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1.
目的比较进行改良ECT(Modified Electric Convulsive Therapy简称MECT)治疗时能量百分比的选择是否存在性别差异。方法对2004年3月至2005年3月我院ECT室接受治疗的88例、656人次男性患者和73例,453人次女性患者进行比较。能量百分比从10%~100%,以5%能量百分比为一个能量百分比增加值。在每一能量百分比下将患者分成男女两组。进而根据衡量一次改良ECT是否发作完全的3项指标(①EEG endpoint;②SEI;③PSI)之2或2项以上再将患者分为完全组和不完全组两组。结果男、女患者在进行改良ECT治疗时能量百分比选择无差异。结论改良ECT治疗时若患者年龄和体重指数无统计学差异时,治疗能量百分比的选择无性别差异。  相似文献   

2.
目的比较不同体重指数对多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者妊娠结局和新生儿结局的影响。方法回顾性分析2011年1月至2013年12月于首都医科大学附属北京妇产医院产科就诊的PCOS孕妇328例,按照孕前体重指数(body mass index,BMI)分为体重正常组(BMI 18.5~24.9kg/m^2)和超重及肥胖组(BMI≥25.0kg/m^2),比较两组PCOS孕妇妊娠结局及新生儿结局等情况。结果超重及肥胖组的既往流产率和辅助生殖技术助孕妊娠比例、妊娠期糖尿病、妊娠期高血压疾病和胎盘早剥的发生率显著高于正常体重组(P〈0.05);两组问胎膜旱破、胎儿生长受限、前置胎盘和产后出血等并发症无统计学差异(P〉0.05);在分娩方式上,超重及肥胖PCOS孕妇与对照组相比顺产率低而剖宫产率高,早产和巨大儿的发生率也显著增加,差异具有统计学意义(P〈0.05)。结论孕前超重及肥胖的PCOS患者发生妊娠期并发症的风险增高,新生儿容易出现不良结局,对这类患者应加强健康管理,孕前即注意体重的控制以改善母婴结局。  相似文献   

3.
目的:了解南京地区中学生超重肥胖现状及与抑郁症状的关系。方法:采用儿童抑郁量表(Children's Depression Inventory,CDI)对南京地区13个区县的56个学校的168个班级7161名在校的初一至高三的中学生进行抑郁症状评定。同时参考中国儿童青少年超重和肥胖筛查BMI值分类标准分体重正常、超重和肥胖三组。结果:男生超重和肥胖检出率均显著高于女生(超重:9.6%vs.5.4%,)(2=49.835,P〈0.01;肥胖:3.9%vs.2.3%,P〈0.01)。中学生抑郁症状检出率为14.8%,男生的检出率显著高于女生(16.4%vs.13.0%,P〈0.01)。经多因素调整后,与体重正常者比较,超重、肥胖的青少年罹患抑郁症状的风险分别增加37.1%和48.8%。结论:超重肥胖可能是罹患抑郁症状的一个危险因素;体重指数值越高,罹患抑郁症状的风险越大。  相似文献   

4.
广州市457名在校学生肥胖和血脂紊乱状况分析   总被引:1,自引:0,他引:1  
目的分析广州市457名在校学生肥胖和血脂紊乱状况。方法随机抽取广州市区小学、初中、高中各一所学校的学生共457名,测量身高、体重、脂肪含量,采集静脉血测定总胆固醇(TC)、高密度脂蛋白胆固醇(HDL—C)、低密度脂蛋白胆固醇(LDL—C)、甘油三酯(TG),按照美国国家胆固醇教育计划(NCEP)推荐的儿童血脂异常诊断标准进行分析。中国学龄儿童青少年超重、肥胖筛查体重指数依据中国肥胖问题工作组推荐标准。结果该样本中31.1%出现血脂紊乱,超重+肥胖率为36.3%,肥胖率为15.8%;血脂紊乱发生率在体型正常者中与超重或肥胖者中有显著性差异(P〈0.05);TC和脂肪含量在男女性别之间总体均数差异有统计学意义(P〈0.05);体重指数(BMI)除LDL-C外,与TG、TC、HDL—C相关系数差异有统计学意义(P〈0.05)。结论此次调查结果显示,457名学生中,按照青少年肥胖分级,超重与肥胖率已达到Ⅲ级水平中的高度警戒水平。  相似文献   

