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1.
目的 探讨溶栓治疗对纤维系统的影响以及各指标与临床疗效的关系。方法 本研究对91 例病后24 h 内就治的急性脑梗死随机分为4 组,其中进行血样检测者对照组14 例,应用尿激酶(UK)6×105 U 组22 例,16×105 U 组22 例,26×105 U组11 例。在治疗前及治疗后2 h、24 h、7~10 天(d)进行组织型纤溶酶原激活物(tPA)、纤溶酶原激活物抑制物(PAI)、纤溶酶原(PLG)、D-二聚体(D-D)检测。结果 对照组tPA、PAI、PLG、D-D在治疗前及治疗后各时期无变化,溶栓治疗组于治疗后2 h tPA 及D-D明显升高,PAI、PLG下降。溶栓治疗并发出血的病例,于治疗后24 hPAI仍明显降低。结论 溶栓治疗病例存在超早期纤维激活,凝血障碍是溶栓治疗并发出血的重要机制  相似文献   

2.
目的:探讨蝎毒制剂-速可平(SV)对溃疡性结肠炎(UC)的治疗效果。方法:60例UC患者随机分组,采用蝎毒制剂—速可平保留灌肠(治疗组),同时与用柳氮磺胺吡啶(SASO)肛栓剂(对照组)进行前瞻性对照研究。结果:两组治疗后主要症状、体征及肠粘膜结构积分均有明显改善(P<0.01或P<0.01),且治疗组较对照组改善更明显(P<0.01);主要实验室指标治疗前后也均有显著的改善(P<0.01或P<0.01),且治疗组较对照组改善更明显(P<0.01);治疗组平均治疗时间为34天,而对照组为48天(P<0.05),治疗组治愈率及总有效率分别为60%和93.3%与对照组33.3%和80%相比,差异有显著性(P<0.01或P<0.05);治愈病例进行6个月及12个月的随访,治疗组复发率分别为11.1%和16.7%与对照组40%和60%相比,有显著性差异(P<0.01或P<0.01);两组副作用发生率分别为3%和13.3%(P<0.01)。结论:速可平对UC具有较好治疗效果,同时能改善UC相关的免疫学指标,无明显副作用。  相似文献   

3.
光化学大鼠大脑中动脉血栓形成模型的静脉溶栓治疗研究   总被引:5,自引:0,他引:5  
目的 探讨经静脉溶栓治疗脑梗塞的价值和给药方法。方法 光化学大鼠大脑中动脉( M C A)血栓形成后 1h,治疗组 15 只静脉注射尿激酶( U K),血栓形成后 24h 行神经功能评分,72h M R检查后处死行病理检查。结果 治疗组 86.67% 的血栓在 1~3h 内溶开,对照组均无溶开。治疗组的神经功能比对照组好,梗塞灶体积小。结论 大鼠 M C A 血栓形成后 1h 经静脉 U K 溶栓可改善神经功能,减少梗塞体积,最小有效剂量为 2.5×104 U/kg,最大剂量 7.5×104 U/kg,不增加颅内出血率。  相似文献   

4.
降纤酶治疗脑梗塞临床分析(附56例临床报告)   总被引:18,自引:1,他引:17  
目的 观察降纤酶治疗脑梗塞的疗效及副作用,方法 选择脑梗塞患者56例,应用降纤酶10u静脉点滴3d并用5%低分子右旋糖酐+复方丹参注射液静脉点滴7-10d的32例脑梗塞患者作对照研究。结果 治疗组疗效明显高于对照组(P〈0.01),发病24h内用药的疗效显著高于24h后用药组(P〈0.01),且不受年龄影响。结论 常规剂量降纤酶治疗脑梗塞能显著改善临床症太,降低致残率。  相似文献   

5.
目的研究小剂量尿激酶(UK)DSA选择性动脉导管溶栓治疗急性脑梗塞的效果。方法选择急性脑梗塞住院病人60例,随机分为动脉导管溶栓组(导管组)和静脉溶栓组(静脉组)各30例,分别动脉导管注射和静脉注射小剂量UK10~20万U,于治疗前及治疗后15天行临床神经功能缺损程度评分及脑CT检查作出疗效评价。结果导管组临床有效率93.33%,影像学有效率80%,静脉组临床有效率70%。两组有显著性差异(P<0.05)。结论小剂量UK选择性动脉导管溶栓在72小时内治疗急性脑梗塞是一种安全有效的方法  相似文献   

6.
超早期溶栓联合神经保护剂治疗急性脑梗死的临床研究   总被引:11,自引:0,他引:11  
目的:研究尿激酶(UK)溶栓溶栓治疗的疗效、最佳时机、安全性及神经保护剂对溶栓疗效的影响。方法:45例急性脑梗死患者,起病6小时内30例,6~12小时15例,根据起病时间及是否使用神经保护剂分为A、B、C三组,快速静脉商注尿激酶50~80万单位,另设对照组30例,分别对治疗前,后患者神经功能缺损及疗效进行定。结果: 与对照组相比神经功能缺损评分下降显著,A、B组(〈6小时组)P〈0.01,C组)6  相似文献   

