偏头痛与感染性头痛患者血清超敏C反应蛋白与降钙素基因相关肽测定的意义及相关性

目的研究超敏C反应蛋白（hs-CRP）与降钙素基因相关肽（CGRP）在偏头痛与感染性头痛患者血清中的变化意义及相关性。方法选择39例偏头痛、38例感染性头痛患者及36例健康者,用免疫比浊法测定hs-CRP,放射免疫分析法测定血浆CGRP含量。结果 hs-CRP含量：偏头痛先兆期（3.86±1.45）mg/L、发作期（4.42±1.56）mg/L、间歇期（2.73±1.06）mg/L,感染性头痛（8.56±1.64）mg/L,均明显高于对照组（1.62±0.38）mg/L,分别P〈0.01、P〈0.05;而感染性头痛又明显高于偏头痛发作期（P〈0.01）。CGRP含量：偏头痛发作期（80.64±10.83）pg/mL,感染性头痛（67.25±9.86）pg/mL,高于对照组（59.32±7.62）pg/mL,分别P〈0.01、P〈0.05;先兆期、缓解期与正常对照组比较差异无统计学意义。相关分析发现,偏头痛发作期hs-CRP与CGRP呈正相关（r=0.3426,P〈0.05）。结论偏头痛患者hs-CRP阶段性改变,CGRP的释放与炎性标记物hs-CRP有明显相关性,hs-CRP可作为偏头痛发作各期的一种低水平炎性反应检验学指标,对感染性头痛有一定鉴别诊断意义。     

偏头痛患者血清C-反应蛋白测定

偏头痛是一种常见病，其发病机制尚不完全清楚，许多证据表明偏头痛与免疫炎症反应有关，而C-反应蛋白(CRP)与免疫调节关系密切，此研究检测了52例偏头痛患者血清CRP水平，以有助于探讨偏头痛的发病机制。     

血清C反应蛋白水平与脑梗死的相关分析

目的 探讨C反应蛋白水平在不同类型急性脑梗死（ACL）患者血清中的变化规律及其,临床意义。方法 采用酶联免疫吸附法（ELISA法）对100例本院住院的脑梗死（发稿1周内）进行CRP水平测定,其中大动脉粥样硬化梗死24例,小动脉闭塞性脑梗死27例,心源性栓塞性脑梗死2例,其他病因明确性脑梗死34例,不明病因性脑梗死13例,并进行对照分析。结果 以CO中毒为主要危险因素组,其次冠心病组;高血压组与糖尿病组组间对比无明显差异。结论 血清CRP可能在ACI患者的发生,发展中起一定作用,且水平随卒中类型的不同而变化。     

脑梗死患者血清超敏C反应蛋白及相关研究

目的探讨动脉硬化性脑梗死患者血清超敏C反应蛋白(hs-CRP)含量变化及意义。方法检测99例脑梗死患者的血清hs-CRP含量,选80例健康人做为对照组。同时测总胆固醇(TC)水平及高密度脂蛋白(HDL-C)含量,计算TC/HDL值。结果(1)hs-CRP脑梗死组为(4.83±2.14)mg/L,健康组为(1.02±0.91)mg/L,有显著差异(P<0.01),(2)TC/HDL值脑血管组为3.82±1.13,健康组为2.15±0.53,有显著差异(P<0.01)。结论hs-CRP水平升高是脑梗死发生的一个独立危险因素,hs-CRP和TC/HDL联合分析对于脑梗死的预测和干预处理有一定临床价值。     

脑囊虫病并发癫痫的相关因素分析

本组收集５１例脑囊虫病患者的临床资料，其中伴癫痫发作３９例，现总结报告如下，并结合文献对脑囊虫病并发癫痫的相关因素进行讨论。临床资料１．一般资料本组男３０例，女９例，年龄７～６２岁，平均３６．８岁，其中２０～５０岁２７例（６９％），病程１天～３０年，...     

伴有代谢综合征的脑梗死患者高敏C反应蛋白浓度的变化

目的探讨伴有代谢综合征(MS)的脑梗死患者血清中高敏C反应蛋白(hs-CRP)浓度的变化。方法选择262例脑梗死患者为脑梗死组,根据脑梗死组患者是否伴有MS分为2个亚组;伴MS脑梗死组(126例)和不伴MS脑梗死组(136例),同期选择体检健康者136例为正常对照组。检测腰围、血压、血糖、血脂和hs-CRP等相关指标,分析血清hs-CRP浓度与脑梗死、MS的关系。结果脑梗死组血清hs-CRP浓度较正常对照组明显增高(P0.05)。伴MS的脑梗死组血清hs-CRP浓度较不伴MS脑梗死组明显增高(P0.05)。血清hs-CRP浓度随着MS组分数目的增加而增高,且差异有统计学意义(P0.05)。结论脑梗死患者血清hs-CRP浓度增高,尤其以伴有MS的脑梗死患者增高明显。     