5.
孕妇体重状况与妊娠并发症及分娩结局的关系   总被引:3,自引:0,他引:3  
目的探讨孕妇孕前体重指数(BMI)、孕期BMI增幅与妊娠期高血压疾病子痫前期、妊娠期糖尿病及分娩结局的关系。方法将870例单胎孕妇按孕前BMI分为正常组(18.5≤BMI(23)、超重组(23≤BMI〈25)和肥胖组(BMI〉125)三组。再根据整个孕期BMI的增幅,分为Ⅰ组(BMI的增幅〈4)、Ⅱ组(4≤BMI的增幅≤6)和Ⅲ组(BMI的增幅〉6),并分别对妊娠期高血压疾病子痫前期、妊娠期糖尿病及分娩结局的关系作前瞻性分析。结果肥胖组、超重组孕产妇的妊娠期高血压疾病子痫前期、妊娠期糖尿病;巨大儿、胎儿窘迫、难产发生率明显高于正常组,具有统计学意义(P〈0.01);Ⅱ组、Ⅲ组孕产妇的妊娠期高血压疾病子痫前期、妊娠期糖尿病;巨大儿、胎儿窘迫、难产发生率明显高于正常组,具有统计学意义(P〈0.01)。产后出血的发生与孕前BMI及孕期BMI增幅无明显关系。结论孕前BMI及孕期BMI增幅与妊娠期高血压疾病子痫前期、妊娠期糖尿病;巨大儿、胎儿窘迫、难产发生率之间有密切关系,控制孕前体重及孕期体重的增加可减少妊娠期高血压疾病子痫前期、妊娠期糖尿病;巨大儿、胎儿窘迫、难产的发生。  相似文献   

6.
目的探讨儿童青少年血浆促酰化蛋白(ASP)水平与肥胖及代谢综合征(MS)的关系。方法以2004年北京市儿童青少年代谢综合征(BCAMS)调查总样本中1603名6~18岁儿童青少年为研究对象。采用中国肥胖问题工作组推荐的标准诊断超重和肥胖。符合下述5项指标中的3项及以上者诊断为MS:①腹型肥胖(腰围≥‰);②高血压(≥P90);③高密度脂蛋白胆固醇≤1.03mmol·L^-1;④三酰甘油≥1.24mmol·L^-1;⑤高空腹血糖(≥5.60mmol·L^-1)。采用ELISA法检测血浆ASP水平,免疫透射比浊法检测补体3(c3)水平。采用方差分析比较超重、肥胖及MS儿童青少年的血浆ASP水平,多因素Logistic回归分析血浆ASP水平与超重、肥胖及MS的关系。结果1603名研究对象中男性873名(54.5%)、女性730名(45.5%);超重和肥胖者分别为291名(18.2%)和709名(44.2%);MS为376名(23.4%)。正常体重、超重和肥胖组MS检出率分别为2.2%(13/603名)、15.5%(45/291名)和44.9%(318/709名)。正常体重组血浆ASP水平男性低于女性,差异有统计学意义(t=2.527,P〈0.05)。正常体重、超重和肥胖组血浆ASP的几何均值(P25-P75),男性分别为37.52(22.36~64.58)、57.88(34.10~95.11)和60.63(35.30~109.72)nmol·L^-1;女性分别为44.16(27.27~74.72)、60.25(35.68~113.15)和66.68(44.56-113.97)nmol·L^-1,均呈逐渐升高趋势(男性:,=34.329,P〈0.001;女性:F=22.246,P〈0.001)。C3水平仅在肥胖女性中升高(P〈0.01)。血浆ASP水平随MS组分聚集的数目增加而升高(男性:F=16.422,P〈0.001;女性:F=9.661,P〈0.001),与高血压、腹型肥胖和高空腹血糖的关系尤为密切。血浆ASP水平升高与儿童青少年超重、肥胖和MS的患病风险密切相关,相对于最低5分位值,位于最高5分位值的ASP水平与超重、肥胖和MS关系的OR值(95%CI)分别为3.90(2.38~6.39)、6.05(4.06~9.01)和2.89(1.93~4.33)。结论超重、肥胖和MS儿童青少年血浆ASP水平明显升高,血浆ASP水平可能对儿童青少年超重、肥胖和MS的发生具有较好的预测价值。  相似文献   

