脑梗塞患者血浆降钙素基因相关肽与血管紧张素Ⅱ的动态观察

本文动态观察４０例脑梗塞（ＣＩ）患者血浆降钙素基因相关肽（ＣＧＲＰ）及血管紧张素Ⅱ（ＡⅡ）的变化。结果发现：ＣＩ病程３天内及１０～１４天，血浆ＣＧＲＰ高于病程２５～２８天者及脑动脉硬化组，ＣＩ整个病程中血浆ＣＧＲＰ均低于正常对照组。血浆ＡⅡ在ＣＩ病程３天内及１０～１４天均高于２５～２８天，脑动脉硬化组及正常对照组，病程２５～２８天者与脑动脉硬化组无显著性差异，但二者均高于正常对照组，脑梗塞伴高血压者，血浆ＡⅡ高于不伴高血压者，而ＣＧＲＰ低于不伴高血压者。提示血中ＣＧＲＰ不足及ＡⅡ增高，是高血压、动脉硬化及脑梗塞发病的重要因素。     

脑梗塞患者血浆降钙素相因相关肽与血管紧张素II的动态观察

本文动态观察４０例脑梗塞（ＣＩ）患者血浆降钙素基因相关肽（ＣＧＲＰ）及血管紧张素Ⅱ（ＡＩＩ）的变化。结果发现：ＣＩ病程３天内及１０～１４天，血浆ＣＧＲＰ高于病程２５～２８天者及脑动脉硬化组，ＣＩ整个病程中血浆ＣＧＲＰ均低于正常对照组，血浆ＡＩＩ在ＣＩ病程３天内及１０～１４天均高于２５～２８天，脑动脉硬化组及正常对照组，病程２５～２８天者与脑动脉硬化组无显著性差异，但二者均高于正常对照组，脑梗塞伴高     

载脂蛋白E与脑动脉硬化症

本文观察７８例脑动脉硬化症患者与对照组４４例，对其血清载脂蛋白Ｅ（ＡＰＯＥ）和高密度脂蛋白（ＨＤＬ－Ｃ）、低密度脂蛋白（ＬＤＬ－Ｃ）、胆固醇（ＴＣ）、甘油三脂（ＴＧ）、载脂蛋白ＡＩ（ＡＰＯＡＩ）、载脂蛋白Ｂ（１００）（ＡＰＯＢ（１００））进行含量测定，并将ＡＰＯＥ与ＨＤＬ－Ｃ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡＰＯＡＩ、ＡＰＯＢ（１００）逐一进行相关比较，结果发现：脑动脉硬化症病人（ＣＡＳ）血清ＡＰＯＥ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡＰＯＢ（１００）明显高于正常对照组（Ｐ＜０．０１），ＨＤＬ－Ｃ显著低于正常对照组（Ｐ＜０．０１），ＡＰＯＡＩ无明显变化（Ｐ＞０．０５），且ＡＰＯＥ与ＨＤＬ－Ｃ呈负相关；与ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡＰＯＢ（１００）呈正相关；与ＡＰＯＡＩ无直线相关关系。提示ＡＰＯＥ可做为诊断脑动脉硬化症的重要指标。     

血清ApoE对脑动脉硬化症的诊断价值

本文观察４２例脑动脉硬化症患者与正常对照组４４例，对其血清ＡｐｏＥ和ＨＤＬ－Ｃ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡｐｏＡＩ、ＡｐｏＢ１００２６含量进行测定，并将ＡｐｏＥ与ＨＤＬ－Ｃ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡｐｏＡＩ、ＡｐｏＢ１００逐一进行相关比较，结果发现：脑动脉硬化症病人血清ＡｐｏＥ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡｐｏＢ１００明显高于正常对照组（Ｐ〈０．０１），ＨＤＬ－Ｃ显著低于正常对照组（Ｐ〈０．０１）     

动脉粥样硬化性血栓性脑梗塞患者血浆氧化修饰低密度脂蛋白含量的研究

目的探讨氧化修饰低密度脂蛋白（ＯＸ－ＬＤＬ）与动脉粥样硬化性血栓性脑梗塞（ＡＴＣＩ）发生、发展的关系。方法应用酶联免疫吸附试验（ＥＬＩＳＡ）双抗夹心法检测了８３例ＡＴＣＩ患者血浆ＯＸ－ＬＤＬ含量变化。结果（１）ＡＴＣＩ组血浆ＯＸ－ＬＤＬ水平显著高于正常对照组（Ｐ＜０．０１）;血浆ＯＸ－ＬＤＬ水平变化与病程有关,但与梗塞部位无关。（２）ＡＴＣＩ患者血浆ＯＸ－ＬＤＬ水平与血糖、血胆固醇呈正相关。结论ＯＸ－ＬＤＬ可能参与了ＡＴＣＩ的发生和发展过程。     

