气体信号分子NO和CRP在脑血管性疾病及血管性痴呆患者血浆中的变化和意义

目的探讨血管性痴呆、脑血管疾病患者血浆中一氧化氮(NO)和C反应蛋白(CRP)水平变化及可能的临床意义。方法 1.收集脑血管疾病患者40例、血管性痴呆患者46例,正常对照50例。全部研究对象均应用简明精神状态量表、日常生活能力量表、Hachinski缺血指数和Hamilton抑郁量表量表进行检测,血管性痴呆患者用全面衰退量表分级。取空腹静脉血2ml,迅速分离血浆并置于-70℃冰箱保存。2.NO和CRP分别以硝酸还原酶法及散射比浊法进行测定。结果 1.NO水平:血管性痴呆组为39.84±17.28μmol/L、脑血管疾病组为42.72±17.19μmol/L,均较对照组的62.92±17.58μmol/L明显降低(P0.01);病例组之间差异无统计学意义(P0.05)。相关分析显示血浆NO水平与血管性痴呆患者痴呆的严重程度没有相关性。2.CRP水平:血管性痴呆组(5.26±3.47mg/L)和脑血管疾病组(3.01±1.78mg/L)较对照组(1.36±1.33mg/L)升高(P0.05),且血管性痴呆组血浆CRP水平明显高于脑血管疾病组(P0.05)。血浆CRP水平与血管性痴呆的严重程度呈正相关。3.各组内NO与CRP的相关分析显示:各组内NO与CRP血浆水平没有明显的相关性。结论 1.气体信号分子NO在血管性痴呆及脑血管疾病患者中水平降低,但与血管性痴呆患者痴呆的严重程度没有相关性;2.血管性痴呆和脑血管疾病患者CRP升高提示炎症可能参与了脑卒中的发病。     

头针结合体针治疗中风后轻度认知障碍34例

血管性轻度认知功能障碍(V-MCI)是介于正常老年人和痴呆之间的一种功能障碍,可进一步发展血管性痴呆.研究表明,我国每年新发卒中病例约250万,发病后1年内有近70％的患者存在认知功能障碍[1];65岁以上人群中痴呆的患病率约为5％,其中血管性痴呆占20％左右.因此寻找有效治疗轻度认知障碍(MCI)的方法尤为重要.本研究旨在评价针灸对MCI的临床疗效.     

盐酸美金刚治疗血管性痴呆临床疗效观察

目的观察盐酸美金刚(易倍申)治疗血管性痴呆的疗效及安全性。方法采用自身对照研究,36例血管性痴呆患者服用美金刚治疗12周,治疗前及治疗后第12周用简易智能精神状态检查量表(MMSE)和日常生活活动能力量表(ADL)评定疗效,并进行安全性评价。结果美金刚治疗12周后MMSE评分较治疗前提高3.6分,ADL评分较治疗前下降7.3分,差异均有统计学意义;3例(8.33%)出现轻度不良反应,均为一过性反应。结论美金刚治疗血管性痴呆有较好的疗效且安全性好。     

头针联合耳穴贴压对老年血管性痴呆患者临床症状及认知行为能力的影响

<正>研究显示〔1〕,血管性痴呆是目前唯一可有效防治的痴呆,患病早期有效治疗能够逆转病情。我国已迈入老龄化社会,血管性痴呆的发病率快速上升。但针对血管性痴呆的治疗目前仍停留在对基础疾病的控制、脑保护剂、康复锻炼等方面,且疗效并不满意。头针、耳穴疗法已在基础研究和临床治疗中广泛应用。本研究探讨头针联合耳穴贴压疗法改善老年血管性痴呆患者临床症状及认知行为能力的效果。1资料与方法1.1一般资料选取2012年7月至2013年7月本院收治的     