复发性脑梗死与血清超敏C反应蛋白关系探讨

目的观察脑梗死初发、复发患者血清CRP水平,探讨脑梗死复发与血清CRP的关系。方法用免疫透射比浊法测定200例急性脑梗死患者及100例非急性脑卒中患者的血清CRP水平,并进行分析。结果各类型急性脑梗死患者血清CRP均高于非急性脑卒中患者(P<0.01);各类型脑梗死患者之间血清CRP差异无统计学意义(P>0.05)。脑梗死复发患者血清CRP高于初发患者(P<0.01),且高血清CRP比率亦高于初发患者(P<0.05)。各类型脑梗死复发患者之间血清CRP差异无统计学意义(P>0.05)。结论脑梗死复发患者血清CRP高于初发患者提示脑梗死复发与血清CRP升高有一定关系,高血清CRP是脑梗死复发的独立性危险因素。     

血清高敏C反应蛋白和半乳糖凝集素-3对偏头痛的诊断

目的分析血清高敏C反应蛋白(hs-CRP)和半乳糖凝集素-3(galectin-3)对偏头痛的诊断价值。方法本前瞻性研究选取2017年3月至2018年6月宝鸡市中心医院神经内科收治的偏头痛患者60例(观察组)和健康者60例(对照组)。分别采用免疫散射比浊法和酶联免疫吸附法检测各组血清hsCRP和galectin-3水平。受试者工作特征曲线分析血清hs-CRP和galectin-3对偏头痛的诊断价值。结果观察组血清hs-CRP(11.38±4.70 mg·L~(-1))和galectin-3(3.96±1.15 ng·mL~(-1))显著高于对照组(hs-CRP:3.59±1.58 mg·L-1,P <0.001;galectin-3:2.01±0.49 ng·mL~(-1),P <0.01)。ROC分析联合血清hs-CRP和galectin-3辅助诊断偏头痛时,敏感性为98.33%,特异性88.23%,AUC=0.978,95%CI=0.933～0.996,P <0.001。比单独用血清hs-CRP或galectin-3辅助诊断效果好(P <0.05)。结论偏头痛患者血清具有高水平的hs-CRP和Galectin-3。联合血清hs-CRP和galectin-3可用于辅助诊断偏头痛。     

脑梗死患者血清高敏C反应蛋白水平的变化及其临床意义

目的　探讨脑梗死患者血清高敏C反应蛋白(hsCRP)水平的变化及其与脑梗死严重程度的关系。方法　测定93例脑梗死患者和44名健康人的血清hsCRP含量,并分析其与脑梗死患者临床神经功能缺损程度评分的相关性。结果　脑梗死组血清hsCRP水平明显高于正常对照组(P<0. 01)。脑梗死不同临床分型组间血清hsCRP水平比较,重型组明显高于中型、轻型组,差异均有显著性(均P<0 .05)。脑梗死患者血清hsCRP含量与临床神经功能缺损程度评分呈正相关(r=0 .252,P<0 .05)。结论　血清hsCRP水平增高与脑梗死的发生和严重程度有密切关系,hsCRP可能是脑梗死发病的一个危险因素。     

急性脑梗死及并发肺部感染患者血清C反应蛋白水平的变化

目的 探讨急性脑梗死及其并发肺部感染患者血清C反应蛋白（CRP）水平的变化及其意义。方法 采用免疫散射比浊法测定20例健康体检者（对照组）和55例脑梗死患者（按梗死面积分为大、中、小3组）血清CRP含量,中等面积梗死患者据是否合并肺部感染分组,于入院7d后复测CRP。结果 CRP含量为大面积梗死组〉中面积梗死组〉小面积梗死组〉对照组,组间差异均具显著性（P〈0．05～0．01）。中面积梗死组,1周后并发感染者较入院1d时CRP含量增高,未并发感染者降低（均为P〈O．01）;中面积梗死者,入院时CRP含量虽无显著性差异（P〉0．05）,1周后感染者较未感染者CRP含量显著升高（P〈0．01）。结论 血清CRP含量反映脑梗死严重程度,动态观察对了解有无合并感染的病情变化有帮助。     

Health-related quality of life measures and psychiatric comorbidity in patients with migraine

