联合卒中单元治疗急性脑卒中的近期疗效观察

脑卒中是本世纪导致人类残疾和死亡的主要疾病之一,尽管新的治疗方法及药物不断出现,但是卒中后的高致残率、高死亡率以及患者生活质量极低仍未得到很好的改善。医学研究表明,研究和建立新的管理体系是卒中医疗的根本出路,在众体系中卒中单元概念的提出为完善卒中病人的管理和治疗提供了新的模式,国外报道目前脑血管病治疗中,最有效的方法即为卒中单元。卒中单元是一种全新病房管理模式,     

加强脑卒中健康管理,提升老年健康素养

正2004~2005年完成的全国第3次死因回顾性抽样调查报告显示,脑血管病已跃升至我国疾病死因的首位[1]。急性脑血管病(脑卒中)是单病种致残率最高的疾病,其高发病率、高死亡率和高致残率给社会、家庭和患者带来沉重的负担和巨大的     

老年急性脑出血患者心电图、心肌酶谱、肌钙蛋白-T变化的意义

急性脑血管病发病率高,致残率高,是严重影响老年人生活质量的疾病之一。本文对我院113例老年急性脑出血患者心电图、血清心肌酶谱、肌钙蛋白-T（Tn-T）进行检测,并探讨其变化的临床意义。     

脑卒中后抑郁的临床分析

脑卒中是一种发病率、致残率很高的疾病,它不仅导致患者的生理性残疾,同时造成精神心理上的损害,是当今危害人类健康的主要疾病之一,卒中后抑郁（PSD）是其常见并发症之一,它不仅影响患者的生存质量,并且在很大程度上阻碍了脑卒中患者神经功能和认知功能的康复,增加了脑卒中患者的死亡率,直接影响卒中患者的神经功能康复和生活质量,对PSD患者进行早期诊断和治疗有利于患者躯体功能恢复,改善预后。     

急性脑卒中并存心血管疾病的问题与对策

<正>急性脑卒中(急性脑血管病)是我国人口死亡的第二位原因,尽管近年来脑卒中治疗已有长足的进步,但患者的预后仍不容乐观,较高的死亡率和致残率使全社会都给予脑卒中的治疗与预防以高度关注。由于脑卒中患者普遍并存心血管疾病,尤其是在卒中的急性期,心血管问题的出现使治疗过程复杂化,预后更加凶险,所以,发现和处理脑卒中患者的心血管     

老年脑梗死的神经影像诊断

脑梗死（cerebral infarction）也称缺血性卒中（ischemic stroke），是由于脑血管狭窄、闭塞后脑组织缺血、缺氧，导致神经元和其他神经细胞死亡。脑梗死是老年人最常见的脑血管病，具有发病率高、致残率高、死亡率高的特点，因此，早期诊断、及时治疗对病人预后有非常重要的意义。     

老年人群脑卒中后骨质疏松的机制和治疗

<正>1老年人群脑卒中与骨质疏松现状脑卒中是以脑组织缺血或出血性损伤症状为主要临床表现的一组急性脑血管病,在老年人群中具有发病率高、死亡率高、致残率高、复发率高、社会及家庭经济负担重的特点。脑卒中是60岁以上人群首位致残原因,约70%病人卒中后5年内会发生残疾或死亡~([1])。我国每年新发脑卒中病人约240万,其中约110万人死亡,实际存在脑卒中病人约1100万,很大一部分病人缺少明显有效的康复措施,尤其在老年人     

轻型缺血性卒中rt-PA溶栓后24 h内抗血小板治疗的疗效观察

正脑卒中是由脑血液循环障碍引起的一种脑部疾病,具有发病突然、致死率和致残率相对较高的特点。急性缺血性卒中是脑卒中死亡率最高的一类。阿替普酶是治疗急性脑梗死的一种重要药物,轻型缺血性卒中通常因病情太轻医院不给予溶栓治疗。本研究探讨静脉溶栓后1 h采用抗血小板药物治疗的临床疗效。1资料与方法1.1一般资料选2010年1月至2017年1月本院收治的轻型缺血性卒中患者55例,随机分成观察组和对     

亚低温治疗缺血性脑卒中的机制探讨

<正>脑血管病是威胁人类健康的三大疾病之一,具有高发病率、高致残率、高死亡率的特点,其中缺血性脑卒中占所有脑血管疾病的2/3。缺血性脑卒中目前仍缺乏确切的治疗手段,由于其严格的时间窗限制,仅有不到5%的患者可以     