7.
大剂量三七总皂甙治疗急性脑梗死的疗效观察   总被引:23,自引:0,他引:23  
目的 观察大剂量三七总皂甙治疗急性脑梗死患者的疗效。方法 对198例急性脑梗死患者随机分为两组;(1)三七总皂甙治疗组103例;(2)对照组95例。比较两组疗效。结果 三七总甙组基本痊愈24例(23.3%),总显效率51.5%,总有效率94.2%,明显高于对照组(7.3%,32.6%,68.3%)(P〈0.01)。三七总甙治疗后血液流变学改善也较对照组非常明显(P〈0.01),且未见明显副作用。结  相似文献   

8.
瑞文测验在脑血管病患者中的应用及意义   总被引:1,自引:0,他引:1  
采用瑞文测验对50例脑血管病患者及50例健康人进行检查。结果表明:1.脑血管病组的瑞文成绩为24.26±12.39,对照组为39.70±12.16,(P<0.01)。2.脑血管病组老年人平均瑞文成绩为24.41±11.11,非老年人为42.85±12.71,(P<0.05);对照组老年人平均成绩为37.60±11.51,非老年人42.85±12.71(P>0.05)。3.脑血管病患者中瑞文测定符合智力缺陷者22例(44%),而MMSE检查符合痴呆者仅5例(10%)。本文对上述结果进行讨论。  相似文献   

9.
为探讨精神分裂症的发病机理,应用抗人T淋巴细胞单克隆抗体OKT系统,间接葡萄球菌A蛋白花环法,检测47例精神分裂症外周血T淋巴细胞亚群;应用姬姆萨染色法,检测87例精神分裂症外周血涂片异常淋巴细胞;并与26名正常人对比。结果显示,精神分裂症患者的OKT+3(P<0.01)、OKT+4(P<0.05)、OKT+4/OKT+8(P<0.01)均较正常人显著减少,异常淋巴细胞显著增多(P<0.01)。57例服用与30例未服用抗精神病药物的患者的异常淋巴细胞差异无显著性(P>0.05)。提示精神分裂症确有免疫功能异常,异常淋巴细胞的改变与应用抗精神病药无明显相关。  相似文献   

10.
大剂量东菱克栓酶(DF—521)抗栓治疗急性脑梗塞临床观察   总被引:10,自引:0,他引:10  
目的探讨东菱克栓酶(DF-521)大剂量与常规剂量溶栓疗效的差别。方法选择发病12小时之内的急性脑梗塞患者12例,应用DF-521溶栓,首剂20BU,第2、3日各用10BU静滴为治疗组,以病人年龄、病情、发病时间相似,及用此药常规推荐剂量(首剂10BU、隔日5BU,共3次)的12例患者作1:1配对研究。结果治疗组疗效明显高于对照组(P<0.01).结论大剂量DF-521治疗急性脑梗塞疗效显著,且能缩小梗塞灶体积,用药过程中未见出血等明显副作用  相似文献   

11.
Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.  相似文献   

12.
Hepatic Considerations in the Use of Antiepileptic Drugs   总被引:5,自引:4,他引:1  
Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.  相似文献   

13.
Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.  相似文献   

14.
Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.  相似文献   

15.
Carbamazepine Efficacy and Utilization in Children   总被引:4,自引:3,他引:1  
W. Edwin Dodson 《Epilepsia》1987,28(S3):S17-S24
Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects.  相似文献   

16.
S. FELDMAN 《Epilepsia》1971,12(3):249-262
  相似文献   

17.
Neonatal Seizures: Problems in Diagnosis and Classification   总被引:6,自引:5,他引:1  
Eli M. Mizrahi 《Epilepsia》1987,28(S1):S46-S54
Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.  相似文献   

18.
Valproate Monotherapy in the Management of Generalized and Partial Seizures   总被引:4,自引:2,他引:2  
David W. Chadwick 《Epilepsia》1987,28(S2):S12-S17
Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.  相似文献   

19.
In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.  相似文献   

20.
Special Pharmacokinetic Considerations in Children   总被引:4,自引:2,他引:2  
W. Edwin Dodson 《Epilepsia》1987,28(S1):S56-S69
Summary: Pediatric patients have greater degrees of pharmacokinetic variability and unpredictability than adults. This variability results from the effects of pharmacogenetics, age and growth, prior and current comedication, and disease. Newborns with seizures have the least predictable dosage requirements, and their needs change as drug-eliminating mechanisms mature in the neonatal period. Infants have the highest relative capacities to eliminate antiepileptics of any age group and require the largest relative doses. In addition to age-related trends, children demonstrate the same drug-specific, pharmacokinetic phenomena that adults do, including nonlinear phenytoin elimination, nonlinear valproate binding, and autoinduction of carbamazepine. Intercurrent illness and drug interactions further modify the age-related pharmacokinetic patterns in children and make dosage requirements even more unpredictable. Recent studies have shown that febrile illness can affect drug elimination, sometimes decreasing drug levels by 50% or more. Intermittent treatment with benzodiazepines administered either orally or rectally can be an important adjunct and help minimize this type of problem for children with marginally controlled epilepsy. Intermittent benzodiazepines are also helpful for children who have febrile seizures and who need only occasional antiepileptic protection.  相似文献   

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