Background and purpose:  The identification of factors associated to health-related quality of life (HRQoL) measures in patients with migraine has major implications in terms of prognosis and treatment. This study aimed at investigating associations between HRQoL and comorbid mood and anxiety disorders.
Methods:  Consecutive adult outpatients with a diagnosis of migraine with or without aura were assessed using the Mini International Neuropsychiatric Interview (M.I.N.I.) Plus version 5.0.0 and the Migraine-Specific Quality-of-Life Questionnaire (MSQ).
Results:  Data of 112 patients (82 females), 69 without aura, mean age 41.2 ± 13.3 years were analyzed. According to the M.I.N.I., 50% patients had a lifetime or current DSM-IV diagnosis of mood or anxiety disorder. There was no between-groups difference in MSQ total and subscale scores in relation to the presence/absence of psychiatric comorbidity, independently whether that was current or lifetime. In the group of subjects with psychiatric disorders, age at onset of migraine correlated with MSQ-total (rho = −0.407 P  = 0.002), and subscale scores (Role Function-Restrictive, rho = −0.397, P  = 0.002; Emotional Function, rho = −0.487, P  < 0.001).
Conclusions:  Our findings suggest that current and/or lifetime psychiatric comorbidities are not associated with HRQoL measures in patients with migraine. However, patients with migraine and psychiatric comorbidities may represent a specific subgroup deserving particular attention for targeted interventions.     

抑郁症和糖尿病共病患者的瘦素水平

目的:探讨抑郁症和糖尿病共病患者血清瘦素水平的特点。方法:采用放射免疫方法测定抑郁症和糖尿病共病患者(共病组:n=30)和单纯抑郁症患者(单纯抑郁症组:n=30)给予抗抑郁药治疗前后的血清瘦素水平,并与正常人(正常对照组:n=30)的血清瘦素水平进行比较。结果:治疗前共病组血清瘦素水平与单纯抑郁症组差异有统计学意义(t=3.42,P<0.01);与正常对照组差异无统计学意义(t=0.35,P>0.05);治疗后共病组与单纯抑郁症组血清瘦素水平均较治疗前显著下降(t分别=2.455,7.002;P<0.05或P<0.001);共病组与正常对照组差异有统计学意义(t=-4.18,P<0.001)。结论:抑郁症和糖尿病共病可能存在瘦素分泌不足,抗抑郁药可降低血清瘦素水平。     

偏头痛伴发脑微出血的相关危险因素分析

目的分析偏头痛患者伴发脑微出血(CMBs)的临床特点及影响因素。方法连续收集178例临床确诊的偏头痛患者,根据头颅MRI有无CMBs表现分为两组,收集患者一般资料,头痛特点并进行比较。结果 (1)178例偏头痛患者中CMBs患者56例,偏头痛合并CMBs发生率为31.5%,其中单发病灶17例(30.4%),多发病灶39例(69.6%),单纯脑叶病灶31例(55.4%);(2)与无CMBs的偏头痛患者比较,合并CMBs的偏头痛患者更容易合并高血压(P=0.028),头痛病程长(P=0.002)、头痛发作频率高(P=0.001)且容易伴发先兆(P=0.036);(3)多因素Logistic回归分析显示,在校正年龄、性别及其他危险因素后,头痛病程(OR=1.166,95%CI:1.044~1.303,P=0.007)、头痛发作频率(OR=1.353,95%CI:1.116~1.640,P=0.002)和先兆偏头痛(OR=10.080,95%CI:1.630~62.329,P=0.013)与偏头痛发生CMBs相关。结论偏头痛病程长、发作频率高及伴有先兆是偏头痛发生CMBs的危险因素。     

The aetiology of psychogenic non‐epileptic seizures: risk factors and comorbidities

Psychogenic non‐epileptic seizures (PNES), also known as dissociative seizures, are paroxysms of altered subjective experience, involuntary movements and reduced self‐control that can resemble epileptic seizures, but have distinct clinical characteristics and a complex neuropsychiatric aetiology. They are common, accounting for over 10% of seizure emergencies and around 30% of cases in tertiary epilepsy units, but the diagnosis is often missed or delayed. The recently proposed “integrative cognitive model” accommodates current research on experiential, psychological and biological risk factors for the development of PNES, but in view of the considerable heterogeneity of presentations and medical context, it is not certain that a universal model can capture the full range of PNES manifestations. This narrative review addresses key learning objectives of the ILAE curriculum by describing the demographic profile, common risk factors (such as trauma or acute stress) and comorbid disorders (such as other dissociative and functional disorders, post‐traumatic stress disorder, depressive and anxiety disorders, personality disorders, comorbid epilepsy, head injury, cognitive and sleep problems, migraine, pain, and asthma). The clinical implications of demographic and aetiological factors for diagnosis and treatment planning are addressed.     