7.
目的探讨体重指数对多囊卵巢综合征患者体外受精一胚胎移植妊娠结局的影响。方法回顾性分析2010年1月至2011年11月于哈尔滨医科大学附属第一医院接受IVF/ICSI治疗的PCOS(polycystie ovarian syndrome)患者64例共67个周期,按照体重指数分为正常体重组(A组)、超重组(B组)、肥胖组(C组)。比较三组之间基本临床资料;促排卵过程、卵子、胚胎情况及妊娠结局情况。结果FSH值C组低于A组、B组,空腹胰岛素及胰岛素抵抗指数C组高于其他两组,差异均有统计学意义;HCG日E2水平A组高于B组、C组,GN用量A组低于其余两组,差异有统计学意义;受精率、胚胎种植率、临床妊娠率、流产率及活产率三组问差异没有统计学意义。结论超重和肥胖增加了PCOS患者体外受精一胚胎移植促排卵过程中促性腺激素的用量,但对妊娠结局没有显著影响。  相似文献   

8.
目的 研究解偶联蛋白3基因(UCP3)启动子区-55(C〉T)多态与中国人静息能量消耗、体脂参数的关系。方法 在300名中国人(正常体重91人,超重/月巴胖209人)中,用聚合酶链反应一限制性片段长度多态性(polymemse chain reaction-restriction fragment length polymorphisms,PCR—RFLP)检测伙巧基因启动子区-55(C〉T)变异,并测定其静息能量消耗、体脂含量及分布。结果 UCP3基因启动子区-55(C〉T)多态基因型频率与肥胖及肥胖类型均无相关。正常体重组1T基因型者静息能量消耗水平显著高于CT及CC基因型者(P〈0.05);超重/肥胖组各基因型者间比较亦有同样趋势。在超重/肥胖组,TT基因型者FM/FFM值与CT及CC基因型者差异有显著意义(P〈0.01)。结论 UCP3基因启动子区-55(C〉T)多态与中国人静息能量消耗相关,该变异可能通过对静息能量消耗的影响调节机体的能量代谢。  相似文献   

9.
目的探讨体质指数对超重与肥胖青少年高血压的影响。方法测量郴州市6所学校部分12~15岁青少年体重、身高、血压。结果 2566名在校学生血压偏高率为20.7%,其中血压偏高在非超重组、超重组和肥胖组检出率分别为19.15%、34.55%和39.29%,非超重组、超重组和肥胖组儿童血压偏高检出率组间差异有统计学意义(P〈0.05)。结论青少年血压偏高检出率随体质指数增加而明显增高。  相似文献   

10.
目的探讨N-端脑利钠肽前体(NT—proBNP)在妊娠高血压疾病(PIH)心功能评估中的价值。方法将102例PIH孕妇分为妊娠高血压组37例,轻度子痫前期组33例,重度子痫前期组32例,另外选取正常妊娠组32例及正常未孕育龄妇女32例作为对照组,采用电化学发光法测定患者血清NT—proBNP浓度。结果PIH组、正常妊娠组和对照组的NT—proBNP水平分别为(300.52±134.44)、(83.42±26.26)和(59-83±12.89)pg/ml,三者间比较差异均有统计学意义(P〈0.01)。重度子痫前期组、轻度子痫前期组、妊娠高血压组的NT-proBNP水平分别为(488.56±155.54)、(323.39±148.90)和(185.73±43.78)pg/ml,三者间比较差异均有统计学意义(P〈0.01)。NT—proBNP与孕妇体重指数(BMI)呈正相关(r=0.602),与新生儿体重呈负相关(r=-0.279)。结论孕后NT-proBNP有所升高,而且是能够用于评估PIH孕妇心功能的敏感指标之一。  相似文献   