IL-1β,IL-2,IL-10在糖耐量减低并血管性痴呆患者发病中的作用

目的探讨白细胞介素(IL)在糖耐量减低(IGT)并发血管性痴呆患者发病中的作用。方法选择血管性痴呆患者100例分成血管性痴呆组和血管痴呆合并IGT组各50例;然后再随机选取健康人50例对照组。检测空腹血糖(FPG)、餐后2 h血糖(2 h PG)和IL-1β、IL-2、血清IL-10水平。结果血管痴呆合并IGT组跟对照组、血管性痴呆组相比,2 h PG明显升高(P0.01);血管性痴呆组、血管痴呆合并IGT组跟对照组相比,血IL-1β水平明显升高(P0.05),血IL-2水平明显升高(P0.05),血清IL-10水平明显升高(P0.05),且血管痴呆合并IGT组明显高于血管性痴呆组的(P0.05)。结论在血管性痴呆合并IGT患者体内,IL水平升高明显,说明血管性痴呆合并IGT患者体内炎症反应增强。     

红灯散瘀汤改善老年血管性痴呆患者智能研究

目的 探讨红灯散瘀汤改善老年血管性痴呆患者智能的临床疗效.方法 将老年血管性痴呆伴有智能损害的106例患者随机分为治疗组(53例)与对照组(53例).治疗组用红灯散瘀汤,对照组用吡拉西坦(脑复康),采用随机双盲给药.按长谷川痴呆量表和简易精神量表统计评分.结果 治疗组总有效率为86.79%,明显优于对照组的64.15%(P<0.05).治疗组在记忆能力的提高和认知功能改善方面均明显优于对照组.结论 红灯散瘀汤改善老年血管性痴呆智能方面优于脑复康.     

血管性痴呆危险因素的研究

目的研究脑梗死后痴呆的危险因素。方法本研究纳入546例脑梗死急性期住院患者,完成随访434例,于住院期间和脑卒中3个月后进行神经心理测试,其中痴呆组118例,非痴呆组316例。运用t检验、χ2检验和logistic回归法分析血管性痴呆的发生率和危险因素。结果本研究中血管性痴呆的发生率为27.2%。单因素分析表明,血管性痴呆组的年龄比非痴呆组高8.5岁,在低教育水平(小学以下)、每日饮酒、脑卒中史等方面的比例显著高于非痴呆组。logistic回归分析表明,年龄、低教育水平、每日饮酒和脑卒中史与血管性痴呆相关。结论血管性痴呆是血管因素和退行性因素共同作用的结果,其中血管因素在血管性痴呆发病机制中起主导作用。年龄、低教育水平、每日饮酒和脑卒中史是血管性痴呆的危险因素。     

针刺加穴注治疗血管性痴呆的临床观察

目的 探讨针刺、穴注、舌针治疗血管性痴呆的疗效.方法经CT检查确诊为脑出血或脑梗塞后引起血管性痴呆患者120例,随机分为两组治疗组80例采用针刺百会,穴注风池,舌针法进行治疗;对照组40例采用常规针刺法进行治疗. 结果治疗组的总有效率(92.5%)明显高于患者对照组(75%),P<0.05;长谷川痴呆量表(HRS-R)分,认知能力(CCSE)、日常活动能力(ADL)的改善非常显著地优于对照组(P<0.01).结论针刺、穴注、舌针治疗血管性痴呆疗效较好,有研究与应用价值.     

丁苯酞对治疗老年血管性痴呆的临床疗效研究

目的分析丁苯酞作用于老年血管性痴呆治疗中的效果。方法选取我院2014年8月~2015年6月收治的老年血管性痴呆患者40例作为研究对象,分为观察组和对照组,各20例;对照组采用尼莫地平治疗,观察组采用丁苯酞治疗。结果两组患者在疗效、生活能力评分以及MMSE(简易精神状态量表)评分上比较,观察组均优于对照组,差异有统计学意义(P0.05)。结论在老年血管性痴呆患者的治疗中,丁苯酞具有较好的效果,方法值得借鉴。     

喹硫平治疗痴呆患者精神行为症状30例

阿尔茨海默病(AD)和血管性痴呆(VD)是老年人常见慢性脑病综合征,呈慢性或进行性过程,80%痴呆患者在病程某个阶段会出现痴呆精神行为症状,严重影响患者和照料者。本研究对比喹硫平和奋乃静治疗痴呆患者精神行为症状的疗效,为其临床应用提供依据。     

Cognitive decline and hypertension

The prevalence and incidence of degenerative and vascular dementia increase exponentially with age. Several studies in recent years have implicated hypertension as a risk factor not only for vascular dementia but also for degenerative dementia such as Alzheimer's disease. This is an important finding because it suggests that the treatment of hypertension could reduce the incidence of dementia. In particular, the results of the Syst-Eur study, showing that a calcium inhibitor, nitrendipine, could reduce not only the incidence of stroke but also that of dementia, should be confirmed.     

