助诊断具有临床意义。     

71例精神障碍患者的脑电地形图分析

总结分析７１例精神病人的自发脑电地形图表现，异常率为４９．４％．其中精神分裂症２８例，异常率６４．３％，异常表现主要为头前部、或广泛分布的δ、θ频域电活动功率不同程度升高．神经症２５例，异常率４０．０％，异常表现主要为脑功能低下和轻度的δ、θ频域活动异常．     

昏迷病人脑电地形图与脑电图临床研究--附56例报告

目的:探讨昏迷患者脑电地形图(BEAM)与脑电图(EEG)的改变,监测脑生物电和跟踪观测的价值.方法:检测56例昏迷患者治疗前后的脑生物电,并进行对比分析.结果:昏迷患者的EEG,高度异常17例,中度异常39例.BEAM为弥漫性7～13级慢波分布图.经治疗后,43例痊愈,脑电恢复正常;6例继发癫痫,脑电为异常;大脑死亡4例,脑电示零电位,BEAM为"秃图".死亡3例均为治疗前脑电高度异常者.结论:昏迷病人进行脑电监测对诊断、治疗及判断预后均具有重要价值.     

亚健康人群中失眠者与正常人群脑电地形图对比分析

目的:比较分析亚健康人群中失眠患者与正常人群的脑电地形图,获得诊断学上的证据.方法:对500例亚健康人群中失眠患者(亚健康组)及500例健康人群(健康组)均进行脑电地形图及头颅CT检测,并把二者进行对比研究.结果:脑电地形图中亚健康组中失眠者α波波幅降低463例,调节调幅欠佳474例.β活动增多473例.过度换气(HV)后θ活动增多456例.δ活动增多27例.无明显变化17例.α频带平均功率谱降低且不对称,在Scale(标尺)为32时其平均功率谱值<1.5uV,颜色灰阶为<3灰阶为479例 ,θ频带平均功率谱在大脑前部有增高者276例.平均功率谱值在<1.5 uV.β频带平均功率谱增高为479例 .健康组中α波波幅降低26例,调节调幅欠佳23例.β活动增多37例.过度换气(HV)后θ活动增多33例.δ活动增多2例.无明显变化465例.α频带平均功率谱正常并且对称,在Scale(标尺)为32 时其平均功率谱值在>3.5uV,颜色灰阶为>5灰阶为465例.与健康组比较,亚健康组出现的异常率明显增高(P<0.05);头颅CT检测2组均显示正常范围.结论:亚健康失眠患者的脑电活动不稳定,具有明显焦虑趋势,脑电地形图侧重于大脑功能性诊断,对亚健康人群中失眠患者有诊断价值.     

380例小儿脑电地形图分析（摘要）

３８０例小儿脑电地形图分析（摘要）郭林林，李汴玲将两年来９４７例１３岁以下儿童脑电地形图与临床诊断符合率进行分析。其中正常脑电地形图５６７例，异常３８０例，重点分析异常小儿脑电地形图与年龄、疾病的关系。在３８０例异常儿童脑电地形图中，男２２６例。女１...     

原发性高血压患者的脑电地形图改变

目的：通过患者脑地形图改变的特点探讨高血压对大脑的影响。方法：使用国产BIE-ND7脑电地形图仪对600例血压异常的患者进行脑地形图(BEAM)检查，其结果与200例正常健康人(对照组)的脑地形图结果进行比较。结果：各种高血压患者，BEAM均有不同程度的改变，主要表现为病理性δ、θ波的出现和功率增高及α1，α2功率降低和α1、α2出现的位置异常(前移，泛化)，其中轻度高血压(高血压Ⅰ级)、单纯收缩期高血压主要表现为α1，α2前移、泛化，随着高血压的时间延长和病情加重，不无例外的出现异常δ和θ波，Ⅱ、Ⅲ级高血压同时出现α功率降低(甚至消失)，说明高血压使大脑血流供应障碍，继而造成大脑功能紊乱和损害。结论：脑地形图能比较灵敏的反映高血压患者脑功能的变化情况和大脑受损害的程度，从而为临床治疗提供参考和依据。     

650例脑电地形图和脑电图检查的比较

对６５０例临床已确诊的几种主要脑部疾患的检查资料，进行分析比较，结果表明，脑电地形图（ＢＥＡＭ）的异常率为９２．９２％，脑电图（ＥＥＧ）的异常率为８３．０８％。在定位上脑电地形图的异常率是一侧或局限性为３０％，弥漫性为８２．８％，脑电图的异常率是一侧或局限性为２４．３％，弥漫性为５８．６％。两项比较，对脑部弥漫性病变检查，ＢＥＡＭ优于ＥＥＧ，但ＢＥＡＭ是在ＥＥＧ采样分析后产生，故需两项结合分析，其准确性才能更高。     