11.
改良ECT与阿米替林治疗抑郁症的疗效观察   总被引:1,自引:1,他引:0  
目的 比较改良 ECT和阿米替林治疗抑郁症的疗效。方法 对 68例抑郁症随机分为改良 ECT组和阿米替林组 ,应用各自的方法治疗 4周 ,期间应用 Hamilton抑郁量表 (HAMD)评定临床疗效。结果 改良 ECT组痊愈 67.6% (2 3 /3 4) ,显著进步 1 7.6% (6/3 4) ,有效率为 1 0 0 %。阿米替林疗效分别为痊愈 5 0 % (1 7/3 4) ,显著进步 2 0 .6% (7/3 4) ,有效率为85 .3 %。 HAMD评分两组间比较有显著性差异 (P<0 .0 1 )。结论 改良 ECT治疗抑郁症起效快、疗效好 ,病人依从性好。  相似文献   

12.
BACKGROUND: The outcome of electroconvulsive therapy (ECT) is affected by the placement and dose of the stimulus. In general, the ECT dose can be selected either by the dose-titration method (on which the measured seizure threshold level is based), or the method of predetermined dose (e.g. the age-based dosing and the fixed high dose method). METHODS: Seizure thresholds were measured in 50 patients with right unilateral (RUL) and in 30 patients with experimental bifrontal (BF) ECT stimulus. The ECT dose (mC) of the age-based dosing was calculated by multiplying the age (years) by 5.0 (age method) or 2.5 (half-age method). The fixed high dose was set to 378 mC. RESULTS: The seizure thresholds had only a moderate correlation with the age of the patients. The methods based on the predetermined dose would have led us to give patients with the lowest seizure thresholds in the RUL ECT group very high stimulus doses, up to 12 (age method) or 15 (fixed high dose method) times the individual seizure threshold. In contrast, the RUL ECT patients with the highest seizure thresholds would have received low stimulus doses down to 1.5 times (half-age method) the initial seizure threshold. In the BF ECT group the-age based dose would have been similarly dependent on the initial seizure threshold level. CONCLUSION: The use of the dose-titration method is recommended, because it is the only method that allows for the individual selection of ECT stimulus dose relative to the seizure threshold.  相似文献   

13.
BACKGROUND: Electroconvulsive therapy (ECT) is a highly effective treatment for depression but its use is limited by the risk of cognitive side effects. This study explored the potential of a novel approach, ultrabrief pulsewidth (0.3 ms) right unilateral (RUL-UB) ECT, to minimise cognitive effects while preserving efficacy. METHODS: Mood and neuropsychological functioning were objectively rated in 30 patients over a course of RUL-UB ECT at 6 times seizure threshold. Results (mood outcomes, ECT treatment parameters) were compared with a retrospectively assessed group of 30 age and gender matched patients who received RUL ECT (1.0 ms pulsewidth, 3.5 times seizure threshold) at the same hospital. RESULTS: Six treatments of RUL-UB ECT resulted in relatively few cognitive side effects, compared to reports of previous studies. The number of responders did not differ between groups but significantly more treatments were required in the RUL-UB group, suggesting a slower speed of response. LIMITATIONS: Patients were not randomised to the two forms of ECT and data was obtained retrospectively in the RUL ECT comparison group. CONCLUSIONS: This study suggests that RUL-UB ECT can be effective in treating depression while incurring lesser cognitive side effects than a commonly used form of RUL ECT, but a greater number of treatments may be required for response.  相似文献   

14.
Spasticity has been defined as a motor disorder characterized by a velocity-dependent increase in tonic stretch reflex (muscle tone). Muscle tone consists of mechanical-elastic characteristics, reflex muscle contraction and other elements. The aims of this study were to determine whether to assess spasticity quantitatively, and to characterize biomechanical and electromyographic spasticity assessment parameters. These assessment parameters were described by investigating the correlation between clinical measures and the response to passive sinusoidal movement with consecutive velocity increments. Twenty post-stroke hemiplegic patients and twenty normal healthy volunteers were included in the study. Five consecutive sinusoidal passive movements of the ankle were performed at specific velocities (60, 120, 180, and 240 degrees/ sec). We recorded the peak torque, work, and threshold angle using a computerized isokinetic dynamometer, and simultaneously measured the rectified integrated electromyographic activity. We compared these parameters both between groups and between different velocities. The peak torque, threshold angle, work, and rectified integrated electromyographic activity were significantly higher in the post-stroke spastic group at all angular velocities than in the normal control group. The threshold angle and integrated electromyographic activity increased significantly and linearly as angular velocity increased, but the peak torque and work were not increased in the post-stroke spastic group. Peak torque, work, and threshold angle were significantly correlated to the Modified Ashworth scale, but the integrated electromyographic activity was not. The biomechanical and electromyographic approach may be useful to quantitatively assess spasticity. However, it may also be very important to consider the different characteristics of each biomechanical parameter.  相似文献   