抗精神病药治疗精神分裂症引致糖尿病的相关因素分析

目的　探讨抗精神病药物治疗精神分裂症引致糖尿病的相关因素。方法　回顾性调查住院精神分裂症患者中糖尿病的患病情况 ,观察治疗前后血糖的变化 ,比较各种抗精神病药物对糖代谢异常的影响。结果　本组患者中糖尿病的发生率为 7 84 % ;男女性别比较无显著性差异 (P >0 0 5 ) ;病程 <10年与≥ 2 0年组比较及年龄<4 0岁与≥ 4 0岁组比较 ,糖尿病发生率均有极显著性差异 (P <0 0 1)。抗精神病药引发糖尿病的发生率依次为 :氯氮平 (14 16 % )、氯丙嗪 (7 4 1% )、利培酮 (6 5 4 % )和其它 (5 5 8% )。氯氮平组与利培酮组比较 ,糖尿病发生率和空腹血糖均有显著性差异 (P <0 0 5 ) ,餐后 2h血糖亦有极显著性差异 (P <0 0 1)。结论　精神分裂症合并糖尿病与患病年龄、病程有关系 ,5 0岁以上患者发生糖尿病的危险性更大。氯氮平引发糖尿病的发生率明显高于其它抗精神病药物 ,且餐后血糖控制不良。     

癫癎患者生活质量及其影响因素的研究

目的研究癫痫间患者的生活质量及其影响因素。方法采用癫痫间患者生活质量量表-31(QO-LIE-31)对56例确诊的癫痫间患者和46例对照者进行评价。结果癫痫间组患者QOL各项得分均显著低于对照组(P<0.05);全身性强直-阵挛发作(GTCS)和复杂部分性发作(CPS)患者QOL各项得分无显著差异(P>0.05);伴有抑郁的癫痫间患者在对发作的担忧、情绪健康、精力/疲乏和总体健康水平方面低于不伴有抑郁的癫痫间患者(P<0.05);服用1种抗癫痫间药物(AED)的患者与服用1种以上的患者比较,在对发作的担忧、综合生活质量、情绪方面、药物的影响以及总体健康水平方面得分显著降低(P<0.05)。结论癫痫间患者生活质量显著降低,抑郁和服用多种AED对生活质量影响较大。     

The impact of comorbidity and other clinical and sociodemographic factors on health-related quality of life in Greek patients with Parkinson's disease

Objectives: This study was designed to evaluate the impact of other common self-reported comorbid disorders (hypertension, dyslipidemia, ischemic heart disease, diabetes mellitus, minor stroke, arthritis, low back pain or osteoporosis and depression) on health-related Quality of Life (HRQoL) of Parkinson's disease (PD) patients and to explore the association of their HRQoL with various sociodemographic and clinical factors.

Methods: Data about age, gender, education, occupation, income, marital and residential status, social relations, disease duration, functional status, treatment and concomitant diseases were collected of 139 Greek patients (68 men and 71 women) with PD. Patients were consecutively recruited from the outpatient clinic of the first Neurology Department of Athens National University at Aeginition Hospital. Disease severity was assessed using the unified Parkinson's disease rating scale including Hoehn and Yahr and Schwab and England (S&;E) scales. HRQoL was measured by the specific Parkinson's disease questionnaire (PDQ-39). A multivariate multiple regression model with normal errors was used for the statistical analysis.

Results: The main determinants of HRQoL were low degree of independence measured by the S&;E scale (F?=?35.942, p?F?=?20.508, p?F?=?14.983, p?F?=?6.507, p?=?0.013) and gastrointestinal disturbances (F?=?4.643, p?=?0.035) and the presence of depression (F?=?6.022, p?=?0.017).

Conclusion: Among the other chronic comorbidities only depression was associated with a poor HRQoL in PD patients. Functional dependence and social isolation contributed most to worse HRQoL. Our findings suggest that adequate social support and management of depression, sleep and gastrointestinal disturbances could reduce the distress and improve HRQoL in patients with PD.     

癫痫患者的认知功能评估及其影响因素研究

目的评估癫痫患者的认知功能,探索影响癫痫患者认知功能的相关因素。方法将2013年1月-2015年1月在三台县人民医院就诊的符合国际抗癫痫联盟(ILAE)1981年癫痫发作分类及1989年癫痫综合征分类标准的癫痫患者48例作为研究组,选取同期在该院的45例健康体检者为对照组。采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评价两组的认知功能,采用自制调查表收集患者的病历资料,并分析影响癫痫患者认知功能的相关因素。结果研究组MoCA总评分低于对照组[(19.34±7.22)分vs.(28.61±6.89)分],差异有统计学意义(P0.01),MoCA各项目评分研究组低于对照组,差异均有统计学意义(P0.01)。发病年龄、病程长短、发作频率、发作持续时间、发作类型及用药情况对患者的认知功能影响显著(P均0.05)。结论癫痫患者存在认知功能障碍,其认知功能损害与发病年龄、病程长短、发作频率、发作持续时间、发作类型及用药情况有关。