共查询到18条相似文献,搜索用时 61 毫秒
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患者男性,72岁.因右侧肢体不自主舞动2个月于2009年8月17日入院.既往:糖尿病史8年,间断口服二甲双胍,血糖控制不稳定.右侧肢体不自主舞动,呈持续性,睡眠后消失. 相似文献
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患者男性,72岁.因右侧肢体不自主舞动2个月于2009年8月17日入院.既往:糖尿病史8年,间断口服二甲双胍,血糖控制不稳定.右侧肢体不自主舞动,呈持续性,睡眠后消失. 相似文献
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非酮症性高血糖偏侧舞蹈症(HC-NH)的发病机制目前尚不明确,其影像学特点为症状肢体对侧基底节区CT及MRI T1加权序列高信号.作者报道了1例老年非酮症性高血糖偏侧舞蹈症患者,并动态追踪了其影像学变化,以期加深临床医师对非酮症性高血糖偏侧舞蹈症影像学变化的了解. 相似文献
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目的 探讨非酮症性高血糖合并偏侧舞蹈症(HC-NH)的临床表现、发病机制以及影像学改变特点.方法 我院自2000年6月至2009年6月收治非酮症性高血糖合并偏侧舞蹈症10例,对该组患者的临床资料进行分析,总结其临床特点、发病机制以及影像学改变特点.结果 该组患者均为老年人,急性或亚急性发病,发病时血糖水平16.3~27.5 mmol/L,检测尿酮体多为阴性.舞蹈样症状累及患者的单侧或双侧肢体或面部.CT显示为病灶对侧的尾状核头与壳核早期呈高密度,短时间内可消失;MRI于T1呈高信号,T2呈稍低信号,病灶部位区域中心呈混杂信号而周边高信号.结论 HC-NH的MRI表现为T1纹状体高信号,可能构成偏侧舞蹈症临床综合征.影像学改变可能表明由代谢紊乱引起的斑片状脑出血,采用氯丙嗪、氟哌啶醇治疗疗效较好. 相似文献
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�������Ը�Ѫ�ǵ���������� 总被引:4,自引:1,他引:4
餐后血糖升高而空腹血糖正常,即糖耐量减低 (im pairedglucosetolerance,IGT),通常伴随着血胰岛素水平的升高及胰岛素抵抗,其心血管疾病的发生率亦较正常人明显增高。越来越多的证据表明,无论是非糖尿病性餐后高血糖还是胰岛素抵抗或是心血管疾病,均具有一个共同的致病机制,即氧化应激紊乱。氧化应激主要由反应性氧产物 (reactiveoxygenspe cies,ROS)介导,包括过氧化氢H2O2、超氧阴离子O-2 ·、羟基·OH等。近年来的研究提示ROS作为极其重要的细胞内信使,可以活化几乎所有己知的信号传导通道。高糖状态下线粒体电子传递链产生过多… 相似文献
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Persistent hemichorea associated with thyrotoxicosis. 总被引:1,自引:0,他引:1
M Baba A Terada R Hishida M Matsunaga Y Kawabe K Takebe 《Internal medicine (Tokyo, Japan)》1992,31(9):1144-1146
We describe a case with unilateral chorea associated with thyrotoxicosis. A 23-year-old female with no family history of neurological diseases acutely developed choreic movements of the left extremities during gross thyrotoxicosis. CT scan and MRI study demonstrated no abnormality. Single-photon emission CT with technetium Tc 99m-labeled hexamethylpropyleneamine oxime revealed normal cerebral perfusion. Although the choreic movements were partially improved by dopamine antagonist, they persisted for two months until successful treatment of the thyrotoxicosis finally abolished these movements. Increased sensitivity of dopamine receptors may be responsible for persistent choreic movements in thyrotoxicosis. 相似文献
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�������Ը�Ѫ�ǵ��ٴ����������� 总被引:11,自引:0,他引:11
众所周知,高血糖状态对机体的主要影响是产生急性氧化应激作用;使胰岛素合成减少,胰岛素出胞障碍;高渗糖液使血容量增加,心脏负荷加重;糖的渗透性利尿可直接损害肾小管上皮细胞;糖进入肝脏,脂肪与氨基酸代谢障碍,体内的成糖成酯过多,使肝的解毒作用下降;致细胞免疫功能下降 相似文献
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Soysal DE Karakus V Seren AR Tatar E Celik M Hızar S 《European Journal of Internal Medicine》2012,23(4):342-346
BackgroundWe aimed to examine the effect of transient hyperglycemia in non-diabetic patients with febrile neutropenia.MethodsA total of 86 patients with febrile neutropenia were evaluated between June 2006 and December 2009. After measuring random blood glucose level at admission, cases with stress hyperglycemia were included in the study. Stress hyperglycemia was defined as documented random blood glucose level of 140 mg/dl and above without known diabetes mellitus, impaired glucose tolerance and impaired fasting glucose. A Multinational Association for Supportive Care in Cancer (MASCC) scoring system was used for the prediction of low and high risk patients according to medical complications at the onset of the febrile episode.ResultsThere were more patients with stress hyperglycemia than the patients with normoglycemia in the high risk group (p = 0.001). The growth of gram negative bacteria and fungi was higher in patients with stress hyperglycemia than with normoglycemia (p = 0.001). The patients