15.
Nonshivering thermogenesis in the diabetic SHR/N-cp (corpulent) rat   总被引:1,自引:0,他引:1  
The effects of isoenergetic sucrose and starch-based diets on thermogenesis were investigated in young adult, male, lean and corpulent SHR/N-cp rats. Corpulent rats gained weight 1.5 times more rapidly than lean, and sucrose diets resulted in more rapid weight gains in both phenotypes. Rates of resting and of norepinephrine-stimulated oxygen consumption were similar in both groups of lean rats and in sucrose-fed corpulent rats, but were decreased in starch-fed corpulent rats. The thermic response to injected norepinephrine occurred normally in all groups. Colonic and rectal temperatures were greater in lean than in corpulent rats. Acute cold exposure (5 degrees C) resulted in decreases in rectal but not colonic temperature in lean rats fed both diets, but resulted in lower temperatures at both sites in corpulent rats, with the greatest decreases being observed in the starch fed corpulent rats. Fifty percent of the corpulent but none of the lean rats succumbed within 24-48 hours following cold exposure. Urinary vanilmandelic acid (VMA) excretion was greater in lean than in corpulent rats, and the sucrose diet induced a greater increment in urinary VMA excretion in lean rats than in corpulent rats. These results are consistent with an impaired activation of sympathetically-mediated thermogenesis via nutritional or environmental stimuli in the corpulent genotype of the SHR/N-cp rat in concert with an economy in energy expenditure which may be contributing factors in the causation of their obese state.  相似文献   

16.
BACKGROUND: Effects of diencephalic seizure generalization during ECT, e.g., cardiovascular response, may be relevant in indexing its therapeutic potency. A trend for greater rate pressure product (RPP=heart rate x systolic blood pressure) response to modified ECT in responders than in nonresponders is reported. Atropine used in modified ECT is known to increase RPP. This study examined if cardiovascular response during ECT with or without atropine predicts antidepressant effect. METHODS: Twenty nine consenting, major depressive disorder patients received ECTs. Atropine premedication was randomly withheld in the second or third ECT session. RPP was recorded during ECT. Severity of depression was measured at twice weekly intervals. RESULTS: Fifteen patients remitted at the end of 2 weeks. These early remitters had significantly higher poststimulus RPP than the rest in the ECT session without atropine but not so in the session with atropine. Cumulative poststimulus RPP predicted the early antidepressant response. Corresponding motor or EEG seizure durations were not associated with antidepressant effect. LIMITATIONS: Most patients continued to receive antidepressants. ECT stimulus laterality was not controlled. The study focussed on only short term antidepressant effects. CONCLUSIONS: RPP response to ECT recorded under no-atropine condition may reflect its physiological effects relevant to therapeusis and may have the potential to index seizure adequacy.  相似文献   

17.
BackgroundNeurocognitive functioning is well known to be affected after ECT. However quantified data about the severity of the cognitive impairment after ultrabrief pulse and brief pulse ECT are limited, which makes it hard to judge its clinical relevance.MethodsTo review all prospective studies using right unilateral (ultra) brief pulse index electroconvulsive therapy published up until February 2011 which used at least one instrument for cognitive assessment before and after ECT. The severity and persistence of neurocognitive side effects immediately (one to seven days post ECT), between one and six months and after six months post ECT were assessed by calculating effect sizes using Cohen's d.ResultsTen studies fulfilled the inclusion criteria and provided detailed information to compute effect sizes. The results indicate loss of autobiographical memory and impairment of verbal fluency, anterograde verbal and non-verbal memory immediately after brief pulse RUL ECT. To a lesser extent impairment of working memory and reduced speed of processing is found. Autobiographical memory is the only domain still being impaired between one and six months post ECT, but improved in this period. Verbal fluency normalized to baseline performance between one and six months post ECT whereas anterograde verbal and non-verbal memory normalized or even improved. Speed of processing improved within six months after ECT. Long-term data on these cognitive domains were not available. Based on two of the ten included studies the results suggest that ultrabrief pulse RUL ECT causes less decline in autobiographical and anterograde memory after ECT than brief pulse RUL ECT.LimitationsThis review may be limited because of the small number of included studies and due to unreliable effect sizes. Furthermore, few data were available for non-memory domains and cognitive functioning after six months.ConclusionsLoss of autobiographical memory is still present between one and six months after unilateral brief pulse ECT. Ultrabrief pulse RUL ECT shows less decline in autobiographical memory. Other neurocognitive impairments after brief pulse RUL ECT seem to be transient.  相似文献   