78例糖尿病患者脑电地形图分析

对７８例糖尿病进行了脑电地形图（ＢＥＡＭ）检查。结果表明ＢＥＡＭ异常率为６０．３％较对照组ＢＥＡＭ异常率８％明显增高，并与糖尿病得的血糖和果糖胺水平增高有明显相关性，且７８例患者ＢＥＡＭ主要表现为弥漫性慢波增多，这与糖尿病代谢紊乱及血管病变有关。     

老年性痴呆病与正常老年人脑电图、脑电地形图对照分析

目的对老年性痴呆与正常老年人的脑电图(EEG)、脑电地形图(BEAM)进行分析,探讨老年性痴呆患者的大脑功能损害程度其机制和临床应用价值。方法应用EEG、BEAM对老年性痴呆与正常老年人进行检查并进行比较研究。结果26例AD患者EEG异常21例(80.8%)弥漫性异常19例,BEAM异常24例(92.41%)弥漫性异常21例。正常老年人的EEG异常4例(22.23%)弥漫性异常3例、BEAM异常7例(38.9%)弥漫性异常5例。发现AD患者EEG、BEAM的异常率明显高于正常老年人的(P<0.005)。结论EEG、BEAM检查可作为评价脑功能的一项客观的参考指标之一。特别在AD患者中能及时反映脑功能损害程度,对掌握病情进展和判断预后起着积极作用。     

以急性头痛为主要症状的儿童鼻窦炎的诊断问题--附51例报告

目的:探讨以急性头痛为主要症状的儿童鼻窦炎的诊断问题.方法:对51例以急性头痛为主要症状的患儿行鼻窦CT、脑脊液、脑地形图检查,并比较单纯性鼻窦炎与鼻窦炎合并脑炎的患儿治疗前、后的脑地形图检查结果.结果:治疗前,51例儿童鼻窦炎患儿的CT改变均呈上颌窦病变,且较少累及其它鼻窦;脑脊液检查40例(单纯性鼻窦炎组)正常,11例患儿(鼻窦炎合并脑炎组)出现异常;脑地形图检查结果示单纯性鼻窦炎组50%(20/40)出现异常,鼻窦炎合并脑炎组100%(11/11)异常,两组比较差异有统计学意义(P＜0.05).治疗2周后复查,鼻窦炎合并脑炎组的脑脊液检查结果均恢复正常;单纯鼻窦炎组仍有7例脑地形图异常,与鼻窦炎合并脑炎组仍有的5例异常比较差异无统计学意义(P＞0.05).结论:CT检查、脑脊液检查及脑地形图检查对诊断以急性头痛为主要症状的儿童鼻窦炎患者均有一定的价值.     

40岁以下头痛患者颈椎曲度异常及相关检测分析

目的观察40岁以下原发性头痛患者颈椎生理曲度异常的发生率以及引起的脑血流动力学改变,探讨中青年原发性头痛病因及指导治疗。方法40岁以下头痛患者332例及健康对照组131例,均行颈椎x线检查,对颈椎曲度异常头痛患者根据严重程度分为轻度、中度、重度3组,行经颅多普勒超声（T（D）检测脑血流变化,分析各组患者的脑血流异常发生率并进行比较。结果头痛患者颈椎曲度异常检出率与对照组有明显统计学差异（P〈0．005）,颈椎曲度异常发生率达77．71％,脑血流异常检测率为72．48％,3组脑衄流异常检测率比较有统计学差异（P〈0．005）,中度组和重度组脑血流速异常发生率分别高达83．91％和93．94％;颈椎曲度异常轻度组与中、重度组脑血流异常检测率均有统计学差募,中度与重度组之间无明显统计学差异;流速异常以血管痉挛、血流增快为主。结论颈椎曲度异常可能在40岁以下原发性头痛患者发病中起重要作用,其与颅内血流流速异常密切相关,临床上应重视颈椎曲度异常的治疗价值。     

宫腔镜检查诊断子宫异常出血186例临床分析

目的评价宫腔镜检查是子宫异常出血的有效临床诊治方法。方法1997年10月～2005年9月,对186例子宫异常出血患者进行宫腔镜检查,同时行镜下活检。结果在186例子宫异常出血患者中,经宫腔镜检查确诊为宫腔内器质性病变者98例,占51.6%。特别是在40～59岁的子宫异常出血患者中,92%均有镜下异常所见。宫腔镜下所见与宫腔镜下选择性活检的病理组织学诊断符合率达87%以上。结论宫腔镜是寻找子宫异常出血原因,诊治宫腔内病变的一种不可替代的检查方法。     

