银杏内酯对大鼠局灶脑缺血再灌注后神经功能缺失评分、脑梗死体积及皮质神经元凋亡的影响

目的:观察银杏内酯对大鼠局灶脑缺血再灌注后神经功能缺失评分、脑梗死体积、皮质神经元凋亡的影响及其银杏内酯的脑保护作用。方法:实验于2004-01/09在福建医科大学解剖学研究所完成。将月龄3个月雄性SD大鼠96只随机分为实验组和对照组,采用改良线栓法制作大脑中动脉闭塞局灶缺血模型。实验组在缺血即刻腹腔注射银杏内酯20mg/kg,对照组腹腔注射等量的生理盐水。两组又随机分为再灌注6,24和48h组,每组16只,运用Zea-Longa法进行神经功能缺失评分。在再灌注6,24,48h时间点每组随机取8只采用2,3,5-三苯四氮唑染色法观察梗死灶范围,并计算梗死灶体积占半球体积的百分率。另每组8只大鼠应用原位细胞凋亡检测法计数神经元凋亡数目。结果:实验过程中有4只大鼠因未出现神经功能缺损体征予以剔除,补充4只造模成功大鼠,进入结果分析大鼠保持为96只。①再灌注6,24h实验组神经功能缺损评分明显低于对照组(1.69±0.6,1.25±0.45,2.56±0.51,2.06±0.77,U=37,41,P<0.001),再灌注48h实验组评分与对照组基本一致(0.62±0.50,0.69±0.48,U=120,P=0.714)。②再灌注6,24,48h实验组脑梗死体积占半球体积的百分率明显低于对照组犤(12.27±0.55)%,(15.28±0.45)%,(16.30±0.36)%,(19.06±0.80)%,(24.19±0.57)%,(29.27±1.09)%     

幕上型分水岭脑梗死71例临床分析

分水岭脑梗死(WI)是两支主要脑动脉分布区边缘带发生的脑梗死,也称边缘带梗死,是缺血性脑梗死的一种特殊类型,发生率占脑梗死的10％左右.其主要发病机制是低灌注或合并栓子清除障碍,WI以幕上型最多见,主要分三型.一是前WI,梗死病灶发生于大脑前动脉与大脑中动脉皮质分支的边缘带;二是后WI,梗死病灶位于大脑中动脉与大脑后动脉的皮质支的边缘带;三是皮质下WI,梗死病灶位于大脑中动脉皮质与深穿支的边缘带[1].本文收集经影像诊断的幕上型WI病例,对其病因、发病机制、分型、神经功能缺损及预后等进行分析.     

脑电图呈现三相波与临床预后13例分析

目的：探索三相波的脑电图（EEG）与其患者临床预后的可能关系.方法：回顾性分析EEG出现三相波的13例患者的EEG特点,病因以及预后情况.结果：出现三相波的患者均存在不同程度的意识障碍;三相波分布以额区最多;病因上以各种因素导致的代谢性脑病最常见;患者病情的进展或好转,EEG可出现相应改变并且与基础疾病可恢复程度有关.结论：三相波预示患者脑部严重的病变.其病因较多,而患者的预后主要取决于导致三相波的基础疾病的可治愈程度,而不是三相波自身波形.     

全面性发作癫(癎)患者记忆功能与海马质子磁共振波谱改变的相关性分析

Objective To investigate the features of the memory function disturbance in patients of generalized seizures and the correlation between the memory function and proton magnetic resonance spectroscopy(1H-MRS).Methods The clinical memory scale of 45 general seizures and 20 normal age and sex-matched controls wss measured and a1 H-MRs was performed in the bilateral hippoeampal.The levels of NAA.Cho.Cr and the ratios of NAA/Cr+Cho were compared between these two groups.Meanwhile,tHe correlation coefficients was calculated and the results of clinical memory scale scoreB and the level of NAA,Cho.Cr and the ratios of NAA/Cr+Cho in groups were compared.Results As compared with the controls.the scores of pointing memory(17.19±5.86),associational learning(20.00±6.77),image free memory(18.44±6.62),association memory of portrait(13.19±6.62)and memory quotient (MQ,79.07±20.20)excepts insignificant figure recognition wcrc significandy decreased in patients of seizures(t=4.794-10.224,all P<0.01);The scores of scale and MQ of both the group of patients who wok antiepileptic drugs(AEDs)and the group of patients whose frequency exceeded 3 per month were significantly lower than the group who didn't take AEDs and the group whose frequency was lower than 3 per month(t=3.267-6.537,all P<0.01).The volumes of hippocampal formations(2.45 ±0.25 on left and 2.56 ±0.31 on right),the level of NAA(12.93 ±1.73 on left and 11.88 ±1.69 on right),Cho(15.02 ±0.86 on left and 14.94 ±0.96 on right),Cr(11.86 ±0.71 on left and 10.71 ±0.42 on right)and the ratios of NAA/Cr+Cho(0.48 ±0.08 on left and 0.39 ±0.07 on riht)in the group of pailents of generalized seizures were significantly difference than those in the controls(t=4.103-5.768,all P<0.01).Patients with seizures showed significant correlation between tlle scores of all items.MQ in clinical memory scale and NAA,NAA/Cr+Cho ratio(r=0.489-0.727,all P<0.01),and inverse correlation between the scores and MQ and Cho of in the bilateral hippocampal(r=-0.604-0.484,all P<0.01).However,there was no correlation between the scores and MQ and Cr of in the bilateral hippocampal.Condusions The patients of the general seizures do have the problem of the disturbance of short-term memory including acoustic memory and some visual memory.Both the high frequency of seizure and AEDs could affect the short-term memory function.The correlation between the scores of all the items and MQ in clinical memory scale proved that lack of nerve cell and hyperplasia of gliocyte was one of the reasons of the short-term memory disorder in epileptic.     