动脉粥样硬化性血栓性脑梗塞患者血浆氧化修饰低密度蛋白 …

目的 探讨氧化修饰低密度脂蛋白（ＯＸ－ＬＤＬ）与动脉粥样硬化性血栓性脑梗塞（ＡＴＣＩ）发生,发展的关系。方法 应用酶联免疫吸附试验（ＥＬＩＳＡ）双抗夹心法检测了８３例ＡＴＣＩ患者血浆ＯＸ－ＬＤＬ含量变化。结果 （１）ＡＴＣＩ组血浆ＯＸ－ＬＤＬ水平显著高于正常对照组（Ｐ〈０．０１）;血浆ＯＸ－ＬＤＬ水平变化与病程有关,但与梗塞部位无关。（２）ＡＴＣＩ患者血浆ＯＸ－ＬＤＬ水平与血糖、血胆固醇呈正相关。     

紫外线照射自血回输对脑出血患者血浆和脑脊液中内皮素影响的观察

目的观察脑出血时血浆和脑脊液内皮素（ＥＴ）的变化规律及紫外线照射自血回输治疗对其的影响。方法采用放免技术对５４例脑出血患者血浆和脑脊液中ＥＴ水平进行动态观察。结果病程５天内血浆和脑脊液ＥＴ明显高于脑动脉硬化症组及正常对照组（Ｐ＜０．０１），病程２８～３０天血浆和脑脊液ＥＴ低于发病５天内，仍高于正常对照组（Ｐ＜０．０１）。用光量子血治疗＋传统治疗组血浆和脑脊液中ＥＴ低于单纯传统治疗组（Ｐ＜０．０１或Ｐ＜０．０５）。结论说明光量子血疗法能有效抑制ＥＴ合成及释放。     

紫外线照射自血回输对脑出血患者血浆和脑脊液中内皮素影 …

观察脑出血时血浆和脑脊液内皮素的变化规律及紫外线照射自血回输治疗对其的影响。方法 采用放免技术对５４例脑出血患者血浆和脑脊液中ＥＴ水平进行动态观察。结果 病程５天内血浆和脑脊液ＥＴ明显高于脑动脉硬化症组及正常对照组，病程２８－３０天血浆和脑脊液ＥＴ低于发病５天内，仍高于正常对照组。     

达纳康抗高血压脑小动脉硬化与预防脑卒中的初步观察

目的观察达纳康对高血压脑小动脉硬化的作用及预防脑卒中的效果。方法采用肾血管性高血压大鼠（ＲＨＲ）模型，选择与高血压动脉硬化相关的有害因子ＡⅠ、ＡⅡ、ＡＬＤ、ＥＴ及具有扩张血管作用的ＳＯＤ和ｃＧＭＰ，观察其在高血压形成的早期和晚期分别给于达纳康口服后的改变及与高血压脑小动脉硬化的关系。结果高血压组和晚期喂药组动脉硬化较严重，ＡⅠ、ＡⅡ、ＡＬＤ、ＥＴ均接近正常组水平，ＳＯＤ和ｃＧＭＰ增多。结论尽早防治高血压小动脉硬化可减少脑卒中的发生。     

脑动脉硬化的脑电图,脑电地形图经颅多普勒超声的对照研究

目的 探讨脑电图（ＥＥＧ）、脑电地形图（ＢＥＡＭ）及经颅多普勒超声（ＴＣＤ）三项检查联合应用对脑动脉硬化的诊断价值。方法 ２０８例临床诊断为脑动脉硬化的病人,均在发病一月内行ＥＥＧ、ＢＥＡＭ及ＴＣＤ检查。结果 ＥＥＧ异常７４例,ＢＥＡＭ异常１２５例住院ＴＣＤ异常率为１００％。ＥＥＧ与ＢＥＡＭ比较（Ｘ＾２＝２５．０６,Ｐ〈０．０１）。有非常显著差异;ＢＥＡＭ与ＴＣＤ比较（Ｘ＾２＝４．１２,Ｐ〈０．０     

脑梗塞患者血浆内皮素与降钙素基因相关肽动态观察

动态观测40例脑梗塞(CI)患者血浆内皮素(ET)及降钙素基因相关肽(CGRP)的变化。结果发现:CI组3d内及10～14d的患者,血浆ET高于病程25～28d者及脑动脉硬化组与正常对照组。脑动脉硬化组与病程25～28d者无显著差异,但均高于正常对照组。脑梗塞及脑动脉硬化患者血浆CGRP低于正常对照组,CI病程3d内及10～14d者高于病程25～28d者及脑动脉硬化组。CI伴高血压者。血浆ET高于不伴高血压者,CGRP低于不伴高血压者。病程3d内病情重型者血浆ET、CGRP高于轻、中型者,且ET与CGRP呈直线正相关。     