18.
BACKGROUND: Electroconvulsive therapy (ECT) has a long history of use in treating depression. Repetitive transcranial magnetic stimulation (rTMS) has been introduced more recently to the treatment spectrum. Its cost-effectiveness has not been explored. METHOD: Forty-six right-handed people with severe depressive episodes referred for ECT were randomised to receive either ECT twice weekly or rTMS on consecutive weekdays. Health and other service use were recorded for retrospective periods of 3 months prior to initiation of treatment and during the 6 months following the end of allocated treatment. Costs were calculated for the treatment period and the subsequent 6 months, and comparisons made between groups after adjustment for any baseline differences. Cost-effectiveness analysis was conducted with incremental change on the 17-item Hamilton Rating Scale for Depression (HRSD) as the primary outcome measure, and quality-adjusted life years (based on SF6D-generated utility scores with societal weights) as secondary outcome, cost-effectiveness acceptability curves plotted. RESULTS: Based on the HRSD scores and other outcome measures, rTMS was not as effective as ECT. The cost of a single session of rTMS was lower than the cost of a session of ECT, but overall there were no treatment cost differences. In the treatment and 6-month follow-up periods combined, health and other service costs were not significantly different between the two groups. Informal care costs were higher for the rTMS group. Total treatment, service and informal care costs were also higher for the rTMS group. The cost-effectiveness acceptability curves indicated a very small probability that decision-makers would view rTMS as more cost-effective than ECT. LIMITATIONS: Small sample size, some sample attrition and a relatively short follow-up period of 6 months for a chronic illness. Productivity losses could not be calculated. CONCLUSIONS: ECT is more cost-effective than rTMS in the treatment of severe depression.  相似文献   

19.
无抽搐电痉挛与电痉挛治疗对记忆影响的对照研究   总被引:7,自引:0,他引:7  
目的:探讨无抽搐电痉挛对记忆的影响。方法:将入组病例随机分为两组,分别施行无抽搐电痉挛治疗与电痉挛治疗,以修订韦氏记忆量表(WMS)与简明精神病评定量表(BPRS)作为评定工具,比较两组之间的记忆水平及疗效。结果:无抽搐电痉挛对记忆无明显影响,电痉挛对记忆的影响持续两周以上,电痉挛对记忆的影响可能与大脑短时间缺氧有关。结论无抽搐电痉挛不影响患者记忆,治疗时患者不感到痛苦,易于接受,可替代电痉挛治疗  相似文献   

20.
目的探讨中耳胆脂瘤并咽鼓管功能障碍患者使用改良乳突根治术联合咽鼓管球囊扩张术治疗的临床效果。方法回顾性分析86例(86耳)中耳胆脂瘤并咽鼓管功能障碍患者的临床资料,按照手术方式分为球囊组(41例)和非球囊组(45例)。非球囊组采用改良乳突根治术,球囊组采用改良乳突根治术联合咽鼓管球囊扩张术。记录2组患者术前及术后6个月平均听阈、气骨导差、声导抗、七项咽鼓管功能障碍症状评分量表(ETDQ-7)及干耳时间,并评估鼓膜愈合情况。结果2组患者术后6个月平均听阈、气骨导差、声导抗、ETDQ-7评分及干耳时间比较,差异有统计学意义(P<0.05);球囊组鼓膜愈合率较非球囊组高,差异具有统计学意义(P<0.05)。结论对于合并咽鼓管功能障碍的中耳胆脂瘤,改良乳突根治术联合咽鼓管球囊扩张术的近期疗效改善明显。  相似文献   

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