多发性硬化患者磁共振弥散张量成像与智能、记忆障碍研究进展

多发性硬化（multiplesclerosis，MS）是一种中枢神经系统炎性脱髓鞘性疾病，以多灶性血管周围炎性细胞浸润、脱髓鞘为特征。研究表明，MS患者存在智能、记忆障碍较常见，其发生率为40％-65％左右，因此充分认识MS的智能、记忆障碍，对该病的病理生理机制以及诊断和治疗有重要意义。传统MRI由于分辨力的限制以及对不同病理改变的区分能力较差，     

52例多发性硬化眼症状研究

本文52例多发性硬化(MS)中以眼部症状为首发症状的占59.6%,其单纯视力障碍起病者占46.1%,且以单眼视力障碍起病多见。其它包括复视、眼球震颤、单眼外展麻痹和核间性眼肌麻痹。眼科视力检查和眼底检查可提高视神经受累检查阳性率。17例接受视觉诱发电位(VEP)检查,异常率88.2%,其中6例既往无视神经受累表现。VEP双侧异常80%。异常改变主要为各波潜伏期延长,单纯P_(100)延长、一侧波型不规则不易测量、波幅降低及一侧不出波。     

高压氧治疗多发性硬化34例临床研究

目的探讨高压氧（HBO）对多发性硬化（MS）患者的临床疗效及作用机理。方法将62例MS患者随机分为HBO组34例和对照组28例,比较治疗前后有效率及影像学变化。结果 HBO组有效率、影像学及诱发电位好转率优于对照组（P〈0.05）。结论 MS患者HBO治疗时间越早、疗程越长越好,HBO是治疗MS的有效方法之一。     

80例多发性硬化病人临床特点分析

目的分析山西地区多发性硬化(MS)病例的临床特点,以提高对其的认识和诊断。方法回顾性分析80例住院病人的临床表现、影像特点及电生理改变。结果MS病人中女性多于男性;首次发病平均年龄为31.79岁;病人的职业以农民居多,其次是工人;大多数病人以亚急性起病,首次发病症状以感觉障碍最多见,其次是眼部症状;病程发展过程中出现的症状体征几乎囊括所有神经系统,但以运动感觉系统最多,其次是视觉系统。磁共振成像(MRI)检查脑部以侧脑室周围及半卵圆中心病灶最多见,脊髓则以颈髓多见。诱发电位以SEP异常多见,其次是VEP异常。结论多发性硬化可出现各种神经系统症状及体征,利用MRI和诱发电位检查能发现亚临床病灶,提高诊断率。     

多发性硬化的电生理检查

多发性硬化 (MS)的电生理检查 ,主要有诱发电位 (EP)、脑电图 (EEG)、肌电图 (EMG)。其中最有价值的当属 EP,仅在伴有周围神经病变时才有 EMG异常。在此重点讨论 EP的印变化。1　EPEP是一项辅助性电生理检查 ,无特异性 ,不能据此诊断某种疾病。但是通过 EP这种生物电活动 ,我们可以了解患者中枢神经的功能状态 ,发现尚无临床症状体征或尚未形成影像学改变的临床下中枢病变。因此 ,EP有利于 MS的早期诊断。EP检查需要精良的设备 ,严格的检测技术。主要检测各波潜伏期、波形、波幅、两侧潜伏期差和波幅差等。每个实验室应有自己的…     

视觉诱发电位对多发性硬化的早期诊断价值

多发性硬化(mu ltip le selrosis MS)是常见的中枢神经系统脱髓鞘疾病,临床症状表现为空间和时间上的多发性。本文通过视觉诱发电位(visual evoked poteutial VEP)检测处于静息状态的视觉系统的病变,以求寻找提高MS诊断准确而敏感的方法,从而更好地防治MS。1材料与方法1·1一般     

多发性硬化患者血清尿酸水平

<正>多发性硬化(MS)是一种免疫介导的中枢神经系统脱髓鞘疾病,病变晚期轴索亦可受到破坏,其病因和发病机制尚不十分明确,复发率及致残率高。尿酸(UA)是嘌呤核苷酸代谢的终产物,是内源性的抗氧化剂和过氧化亚硝酸阴离子的天然清除剂。临床研究证实MS患者血清UA水平较低,同时给予UA治疗可抑制其病情发展〔1〕。本文探讨血清UA水平在MS发病中的作用机制。1资料与方法1.1一般资料1 MS组:根据Poster的MS诊断标准,选取     

头颅磁共振成像和诱发电位对多发性硬化的诊断价值

目的　比较头颅磁共振成像 (MRI)与诱发电位 (EP)在多发性硬化诊断中的应用价值。方法　对 12例多发性硬化患者分别检查VEP、正中神经SEP、及BAEP ,并与头颅MRI检查结果进行比较。结果　头颅MRI检查的异常率为 83 .3 % ,VEP、SEP、BAEP的异常率分别为 83 .3 %、75 %、5 6.7% ,而三项EP总的异常率为 10 0 %。结论　多项诱发电位同时检测能显著提高诱发电位的异常率 ,而头颅MRI和诱发电位联合检测将大大提高多发性硬化诊断的阳性率     