receiving antifungal therapy had a higher rate of stress hyperglycemia than the patients without receiving antifungal therapy (p = 0.009). The patients with stress hyperglycemia had higher mortality rates than the patients with normoglycemia (p = 0.007). According to the MASCC risk-index, stress hyperglycemia increased 3.35 fold in the high risk patients compared to the low risk patients (p = 0.046) and 4.14 fold in the patients treated with antibacterial and antifungal agents compared to the patients treated with only antibacterial agents (p = 0.038).ConclusionPatients with stress hyperglycemia had more adverse clinical outcomes than patients with normoglycemia. We think further studies are needed to evaluate the relationship between stress hyperglycemia and febrile neutropenia. 相似文献
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糖尿病性偏侧舞蹈症3例临床分析 总被引:1,自引:0,他引:1
目的探讨糖尿病性偏侧舞蹈症的临床表现、发病机制及特殊的影像学变化。方法分析了3例糖尿病性偏侧舞蹈症患者的临床症状、影像变化及治疗经过,并复习相关文献。结果3例均为未经治疗的糖尿病患者,其中2例为糖尿病非酮症高血糖症,1例为酮症高血糖症。舞蹈样症状均为突发起病且以一侧肢体为主,清醒时出现,睡眠时消失。早期CT表现为舞蹈症状对侧的尾状核、壳核和(或)苍白球的高密度影像,并在1个月左右减弱或消失;磁共振(MRI)T1像为病灶部位的片状高信号,在持续数月后信号减低,T2则表现为多变信号,边界清晰,无水肿征象。结论糖尿病性偏侧舞蹈症多见于糖尿病控制不佳的高血糖症患者,糖尿病酮症及非酮症均可发病。病变部位以纹状体为主,其早期CT表现为高密度影,MRIT1像为高信号、T2像为多变信号。认识这种突发的舞蹈症状及影像变化有利于糖尿病高血糖症的早期诊断与治疗。 相似文献
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Roberto Valenti Elena Ceccarelli Alfonso Cerase Martina Ruvio Cosimo Capodarca Giuseppe Martini Ranuccio Nuti 《Acta diabetologica》2012,49(3):233-237
Choreoathetosis is a rare neurologic complication of the diabetic disease. The purpose of this case report is to increase the knowledge of such occurrence by describing the case of an elderly woman who was admitted to our institution for an over 20-day history of choreic movement in the left side of the body. She had a 6-year history of type 2 diabetes mellitus with a poor metabolic control including a glycosylated hemoglobin of 13%. Unenhanced computed tomography of the brain was negative. At magnetic resonance imaging, the right putamen showed high signal intensity on T1-weighted images and an area of high signal intensity on T2-weighted images, diffusion-weighted images and apparent diffusion coefficient maps. During the hospitalization, an adequate diet therapy was performed, and insulin therapy was gradually adjusted using regular insulin at main meals associated with basal insulin (glargine) ??bed time??. This resulted in progressive normalization of blood glucose values and an improvement of dyskinesia. There is a deep correlation between non-chetotic hyperglycemia and neurologic lesions leading to choreoathetosis. The etiopathogenesis seems multifactorial, and include hyperosmolar damage on cortical cells, alteration in GABA neurotransmission and in cerebral vascular self-regulation mechanism. Notably, in DM type 2 choreoathetosis may be related to both vascular and neuro-metabolic alterations in the basal nucleus due to inadequate glycemic control continuing in the time. This rare complication of DM type 2 is a pathological entity to be considered benign, since it is generally transient and reversible with the attainment of an adequate metabolic compensation. 相似文献
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特发性室性心动过速伴心房扑动一例 总被引:1,自引:0,他引:1
患者女性,58岁。因心悸、胸闷2d入院。体格检查:血压110/70mmHg(1mmHg=0.133kPa),双肺呼吸音清晰,心界无扩大,心率194次/min,心律整齐,各瓣膜听诊区未闻及病理性杂音。患者既往有类似发作史,在外院行冠状动脉造影检查,无异常,超声心动图和X线胸片未见异常。入院时记录的心电图未见窦性P波,QRS波时限为134ms,RR间期为380ms,为宽QRS波心动过速,QRS波呈完全性右束支阻滞伴心电轴显著左偏,V6导联R/S〉1,诊断为特发性左心室心动过速。在心电监护下静脉注射维拉帕米5mg,15min后再给10mg,心动过速未终止。6h后改为普罗帕酮70mg,分别间隔15min,共3次静脉推注,描记心电图,宽QRS波形状与图1相同,可见窦性P波,频率72次/min,有的下传夺获心室,QRS波时限变窄。心动过速的QRS波与图1基本相同,RR间期为500ms,可以肯定为左心室心动过速。 相似文献