强迫症患者的氢质子磁共振波谱分析

目的 探讨强迫症患者多个感兴趣脑区可能存在的神经生化代谢异常,并分析这些异常与病程及疾病严重程度间的关系.方法 应用磁共振氢质子波谱分析(1H magnetic resonance spectroscopy 1H-MRS)技术,对19例强迫症住院患者的双侧前额叶、颞叶、顶叶、枕叶、尾状核头及前扣带回、海马旁回、胼胝体压部和膝部、丘脑进行检测,测定这些脑区的N-乙酰天门冬氨酸(N-acetylaspartate NAA)、胆碱复合物(Choline Cho)的含量与肌酸(Creatine Cr)的比值,并与22例健康对照者比较.采用耶鲁-布朗强迫症状量表(YBOCS)评定患者的症状严重程度.结果 (1)右侧尾状核头、左侧海马旁回NAA/Cr均高于正常对照组(1.23±0.37,1.0±0.33,t=2.14,P=0.039;1.34±0.25,1.10±0.45,t=2.41,P=0.021);胼胝体膝部NAA/Cr低于对照组(0.97±0.30,1.19±0.26,t=-2.47,P=0.018).(2)右侧尾状核、左侧颞叶CHO/Cr值高于健康对照组(1.09±0.51,0.67±0.21,t=3.32,P=0.003;2.58±0.62,0.84±0.17,t=2.21,P=0.03).(3)病程与右侧前额叶NAA/Cr呈负相关(r=-0.507,P=0.027).(4)耶鲁-布朗强迫症状量表总评分与胼胝体膝部NAA/Cr以及左颢叶CHO/Cr呈负相关(r1=-0.457,P=0.049;r2=-0.585,P=0.009).结论 强迫症患者右侧尾状核头和左侧海马旁回的神经元功能增强,胼胝体膝部功能减低,可能在强迫症的发病机制中发挥了重要作用.

Abstract：

Objective To approach potential abnormalities of neuro-chemical compounds in cerebrum of obsessive-compulsive disorder and to analyze the relationship among the abnormalities with duration of illness and symptom severity. Methods 19 patients with obsessive-compulsive disorder and 22 comparison subjects were scanned by 1H magnetic resonance spectroscopy to exam bilateral prefrontal lobe, temporal lobe, parietal lobe, occipital lobe, anterior cingutate and caudate nucleus, hippocampus as well as splenium and genu of corpus callosum,thalamus. The ratios of N-acetylaspartate (NAA) and choline (Cho) to creatine (Cr) were respectively recorded.The severities of obsessive-compulsive symptoms were assessed by Yale-Brown Obsessive-Compulsive Scale. Results ( 1 ) The ratios of NAA/Cr in right caudate nucleus and left hippocampus were higher than those in normal controls (1.23 ±0.37 vs 1.0 ±0.33, t=2.14, P=0.039;1.34 ±0.25 vs 1. 10 ±0.45, t=2.41, P=0.021 ), but NAA/Cr ratios in genu of corpus callosum were lower(0. 97 ±0.30 vs 1.19 ± 0. 26, t = -2.47, P= 0.018 ).(2) The Cho/Cr ratios in right caudate nucleus and left temporal lobe were higher than those in control groups (1.09±0.51 vs0. 67±0.21,t=3.32, P=0.003;2.58±0.62vs0.84±0.17, t=2.21,P=0.03). (3) The duration of illness was negatively correlated with the Cho/Cr ratios of right prefrontal lobe ( r = - 0. 507, P =0. 027 ). (4) The NAA/Cr ratios of genu of corpus callosum as well as the Cho/Cr ratios of left temporal lobe were negatively correlated with YBOCS score ( r 1 = - 0.457, P = 0.049; r 2 = - 0. 585, P = 0.009 ). Conclusion Neuronal functions increase in right caudate nucleus and left hippocampus which are opposite in genu of corpus callosum. These abnormalities may play an important role in pathogenesis of OCD.     

辛芩颗粒治疗上呼吸道感染的疗效观察

辛芩颗粒是由细辛、黄芩、白术、防风等多味中草药提取加工制成的无糖型颗粒剂。具固表、祛风通窍功能 ,可改善鼻腔阻塞 ,解除流涕、喷嚏、鼻痒等症状。主治上呼吸道感染 ,过敏性鼻炎等疾病。现用辛芩颗粒治疗上呼吸道感染6 0例 ,疗效满意。1　临床资料与方法1 1　临床资料　在儿科门诊就诊的上呼吸道感染病例 12 0例。随机分为治疗组及对照组。其中治疗组 6 0例 ,男 3例、女 2 8例、年龄 3岁 18例 ,4～ 5岁 2 0例 ,6～ 12岁 2 2例。临床全部有鼻塞、流涕、喷嚏、咽部充血。同时伴有发烧、咳嗽10例。腹泻者 8例。头痛者 6例。 32例查血常规…     

头孢曲松钠注射液治疗外科术后合并感染患者疗效观察

目的比较头孢曲松钠与头孢噻肟钠对外科ICU重度腹外术后合并感染患者的疗效与不良反应。方法197例住院患者随机分为头孢曲松钠组99例,头孢噻肟钠组98例,比较两组用药后疗效。结果临床有效率及不良反应发生率头孢曲松钠组分别为94.9%,10.7%;头孢噻肟钠组分别为93.8%,16.6%。两者有效率无明显差异(P>0.05)。结论头孢曲松钠与头孢噻肟钠治疗重度腹外术后并发感染患者疗效确切,但不良反应两者有区别(P<0.05)。     

环胞菌素A临床用药监护

环胞菌素Ａ临床用药监护山东省博兴县寨郝中心医院（２５６５１１）赵秀芝，李振国，王世英环胞菌素Ａ（ＣｙｃｌｏｓｐｏｒｉＡ，ＣｙＡ）自１９７８年英国最早经大量动物实验后应用于肾移植并获成功后，被广泛应用于器官移植术后排异反应的防治。近年来用于自身免疫性疾...     

血清淀粉样蛋白A在新生儿坏死性小肠结肠炎中的研究进展北大核心CSCD

坏死性小肠结肠炎(necrotizing enterocolitis,NEC)是新生儿期严重的肠道炎症性疾病,可导致新生儿尤其是早产儿死亡。血清淀粉样蛋白A(serum amyloid A protein,SAA)是一种由肝脏分泌的急性时相反应性蛋白,在机体发生急性时相反应时含量急剧升高,作为促炎因子加速机体的炎症反应,对新生儿NEC的早期识别、诊断与评估具有重要价值。