一种治疗多发性硬化药物可加剧记忆消退

记忆消退,顾名思义是指过去回忆的渐渐消失。上的一项研究称,小鼠的记忆消退可在一种目前用于治疗多发性硬化的缓解复发的药物的作用下得到加强。这项发现意味着一旦从人体实验上得出相同的结果 ,那么这种药物可用来治疗创伤后应激障碍和其他焦虑症。     

多发性硬化患者血清尿酸变化及其临床意义

多发性硬化(MS)是一种中枢神经系统的脱髓鞘病变,病变可累及大脑半球、视神经、脊髓、脑干和小脑,临床表现多变,病程常呈复发一缓解交替。一旦出现临床症状及体征时常示症灶已较大或进展。MRI虽可较准确地判断病灶的部位、数量、大小、形态甚至还可通过动态观察病变的演变过程,可以配合临床监测疗效,对预后作出初步评估[1]。但检查经费较大,部分病人还有禁忌症不能普遍应用。为此,作者试图寻求一种简便、经济的方法以间接了解MS患者病情进展情况及进行及时治疗。1资料与方法1·1临床资料:收集我院神经内科2001年1月至2006年1月住院MS患…     

系统性硬化症患者肾脏临床病理学研究

目的：了解系统性硬化症病人肾脏病理改变。方法：首次对５例ＳＳＣ患者进行了肾脏活检和尸检标本的组织学观察。结果：发现４例标本显示有不同程度的小叶间动脉和弓动脉，入球小动脉的受累，其中２例临床无肾脏受累表现，此４例患者病程相近。值得一提的是工达２２年的老年患者其肾脏病理主要为慢性肾小球肾炎。     

CONNECTIVE TISSUE DISEASE MIMICKING MULTIPLE SCLEROSIS

Abstract Systemic lupus erythematosus, primary Sjögren's syndrome and systemic sclerosis may be associated with acute transverse myelitis and chronic relapsing neurological syndromes mimicking multiple sclerosis in the same individuals and/or their relatives. We now present three cases which suggest that there is a wide spectrum of connective tissue disorders mimicking multiple sclerosis and acute disseminated encephalomyelitis. These cases demonstrate that the diagnosis of multiple sclerosis should be kept under constant review by searching for the development of connective tissue disorders in the patients or their relatives.     

A PAROXYSMAL OCULAR MOTILITY DISORDER IN MULTIPLE SCLEROSIS

A 24-year-old woman with multiple sclerosis had frequent episodes of an ocular motility disorder and a crossed corticospinal tract deficit. This symptom complex illustrates a distinctive form of paroxysmal disorder in multiple sclerosis.     

调心、补肾法对中老年记忆功能减退的影响比较

目的研究并比较调心、补肾法对中老年轻度认知损害(MCI)患者记忆功能减退的影响。方法将84例MCI患者采用配对方法随机分为四组,分别用安慰剂、双益平、调心方、补肾方治疗2月,观察治疗前后各组患者MQ值及WMS分因子量表值。结果双益平、调心方、补肾方三组均能提高MCI患者的MQ值(P<0.05、P<0.01、P<0.05);调心方组治疗后以1→100、100→1、累加三项MQ值增加趋势明显,其中100→1测验MQ增值与安慰剂组比较有显著性意义(P<0.05);补肾方组治疗后以再生、触摸两项MQ值增加趋势明显,其中触摸测验MQ增值与安慰剂组比较有极显著性意义(P<0.01)。结论调心、补肾法均能有效改善中老年记忆功能的减退;调心方对WMS中与“所以任物者谓之心”有关心智测验有改善作用,而补肾方对WMS中与“肾者……技巧出焉”有关的操作测验有改善作用。     

INCIDENCE AND OUTCOME OF MULTIPLE MYELOMA IN WESTERN AUSTRALIA, 1960 TO 1984

All patients diagnosed with multiple myeloma in Western Australia have been registered since 1960; 337 men and 280 women were registered in the period 1960–84. During this period there was a 25% increase in incidence. Age adjusted incidence rates rose from 2.34 per 100 000 person years in men and 1.64 in women during the decade 1960–69 to 2.95 in men and 1.92 in women in 1980–84. Overall, the incidence was 1.36 times higher in men than in women (95% confidence interval 1.16–1.59). Survival from multiple myeloma improved substantially during the period. In 1960–69, median survival for both sexes was six months, in 1970–79 it was 19 months, and in 1980–84 median survival in men was 43 months while in women it was at least five years.     