急性脑梗死患者血浆纤维蛋白原，抗凝血酶Ⅲ及D—二聚体的研究

目的 研究急性脑梗死后凝血与纤溶活性的变化规律。方法 检测40例脑梗死患者发病时、病后4－5天、病后2周血浆纤维蛋白（Fg)、抗凝血酶Ⅲ（AT-Ⅲ）及D－二聚体（D-dimer）的水平。结果 急性脑梗死后2周内Fg持续升高;AT－Ⅲ在发病时及病后4－5天明显降低;D－dimer在病时及病后4－5天明显升高;AT－Ⅲ与D－dimer在发病后2周末均恢复至正常。结论 较高水平的Fg促使脑梗死发生;急性脑梗死后有凝血及继发纤溶活性的增强,抗凝血活性降低,但病后2周末多恢复正常。     

脑梗死患者急性期可溶性粘附分子的变化及临床意义

目的:为了解脑梗死患者急性期可溶性粘附分子的变化及临床意义。方法:采用双抗体夹心ELIsA法测定76例脑梗死患者血清sICAM-1、sVCAM-1、sE-selectine,并与52例TIA患者和40例健康老年人对照比较。结果:脑梗死患者24小时内血清sICAM-1、sVCAM-1、sE-selectine水平明显高于TIA和健康对照组(P<0.01)。大梗死灶组血清sICAM-1、sVCAM-1、sE-selectine水平明显高于中梗死灶组和小梗死灶组。脑梗死患者血清sICAM-1、sVCAM-1、sE-selectine水平在脑梗死发生24小时至7天呈现上升趋势,7天至14天呈下降趋势。结论:sICAM-1、sVCAM-1、sEselectine与急性脑梗死密切相关,参与了缺血后脑组织损伤的病理过程。在脑梗死急性期阻断粘附分子的表达可能有助于减轻缺血性脑损伤。     

动脉瘤性SAH迟发性脑血管痉挛的多元因素分析

目的 探讨动脉瘤性蛛网膜下腔出血（SAH）继发脑血管痉挛的相关因素。方法 回顾性分析本院收治的54例动脉瘤性SAH病人的临床资料，判定脑血管痉挛程度，统计分析其相关因素。结果Fisher分级Ⅲ-Ⅳ级患者脑血管痉挛发生率（7014％，19／27）明显高于Fisher分级Ⅰ-Ⅱ级者（4414％，12／27）（P〈0．01）；Hunt—Hess分级Ⅲ-Ⅴ级患者脑血管痉挛发生率（75．0％，21／28）明显高于Hunt—Hess分级Ⅰ-Ⅱ级者（38．5％，10／26）（P〈0．05）；3d后手术患者的脑血管痉挛发生率（70．0％，21／30）明显高于3d内手术患者（41．7％，10／24）（P〈0．05）。结论SAH的Fisher分级〉Ⅱ级和Hunt—Hess分级〉Ⅱ级是颅内动脉瘤继发脑血管痉挛的危险因素。早期手术能降低脑血管痉挛的发生率。     

TIA与TIA形式的脑梗死的相关因素分析

目的分析TIA及TIA形式的脑梗死的临床特点,探索其临床相关因素。方法回顾性分析83例初步诊断为TIA并在症状首发后24 h内行常规MRI及DWI检查的患者,发病1周内行颈部动脉血管彩超、TCD。记录发病后7 d内的临床转归。根据DWI结果分为DWI+组及DWI-组,确定DWI阳性率。比较DWI+组及DWI-组临床特征差别。分析两组患者动脉粥样硬化斑块的部位、性质、数量及颅内外血管狭窄的部位、程度。结果DWI阳性率为36.1%。DWI阳性与动脉粥样硬化相关(P=0.03),与颈部动脉动脉粥样硬化斑块数目相关(P=0.04),TIA症状首发后7 d内,30.0%DWI+组患者TIA症状反复发作或表现为临床症状持续存在,高于DWI-组(22.6%)。结论临床表现为TIA的病例大于1/3急性期已经形成了脑梗死,动脉粥样硬化斑块数量越多,DWI阳性的可能性越大,DWI+的患者7 d内更易进展。     

The kinetic change of the serum angiogenin level in patients with acute cerebral infarction

Serum angiogenin (ANG) levels were measured with ELISA in 30 cerebral infarction patients at different time points (within 48 h and on days 3, 7 and 14 after onset of cerebral infarction) and in 20 control subjects. Serum ANG levels in patients were 415.1 +/- 76.8, 410.6 +/- 82.1, 443.6 +/- 91.1 and 395.3 +/- 83.9 ng/ml within 48 h and on days 3, 7 and 14 after cerebral infarction, respectively. Serum ANG level in control group was 334.9 +/- 93.9 ng/ml. Serum ANG levels were significantly higher in patients with cerebral infarction within 48 h and on days 3 and 7 than in the control group (p < 0.05). Serum ANG level decreased on day 14. Serum ANG levels were significantly higher in patients with large infarction than in those with moderate and small infarction at each time point (p < 0.05). Our observations that serum ANG levels increase significantly in patients with cerebral infarction and the increase in ANG levels correlates with the infarct size suggest that ANG might be involved in the pathophysiologic process of ischemic brain damage.     