早期康复对卒中患者神经功能及生活能力影响

卒中以发病率高、致残率高、复发率高、死亡率高和并发症多“四高一多”为特点，成为危害人类三大疾病之一，目前还没有治疗卒中的有效药物。实践证明，急性卒中的早期康复是安全、有效的，但如何结合基层医院的条件，积极探索早期康复组织程序，使卒中患者得到系统的康复治疗是摆在广大基层医院的课题。我院于2003年1月成立卒中小组，旨在探讨卒中有效的康复治疗方法。     

Hypertension in the Elderly

Hypertension as a risk factor for cardiac and cerebrovascular morbidity and mortality poses a major health problem for our increasingly elderly population. Recent trials have shown large reductions in stroke, heart failure, and coronary artery disease when elderly hypertensive patients are treated. These benefits are also seen in elderly patients with isolated systolic hypertension. The elderly patient with hypertension should be investigated and managed in a similar manner to their younger counterpart. Nonpharmacological measures, such as dietary salt and calorie restriction, regular exercise, cessation of smoking, and reduction of excess alcohol intake, should be recommended. If these are insufficient, pharmacological treatment should be tailored to the individual patient. Diuretics have been shown to improve outcome measures in the elderly. Other antihypertensive drugs may be added or substituted depending on the patient's blood pressure response to therapy and their comorbid conditions. If all elderly hypertensive patients were treated, a major reduction in cardiovascular and cerebrovascular mortality and morbidity would result. Consideration also needs to be given to nonpharmacological treatment, particularly salt restriction in older subjects where blood pressure is at the upper limit of normal, as this would also result in a major reduction in cardiovascular morbidity and mortality.     

Comparison of health status between Portuguese and Finnish elderly people

This study compares the living situation, morbidity and mortality and related factors between two different communities, one in eastern Finland (with high mortality in cardiovascular diseases) and another in Lisbon, Portugal (representing the Mediterranean area with low ischaemic heart disease but nigh cerebrovascular mortality). The representative samples of 65–74 year old population were examined using the same study protocol, and official mortality statistics were analyzed from these countries. The results show that elderly Finns have more facilities at home than elderly Portuguese. Self reported diabetes mellitus, stroke and chronic bronchitis as well as obstipation, urinary problems, leg pain and chest pain, and cough in the morning were more prevalent in Portugal but cardiac failure was more common in Finland. Reported hypertension and antihypertensive drug treatment were equally prevalent in both countries, but diastolic blood pressure level was clearly higher in Portugal. Total CVD mortality in this age group is higher in Finland among men but lower among women, stroke mortality is higher but ischaemic heart disease lower among both genders in Portugal.     

缺血性卒中的药物预防治疗研究进展

目前脑血管疾病占我国死因的第一位,卒中是大多数发达国家的第三位死因,也是最常见的致死、长期致残和住院的原因之一。卒中有诸多的危险因素,但高血压、高胆固醇血症、心房颤动是导致卒中的独立危险因素,因而重视并对其进行积极的干预治疗对卒中的原发和继发性预防至关重要。大量的循证医学研究结果证实对具有诸多危险因素的高危病人,予以降压、降脂和抗血小板治疗以及对行为危险因素进行干预可明显降低卒中的发生率和死亡率。     

急性缺血性脑卒中溶栓药物研究进展

急性缺血性脑卒中是我国中老年人群的常见病及多发病,发病率、死亡率、致残率均较高。溶栓治疗被认为是目前最重要的恢复血流措施,近年来研究者对溶栓药物及其临床应用已进行了大量研究,本文就溶栓药物及其临床应用进展作一综述。     

Oxprenolol in the treatment of hypertension in the elderly

Controversy continues to surround the value of drug treatment of hypertension in the elderly. Epidemiologic evidence implicates hypertension as a major risk factor in the precocious development of stroke and coronary heart disease in the elderly subject as clearly as it is implicated in the younger person. The hemodynamic and neuroendocrine profiles of the older patient with essential hypertension are similar to those of younger patients in the stable phase of the disease. However, the arterial ravages induced by many years of sustained hypertension render the circulation of the elderly subject more sensitive to pharmacologic intervention. The benefit-risk ratio of most antihypertensive drugs appears to be inversely related to age. Diuretics reduce the blood pressure at rest but have no influence on the increases in systolic pressure during normal activity; in addition, they carry potentially serious metabolic hazards in the elderly hypertensive patient. Centrally acting drugs likewise lower the blood pressure at rest without influencing the high systolic pressures induced by exercise. They also enhance the tendency to endogenous depression. Adrenergic-neurone blocking drugs and alpha-adrenoceptor antagonists are contraindicated because of the frequency of impaired cardiovascular reflexes in the elderly. The beta-blocking drugs can reduce the risk of coronary and cerebrovascular disease in the older patient with hypertension. They appear to be well tolerated, but because of their impaired metabolic handling in many elderly patients they should probably be used in smaller doses than those prescribed in younger patients. The influence of antihypertensive treatment on cardiovascular morbidity and mortality in the elderly hypertensive patient is not known.     