ORGAN MANIFESTATIONS IN 100 PATIENTS WITH PROGRESSIVE SYSTEMIC SCLEROSIS: A COMPARISON BETWEEN THE CREST SYNDROME AND DIFFUSE SCLERODERMA

Internal organ function, biochemical, and immunological variableswere assessed in 100 patients with progressive systemic sclerosis(PSS), 37 with diffuse scleroderma and 63 with the CREST syndrome.The frequency of oesophageal symptoms and dysmotility did notdiffer between the two subsets, but patients with diffuse sclerodermahad more pronounced motility disturbances. Calcinosis, Raynaud'sphenomenon, and telangiectasia were equally frequent in thetwo groups. Vital capacity, total lung capacity, and staticlung compliance were lower among patients with diffuse scleroderma(p<0.001), who also had a higher frequency of lung fibrosis(p<0.001) and cardiomegaly (p<0.01). Sixty eight per centof the patients with diffuse scleroderma and 62% of those withthe CREST syndrome had a positive antinuclear antibody test,which was associated with oesophageal hypomotility (p<0.001),fat malabsorption (p<0.01) and pulmonary dysfunction (p<0.05).Thus, the severity of organ manifestations varied not only withthe form of PSS, but also with the absend/presence of antinuclearantibody. This study shows that the term ‘CREST syndrome’could be replaced by ‘limited cutaneous systemic sclerosis’. KEY WORDS: Scleroderma, CREST syndrome, Limited cutaneous systemic sclerosis, Diffuse scleroderma, Oesophageal motility, Malabsorption, Respiratory function, Antinuclear antibody     

高血压病患者心肌灌注断层显像的相关因素研究

目的探讨高血压病患者心肌灌注断层显像的结果和多种临床因素的关系.方法将97例高血压病患者的心肌灌注断层显像结果同患者的年龄、性别、体重指数、患高血压病的时间、有无抗高血压治疗,有无高血压家族史,患者的血清葡萄糖、肌酐、尿素氮、甘油三酯、胆固醇、脉搏、收缩压、舒张压、脉压差、平均动脉压、患者是否吸烟、饮酒进行非条件Logistic回归分析.结果患高血压病的时间(βi=0.4914,P=0.0017)、吸烟(βi=3.5022,P=0.0176)、高胆固醇血症(βi=1.6147,P=0.0194)是高血压病患者并发心肌缺血的危险因素.结论高血压痛患者戒烟、治疗高胆固醇血症,可降低其并发心肌缺血的风险.     

369例急性心肌梗塞患者信号叠加心电图的临床分析

通过对369例急性心肌梗塞患者的临床观察,分析了心室晚电位在心肌梗塞患者和并发室速/室颤(VT/VF)患者中的发生率以及梗塞部位、左心功能与心室晚电位的关系。     

加兰他敏双盲治疗增龄相关记忆障碍及阿尔茨海默病

目的观察加兰他敏对增龄相关记忆障碍(AAMI)及阿尔茨海默病(AD)疗效及副反应。方法双盲法治疗增龄相关记忆障碍(MQ<90,MMSE≥24分)36例及20例阿尔茨海默病,加兰他敏与安慰剂对照组均为每次2片10毫克,每日3次,疗程2个月。以韦氏记忆量表(WMS)、MMSE、及HDS评定疗效。结果①AAMI:11例治疗组与25例对照组治后MQ增值分别为8.00±5.37及1.64±5.51(P<0.01)。治疗组2例恶心呕吐、胃部不适。②AD:加兰他敏与对照组治后MQ增值,治疗组MMSE为2.90±1.85,显著高于对照组0.50±0.97(P<0.01);治疗组HDS为3.19±2.91,显著高于对照组0.50±1.63(P<0.05);治疗组MQ为5.10±7.03,显著高于对照组0.20±4.91(t=1.95,P<0.1)。治疗组胃部不适2例,1例窦性心动过缓。结论加兰他敏对改善AAMI及AD记忆及认知功能有一定疗效且可耐受。     

LACK OF EFFECT OF THE TRH RELATED DIPEPTIDE HISTIDYL-PROLINE DIKETOPIPERAZINE ON TSH AND PRL SECRETION IN NORMAL SUBJECTS, IN PATIENTS WITH MICROPROLACTINOMAS AND IN PRIMARY HYPOTHYROIDISM

We have studied the effects of the TRH related dipeptide histidyl-proline diketopiperazine [cyclo (His-Pro)] on basal and stimulated TSH and PRL secretion in normal volunteers, in patients with microprolactinomas and in patients with primary hypothyroidism. Cyclo (His-Pro), 400 micrograms intravenously did not alter basal TSH or PRL levels in normal males and females and was also without effect upon the elevated basal TSH and PRL levels in patients with primary hypothyroidism and microprolactinomas respectively. The same dose of cyclo (His-Pro) did not affect the TSH or PRL response to TRH (100 micrograms i.v.) in normal male volunteers. These data indicate that cyclo (His-Pro) does not affect TSH and PRL secretion in man at this dosage. It is also unlikely that this molecule will be of any therapeutic benefit in states of hyperprolactinaemia.