TCD在脑血管痉挛早期诊断及治疗中的作用

目的探讨TCD对脑血管痉挛发生时机、持续时间及其对预后的影响诊断的准确性。方法对140例颅脑损伤患者早期行TCD检查并与DSA进行比较,分析TCD检测脑血管痉挛的准确性。结果血管痉挛对应的颅内动脉血流速度异常者共119例,异常率为85％,其中轻度痉挛的异常率为53％,中度痉挛异常率为40％,重症痉挛的异常率为4％。结论TCD检测无创伤,与DSA有较好的一致性,对脑血管痉挛做早期诊断的精确性高：     

体感诱发电位在小儿脑性瘫痪诊断中的应用

目的探讨体感诱发电位(SEP)检测在小儿脑性瘫痪(cerebralpal-sy,CP)诊断中的临床应用价值。方法按国际脑电图学会推荐标准,以180例0～14岁各年龄组小儿SEP正常值为对照组,对77例4月～14岁临床诊断CP患儿进行正中神经及胫后神经SEP检测,并与CT、EEG结果进行比较分析。结果CP患儿中SEP异常率(66/77)86%,CT异常率(37/77)48%,EEG异常率(16/38)42%。37例CT正常者中SEP异常率为(30/40)75%。CP患儿SEP改变上肢以刺激正中神经N20波潜伏期延长、下肢以刺激胫后神经P40波潜伏期延长为明显。结论SEP在检测脑瘫时有较高的阳性率,是早期、客观诊断脑瘫的一种可靠方法。     

Prediction of Arrhythmic Events After Acute Myocardial Infarction Using Two Methods for Late Potentials Recording

One hundred consecutive patients recovering from an acute myocardiai infarction underwent, prior to home discharge, signal-averaged electrocardiography (ECG), left ventriculography. and 24-hour Holter ECG recording. The signal-averaged ECG was recorded and analyzed using two procedures: the orthogonal bipolar XYZ lead configuration with a bidirectional filter: and a precordial unipolar lead configuration with a uonrecursive digital filter. An abnormal signal-averaged ECG was seen in 40% of patients with the XYZ system and in 30% of patients in the precordial method, abnormal ejection fraction (< 40%) in 24% of patients and high grade ectopy activity in 22%. During the 24-month follow-up period, 12 patients (12%) had an arrhythmic event defined as either sudden death (11 patients) or sustained ventricular tachycardia (1 patient). Neither the signal-averaged ECG with the XYZ configuration, the abnormal ejection fraction, nor the high grade ectopy were able to statistically predict a higher arrhythmic event rate. The signal-averaged ECG with the precordial configuration was able to statistically predict a higher arrhythmic event rate, P < 0.03; odds ratio = 3.96. The combination of the orthogonal XYZ configuration signal-averaged ECG with the ejection fraction (P < 0.01, odds ralio = 7.33), or with ejection fraction and Holter monitoring (P < 0.06. odds ratio = 6.17) was able to predict a higher arrhythmic event rate. The combination of the precordial configuration signal-averaged ECG with the ejection fraction (P < 0.002, odds ratio = 14.4), or with ejection fraction and Holter monitoring (P < 0.06. odds ratio =10) was able to better predict a higher arrhythmic event rate. The combination of a normal or abnormal signal-averaged ECG and ejection fraction gave a sensitivity, specificity, positive, or negative value prediction of arrhythmic events of 60%, 90.6%, 37.5%, and 96%, respectively. It must be emphasized that the number of arrhythmic events during the 2-year follow-up was small and further study is required to determine the true predictive value of each method for arrhythmic events.     

Clinical effect of ampicillin with β-lactamase inhibitor (sulbactam/ampicillin) on community-acquired pneumonia in the elderly

 Sulbactam/ampicillin (SBT/ABPC) was administered to 83 patients aged over 75 years with community-acquired bacterial pneumonia (mild, n = 43; moderate, n = 40), and its clinical effect was reviewed. It was effective in 37 of the 43 patients with mild disease (efficacy rate, 86.0%), in 27 of the 40 patients with moderate disease (efficacy rate, 67.5%), and overall in 64 of the 83 patients (efficacy rate, 77.1%). Side effects included drug eruption in 1 patient (1.2%) and abnormal laboratory findings in 11 (13.3%), all of which were mild. Based on the above, SBT/ABPC may be recommended as the first-choice drug for community-acquired bacterial pneumonia in the elderly. Received: October 9, 2002 / Accepted: January 20, 2003     