Association of plasma homocysteine in elderly persons with atherosclerotic vascular disease and dementia, atherosclerotic vascular disease without dementia, dementia without atherosclerotic vascular disease, and no dementia or atherosclerotic vascular disease

BACKGROUND: Increased plasma homocysteine has been associated with atherosclerotic vascular disease in elderly persons. The Framingham Study found that plasma homocysteine was a risk factor for dementia and Alzheimer's disease. METHODS: We investigated in an academic nursing home the association of plasma homocysteine with atherosclerotic vascular disease plus dementia (group 1), atherosclerotic vascular disease without dementia (group 2), dementia without atherosclerotic vascular disease (group 3), and no dementia or atherosclerotic vascular disease (group 4). RESULTS: The mean plasma homocysteine level was 15.3 +/- 3.0 micromol/L in 50 group 1 patients, 15.1 +/- 2.7 micromol/L in 50 group 2 patients, 14.4 +/- 2.7 micromol/L in 50 group 3 patients, and 10.6 +/- 3.2 micromol/L in 50 group 4 patients (p <.0001 for group 1 vs group 4, for group 2 vs group 4, and for group 3 vs group 4). CONCLUSIONS: The mean plasma homocysteine level was significantly higher in elderly patients with atherosclerotic vascular disease plus dementia, atherosclerotic vascular disease without dementia, and dementia without atherosclerotic vascular disease than in patients with no dementia or atherosclerotic vascular disease.     

胆碱酯酶抑制剂治疗除阿尔茨海默病以外的痴呆

本文综述了胆碱酯酶抑制剂治疗血管性痴呆、脑外伤后痴呆、路易体痴呆、帕金森氏病性痴呆和唐氏综合征的进展现况。     

NEUROIMAGING PREDICTORS OF DEMENTIAIN STROKE PATIENTS

The risk of dementia is increased in stroke patients. Dementia syndromes associated with cerebrovascular diseases were commonly recognized as an immediate consequence of stroke. However, more and more data suggest that degenerative pathology and white matter changes (WMC) may play a role in the development of dementia in stroke patients. The aim of this paper was to review the literature concerning the neuroimaging predictors of dementia in stroke patients. From the literature data, it appears that although vascular lesions alone may lead to dementia, in stroke patients, no clear association between stroke location and size has yet been identified, even if the role of the left hemisphere has been suggested. The influence of silent infarcts remains undetermined while more and more data suggest that global cerebral atrophy and WMC are predictive factors of post-stroke dementia (PSD). The influence of medial temporal lobe atrophy on the risk of PSD has until now never been evaluated.     

Neuroimaging predictors of dementia in stroke patients

The risk of dementia is increased in stroke patients. Dementia syndromes associated with cerebrovascular diseases were commonly recognized as an immediate consequence of stroke. However, more and more data suggest that degenerative pathology and white matter changes (WMC) may play a role in the development of dementia in stroke patients. The aim of this paper was to review the literature concerning the neuroimaging predictors of dementia in stroke patients. From the literature data, it appears that although vascular lesions alone may lead to dementia, in stroke patients, no clear association between stroke location and size has yet been identified, even if the role of the left hemisphere has been suggested. The influence of silent infarcts remains undetermined while more and more data suggest that global cerebral atrophy and WMC are predictive factors of post-stroke dementia (PSD). The influence of medial temporal lobe atrophy on the risk of PSD has until now never been evaluated.     