橄榄脑桥小脑萎缩20例的神经电生理检查

目的:探讨橄榄脑桥小脑萎缩(OPCA)患者各项神经电生理检查结果的特点并比较其对OPCA诊断的敏感性.方法:对20例OPCA患者进行多种电生理检查,并结合其临床表现分析电生理变化.结果:各项神经电生理检查中,除了脑干听觉诱发电位(BAEP)结果与患者的年龄、病程以及病情严重程度有关外,其他如体感诱发电位(SEP)和瞬目反射(BR)均与之无关,且这两项检查的异常检出率均低于BAEP(P<0.05).结论:OPCA患者可表现为中枢神经系统广泛损害,而BAEP的敏感性较其他检查的敏感性高也提示OPCA患者在脑干听觉通路中枢段出现功能障碍较其他结构出现障碍的几率大.     

SB-271046对匹罗卡品致痫大鼠空间学习记忆的影响

目的观察5-羟色胺6受体拮抗剂SB-271046对匹罗卡品致痫大鼠空间学习记忆的作用效应。方法成年雄性SD大鼠分为两组:空白对照组(Vehicle组,n=10),氯化锂-匹罗卡品组(Lithium chloride-Pilocarpine,LiCl-PILO组,n=40)。首先根据注射LiCl-PILO后是否出现癫痫持续状态(Status Epilepticus,SE),出现SE者纳入实验,未出现SE和死亡者则剔除;然后再随机分为3组:模型组即侧脑室注射羟丙基-β-环糊精(Hydroxypropyl-β-cyclodextrine,HP-β-CD),4μl;药物组按不同剂量分为2组,即侧脑室注射N-[4-Methoxy-3-(4-methyl-1-piperazinyl)-phenyl]-5-chloro-3-methylbenzo-thiophene-2-yl-sulphonamide monohydrochloride(SB-271047)剂量为10μg,4μl和侧脑室注射SB-271046剂量为20μg,4μl。结果在Y迷宫自主交替行为实验中,模型组自主交替率显著下降(P0.01),药物组显著提高尤其是20μg剂量组(P0.05)。在Y迷宫新奇事物探索实验中,模型组的新臂时间比显著下降(P0.01),药物组有提高趋势(P0.05)。在Morris水迷宫定位航行实验中,模型组平均潜伏期延长显著延长(P0.01),药物组明显缩短尤其是20μg剂量组(P0.05)。在Morris水迷宫空间探索实验中,模型组平均潜伏期延长,穿越平台次数减少,原平台象限停留时间缩短(P0.05),药物组有改善趋势(P0.05)。结论 SB-271046可以改善癫痫大鼠的空间学习记忆,主要作用于记忆获得巩固阶段,20μg剂量作用明显。     

动态脑电图对癫癎的诊断意义

动态脑电图(AEEG)24 h连续监测的应用,提高了癫癎病人脑电检查的阳性率和癎样放电的检出率.我院于1999年8月至2000年5月采用24 h动态脑电图对90例临床诊断癫癎和可疑癫癎的患者进行监测,现将结果报告如下.     

动态脑电图对皮层或脑干病变昏迷病人预后的评估价值

目的 观察动态脑电图对皮层或脑干病变昏迷病人预后的评估价值。方法 收集45例原发皮层病变和22例原发脑干病变昏迷病人。于急性期行动态脑电图检测和Glasgow评分，随访3个月。将动态脑电图结果与病人的预后进行相关分析。结果 两组脑电图异常分级与Glasgow评分均呈负相关；动态脑电图对病人预后评估的敏感性（83．3％）、特异性（100％）和准确率（91．7％）在原发皮层病变组均比脑干病变组高（60．0％。75．0％。75．0％）。结论 急性期动态脑电图检测对原发皮层病变昏迷病人预后的评估有确定的价值，但对原发脑干病变昏迷患者的预后评估价值不确定。     

中风Ⅱ号口服液治疗脑出血恢复期临床观察

对160例脑出血恢复期患者进行随机对照观察,试验组用中风Ⅱ号口服液结合西药治疗,对照组用单纯西药治疗,两组治疗前各方面情况均相似(p>0.05)具有可比性。结果表明:试验组能改善神经功能,减少病死率和致残率,促进颅内血肿吸收,改善风痰阻络、气虚血瘀证证候,各方面的疗效均优于对照组(p<0.01)。