Diabetes mellitus in the elderly

Diabetes mellitus is one of the most frequent chronic diseases of the elderly population with a high prevalence after the age of 65 years. In this group it is a serious cause of increased mortality and morbidity. More than 90% of patients suffer from type 2 diabetes mellitus. The disease takes frequently for a long time an asymptomatic course and if it persists for long it may lead to microvascular complications and is an important risk factor of cardiovascular and cerebrovascular diseases. The objective of treatment of diabetes in old age is in particular to restrict symptomatic hyperglycaemia, but at the same time we must not forget prevention of hypoglycaemia. It is also important to diagnose and treat diabetic complications. As elderly diabetic patients are usually polymorbid, diabetes mellitus in old age calls for a comprehensive approach not only to the treatment of hyperglycaemia but also of hypertension, dyslipidaemia and other associated diseases.     

Cardiovascular disease in later life in Taiwan

In Taiwan, the percentage of the population 65 years of age or older increased regularly, from 3.08% in 1972 to 8.8% in 2001. Taiwan started the national health insurance system in 1995. The aged population utilized a large share of the medical resources, for example 28.73% of the total national medical expenditures in 2000. Cardiovascular diseases are common causes of mortality in Taiwan. Cerebrovascular diseases, heart diseases and hypertensive diseases, held the second, third and 10th positions, respectively, among the 10 leading causes of mortality in 2002, in Taiwan. The mortality rates of cerebrovascular diseases and heart diseases are decreasing, while that of malignant neoplasms and diabetes mellitus are increasing, as evidenced over the past 2 decades. Cerebral hemorrhage is relatively common in Taiwan. As demonstrated in a series, of the 10 772 hospitalized acute stroke cases, 35.4% were diagnosed as cerebral hemorrhage. Hypertension is highly prevalent in the elderly population in Taiwan, more than 55% for both sexes, as indicated by some epidemiologic studies. There are few studies on the prevalence of heart diseases in the elderly population in Taiwan. One large-scale epidemiologic study demonstrated that the prevalence rates of coronary artery disease (CAD) among the elderly population, were 12.3% for males and 10.2% for females. The biostatistic data indicated that, in Taiwan, the mortality due to CAD was rapidly increasing in the 1970s and 1980s and reached a plateau in the 1990s. It is concluded that cardiovascular diseases are common causes of morbidity and mortality in elderly people in Taiwan. Although mortality due to cerebrovascular diseases and heart diseases have decreased over past decades, the mortality due to coronary artery disease is still at the peak level.     

补体与缺血性脑血管病

缺血性脑血管病的发病率、致残率和病死率都很高。越来越多的研究表明,补体系统在脑缺血再灌注损伤中起着重要作用,而抑制补体能改善卒中的预后。文章就脑内补体的来源、在脑缺血时的作用以及缺血性脑损伤后针对补体进行治疗做了综述。     

老年糖尿病的分层管理及治疗方案的优化

我国人口老龄化趋势严重,老年糖尿病患病率呈逐年上升趋势。由于老年糖尿病患者常合并心脑血管疾病以及认知功能障碍、抑郁、跌倒、营养不良等老年综合征,是心脑血管病变、恶性肿瘤、肾脏损害的高发人群,其患病情况和个体差异很大,因此治疗上存在多样化需求,需对老年糖尿病患者进行综合评估及分层管理,制定个性化的治疗目标及方案,从而更好的控制血糖。     

Benefits of antihypertensive drugs when blood pressure is below 140/90 mmHg

Antihypertensive medications are used to lower blood pressure (BP) but, ultimately, their true value lies in reductions in morbidity and mortality (cardiovascular, cerebrovascular, and renal diseases). Hypertension is defined discreetly (generally 140/90 mmHg) but the actual relationship between BP and adverse cardiac and cerebrovascular outcomes is continuous. Observational studies have demonstrated a powerful log-linear relationship between BP and mortality due to ischemic heart disease (IHD) or stroke over the range of 115/75 to 185/115 mmHg. Clinical trials and meta-analyses have clearly demonstrated benefits of antihypertensive drugs in nonhypertensive individuals: delay or prevention of the onset of hypertension and microalbuminuria and reduced morbidity and mortality from IHD, stroke, and chronic kidney disease. This is not surprising given that various antihypertensive drug classes have multiple potential beneficial effects. A persistent concern is that overtreatment of hypertension may increase risk in individuals with coronary artery disease, but a "J-curve" effect is not consistently found in clinical studies. The use of antihypertensive drugs in at-risk individuals who are below the traditional threshold (140/90 mmHg) is fully justifiable, but the decision requires adequate clinical experience and judgment and a full assessment of risks and benefits.