Incidence of Alzheimer's dementia in homes for the elderly

This study tried to emphasize the significance of statistical data (incidence rate) considering Alzheimer dementia (AD) because variations in incidence and types of dementias do exist in different countries. The data of persons living in two homes (elderly people and psychiatric patients) were overviewed together with the patients admitted to our hospital in 1993. It was discovered that there were 40 Alzheimer dementia cases in our catchment area of 107,000 population which may be increased by private and undiscovered cases to approximately 50 cases. The number of the vascular dementia (VD) proved to be higher (2-3 x) than the AD. Our findings need also explanation considering the different proportions in the incidence rate of Alzheimer and vascular dementia existing between Hungary and other countries. It was concluded that the lower life expectancy, a tendency for vascular diseases and some environmental factors may be responsible for the higher number of VD. However these findings and statements should not decrease our effort in the research work which has to include the study of the etiology, pathogenesis and the possibility of a successful treatment of AD in the future.     

Microbleeds in vascular dementia: Clinical aspects

Microbleeds are small dot-like lesions which can be appreciated on gradient echo, T2*-weighted magnetic resonance images as hypointensities. They are considered as an expression of small vessel disease on MRI, next to lacunes and white matter hyperintensities (WMH). Microbleeds are relatively common in vascular dementia, with reported prevalences between 35% and 85%. In the context of vascular dementia, microbleeds are mainly thought to result from hypertensive vasculopathy, but the frequent co-occurrence of lobar microbleeds suggests that neurodegenerative pathology and/or cerebral amyloid angiopathy is also of importance. The presence of multiple microbleeds in vascular dementia or in patients with vascular cognitive impairment is related to worse performance on cognitive tests, mainly in psychomotor speed and executive functioning. They may have some predictive value in terms of predicting development of (vascular) dementia, mortality and disability. Data on the occurrence of stroke and post-stroke dementia in patients with microbleeds are to date not available. New definitions and diagnostic criteria for vascular dementia and vascular cognitive impairment are needed and should take into account microbleeds.     

Atrial Fibrillation and Cognitive Function: JACC Review Topic of the Week

Numerous vascular risk factors and vascular diseases contribute to cognitive impairment and dementia. Many studies and registries show an association of atrial fibrillation (AF) with cognitive impairment, cognitive decline, and dementia. This is true for vascular dementia and Alzheimer's disease. The assumed multifactorial mechanisms include ischemic stroke, both apparent and silent, cerebral microinfarcts, cerebral hemorrhage, and reduced cerebral blood flow. A number of retrospective observational and prospective studies support that anticoagulation in patients with AF may reduce the risk of cognitive decline and dementia. This holds for both vitamin K antagonists (e.g., warfarin) and direct oral anticoagulants. However, it still remains unproven if anticoagulation reduces cognitive decline and dementia in AF patients based on randomized trials.     

银杏叶制剂治疗血管性痴呆的疗效观察

目的　观察银杏叶制剂治疗血管性痴呆的疗效及安全性。　 方法　将 86例血管性痴呆患者 ,随机分为银杏叶制剂金纳多治疗组与脑复康对照组 ,全部患者在用药前、用药后 3、6月 ,分别测试其智能及社会功能状态 ,采用简明精神状态检查量表 (MMSE)、社会功能活动检查量表 (FAQ)。　 结果 　治疗 3月和 6月后 ,治疗组MMSE评分较对照组差异有显著性 (P <0 0 1) ,FAQ评分于治疗 6月后较对照组差异有显著性 (P <0 0 1)。　 结论　银杏叶制剂能持续改善血管性痴呆患者的认知及社会功能 ,能延缓痴呆的发展 ,安全无明显副作用。     

事件相关电位P300对早期血管性痴呆的诊断价值

目的：探讨事件相关电位P300对早期血管性痴呆的诊断价值。方法选择50例血管性痴呆患者（血管性痴呆组）、49例动脉硬化症无痴呆患者（动脉粥样硬化组）和48名健康人（健康人组）分别进行P300检查,比较三组的检查结果。结果血管性痴呆组P300潜伏期较动脉粥样硬化组、健康人组明显延长,波幅降低,差异有统计学意义（ P＜0.01）。结论事件相关电位P300检测在血管性痴呆早期诊断中具有较高的应用价值。