急性冠状动脉综合征检测同型半胱氨酸的临床应用

目的 探讨急性冠状动脉综合征(ACS)患者血清同型半胱氨酸(Hcy)水平的变化,以为ACS进的早期预防、治疗提供依据.方法 检测健康对照组与ACS患者的血清Hcy水平,进行统计分析.结果 心肌梗死(AMI)组Hcy浓度高于不稳定型心绞痛(UAP)组(P<0.05),ACS组的Hcy水平高于健康对照组(P<0.01).健康对照组56例中仅有1例Hcy异常,异常检出率为1.8%;ACS组60例中有40例异常,异常检出率为66.7%.ACS组的异常检出率显著高于健康对照组(P<0.01).结论 ACS患者血清Hcy水平明显升高,AMI的血清Hcy水平较UAP的更高,提示Hcy在ACS的发病机制中起重要作用.高Hcy水平是急性冠状动脉综合征的高危险因素之一.     

Peripheral nerve conduction studies and bulbocavernosus reflex in the investigation of impotence

Patients with erectile dysfunction underwent sensory and motor conduction and bulbocavernosus reflex tests to determine the incidence of peripheral nerve involvement. Of a total of 111 patients, abnormal sensory conduction was found in 87 (78%), abnormal motor conduction in 56 (50%), and abnormal bulbocavernosus reflex in 40 (36%). Most of these patients had other medical problems. Objective evidence of peripheral nerve involvement helped in the management of these patients.     

The Signal Averaged Electrocardiogram and Programmed Stimulation in Patients with Complex Ventricular Arrhythmias

TURITO, G., ET AL.: The Signal Averaged Electrocardiogram and Programmed Stimulation in Patients with Complex Ventricular Arrhythmias. The signal averaged electrocardiogram (SA-ECG), programmed electrical stimulation (PES), and left ventricular ejection fraction (EF) studies were utilized for risk stratification and management of patients with complex ventricular arrhythmias and nonsustained ventricular tachycardia (VT). The study population included 90 patients (63 with coronary artery disease and 27 with dilated cardiomyopathy). Sustained monomorphic VT was induced in 22 cases (24%), ventricular fibrillation (VF) in 10 (11%), and no sustained VT/VF in 58 (64%). An abnormal SA-ECG was recorded in 23 patients (26%) and was more common in patients with than in those without induced sustained VT (68% vs 12%, p < 0.0001). None of 33 patients with normal SA-ECG and EF ≥ 40% had induced VT. Patients were followed-up for 2.5 ± 0.8 years off antiarrhythmic therapy, unless they had induced sustained VT. The 3-year sudden death rate was 19% in the group with induced sustained VT, 0 in that with induced VF, and 9% in that without induced VT/VF (P = NS). The 3-year total cardiac mortality was higher in patients with than in those without EF < 40% (27% vs 7%, p < 0.05). It is concluded that patients with organic heart disease and spontaneous nonsustained VT may not need PES or antiarrhythmic therapy if SA-ECG is normal and EF is ≥ 40%, since their risk of induced VT and sudden death is low. On the other hand, patients with abnormal SA-ECG and/or EF < 40% may require PES, since their risk for induced VT is high. Antiarrhythmic therapy may also be considered in these patients. (PACE, Vol. 13, December, Part II 1990)     

新疆地区1500例男性不育症精液筛检结果分析

目的研究新疆地区男性不育患者精液质量状况。方法利用计算机辅助精液分析技术,收集1500例主诉不育的男性精液进行质量检测,并分析结果。结果新疆地区1500例男性不育患者精液一般性状检查显示,精液量平均2.7±1.3ml,异常率2.2%(33/1500);精液颜色异常率9.7%(146/1500);精子粘稠度异常率32.6%(489/1500);精子液化时间平均32.8±18.5min,异常率33.5%(502/1500);精液白细胞数异常率20.3%(305/1500)。精子质量检查提示精子密度平均(9.1±6.9)×106/ml,精子密度异常率83.6%(1254/1500);精子活力(a+b级)百分率平均为(21.2±14.1)%,异常率79.2%(1188/1500);精子正常形态率(9.2±8.1)%,精子正常形态率异常患者所占比率为90.8%(1347/1500)。结论新疆地区男性不育患者的精液异常表现逐渐与东部发达地区相接近,迫切需要引起当地管理者及生殖医学相关医护人员的重视,加强宣传男性生殖健康的知识教育。