急性脑出血患者血清VEGF的动态变化

目的 通过对急性脑出血患者血清中血管内皮生长因子(VEGF)在发病后不同时程的含量进行监测,研究其动态变化.探讨其在脑出血后脑损伤和修复中的作用.方法 56例急性脑出血患者,分别于发病后1,2,3,7,14d各采血1次,收集血清.正常对照组12例亦取静脉血.应用双抗体夹心ELISA法进行血清VEGF含量检测.结果 脑出血组不同时程VEGF平均水平均高于正常对照组(P<0.01).VEGF浓度于发病1 d内开始升高,2,3 d继续升高,7 d达高峰,随后下降,14 d仍高于正常.结论 脑出血组不同时程VEGF平均水平均高于对照组,且呈动态变化.提示VEGF在脑出血后脑组织继发性损伤和修复过程中发挥作用.     

Reduced erythrocyte membrane essential fatty acids and increased lipid peroxides in schizophrenia at the never-medicated first-episode of psychosis and after years of treatment with antipsychotics

Abnormal membrane phospholipid essential polyunsaturated fatty acid (EPUFA) metabolism (i.e., reduced incorporation into phospholipids and increased breakdown) has been suggested to contribute to the etiopathophysiology of schizophrenia. However, most of the published studies have reported changes in the levels of membrane EPUFA in chronic medicated patients or in drug-naive patients long after onset of illness (1-2 years). Since the EPUFA metabolism can be altered by years of untreated illness or differentially altered by various antipsychotics, the significance of EPUFA membrane status to schizophrenia psychopathophysiology is unclear. We report the erythrocyte membrane EPUFA levels in drug-naive patients within +/- 4.5 days of onset of psychosis from an Army Medical Center, and in patients treated years with antipsychotics from a Veterans Affairs Medical Center. The levels of plasma lipid peroxides (TBARS, thiobarbituric acid reactive substances), products of damaged EPUFAs, were also determined. The levels of EPUFAs, particularly arachidonic acid (AA) and docosahexaenoic acid (DHA) were significantly lower (P < 0.001) in drug-naive patients at the onset of psychosis compared to matched normal controls. These lower EPUFA levels were associated with significantly higher levels of TBARS in patients (P < 0.001). The levels of AA and DHA were also lower (P < 0.001) and TBARS higher in chronic medicated patients than normal controls. However, the EPUFA levels were higher in chronic medicated patients than drug-naive first-episode patients. These data indicate that lower membrane AA and DHA most likely predate the illness and probably contribute to the onset of illness, and furthermore treatment with some antipsychotics may increase the levels of EPUFAs. The lipid peroxidation data suggest that possible increased oxidative stress, either as a part of the illness and/or its treatment with antipsychotics, may be one of the mechanisms of reduced membrane EPUFAs. These findings may have a significant impact on improving strategies for supplementation of EPUFAs and antioxidants to improve the outcome of schizophrenia.     

高血压脑出血后T淋巴细胞亚群的动态变化

目的 观察高血压脑出血患者外周血T淋巴细胞亚群水平动态变化,探讨高血压脑出血后免疫抑制情况.方法 本研究为前瞻性研究,根据入院时GCS评分纳入轻型(GCS 12～15分)、中型(GCS 9～11分)和重型(GCS 3～8分)高血压脑出血患者各30例.另外纳入无脑出血的原发性高血压患者30例为对照组.高血压脑出血患者于发...     

A prospective study of postpartum psychoses in a high-risk group. 1. Clinical characteristics of the current postpartum episodes

Postpartum psychotic episodes (PPPs) occurring during the first 6 months after delivery were prospectively studied in 88 pregnant index women with a history of nonorganic psychosis and 104 pregnant controls with no such history. While no control developed a PPP, PPPs were found following 28% of the index deliveries, almost all of these 25 cases being psychiatrically hospitalized. PPPs were especially frequent among cases with total illness diagnoses of Cycloid Psychosis and Affective Illness. More than half of the 25 cases had symptom onset within 3 weeks of delivery, and these early onset cases represented predominantly affective disorders, many of whom were manic in this episode. Cases with onset after 3 weeks were predominantly schizophrenic. Confusion was part of the current episode symptomatology in about one third of the cases and was well distributed across the different diagnostic groups.