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目的观察慢性心力衰竭(CHF)患者血清甲状腺激素水平的变化,探讨其临床意义。方法用放射免疫法测定81例CHF患者(按心功能分为心功能Ⅰ级组19例、心功能Ⅱ级组23例、心功能Ⅲ级组20例及心功能Ⅳ组19例)及29例心功能正常体检者(对照组)血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)及反—三碘甲状腺原氨酸(rT3)水平,并进行对照分析。结果各级心功能组间除TSH水平外,其他甲状腺激素水平差异均有统计学意义(P<0.05)。各级心功能组FT3水平与对照组比较差异均有统计学意义(P<0.05),各级心功能组TSH水平与对照组比较差异均无统计学意义(P>0.05),心功能Ⅲ级、Ⅳ级组T3水平与对照组比较差异有统计学意义(P<0.05),心功能Ⅲ级组T4、FT4水平与对照组比较差异有统计学意义(P<0.05),心功能Ⅰ级、Ⅱ级及Ⅲ级组rT3水平与对照组比较差异均有统计学意义(P<0.05)。结论慢性心功能不全患者血清甲状腺激素中T3、FT3、T4随心功能减退而降低;rT3随着心衰程度的加重增高越明显,可作为判断心功能损害程度的指标。 相似文献
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目的 探讨经颅多普勒超声(transcranial Doppler ultrasound,TCD)诊断大脑中动脉(middle cerebral artery,MCA)狭窄的价值.方法 对行数字减影血管造影(digital subtract angiography,DSA)和TCD检查的缺血性脑血管病患者的临床资料进行回顾性分析,以DSA为金标准,分析TCD诊断MCA狭窄的敏感性和特异性.对正常以及不同狭窄程度MCA的TCD血流速度进行比较,计算MCA不同狭窄程度时TCD血流速度的最佳截断值.结果 103例患者DSA证实存在MCA狭窄或闭塞,其中轻度狭窄12例,中度狭窄22例,重度狭窄40例,闭塞39例.与DSA相比,TCD检测中度以上MCA狭窄或闭塞的敏感性为78.8%,特异性为96%,准确度为93%,漏诊率为21.2%,误诊率为4%.轻度狭窄组与正常组之间血流速度无显著差异,中度狭窄组与正常组之间血流速度存在显著差异(P<0.001),中度狭窄组与重度狭窄组之间血流速度无显著差异.判定中度狭窄的最佳收缩期峰值血流速度截断值为163.5 cm/s,平均血流速度的最佳截断值为108.5 cm/s.结论 TCD在诊断MCA狭窄或闭塞方面具有一定的优势,可作为DSA检查之前的一种安全而廉价的筛选手段.Abstract: Objective To explore the value of the diagnosis of middle cerebral artery (MCA) stenosis with transcranial Doppler ultrasound (TCD). Methods The clinical data in patients with ischemic cerebrovascular disease examined with digital subtract angiography (DSA)and TCD were analyzed retrospectively. DSA was used as a gold standard to analyze the sensitivity and specificity of the diagnosis of MCA stenosis with TCD. The normal and TCD blood flow velocity with different degrees of stenosis were compared. The best cut-off point of the TCD blood flow velocity of MCA at different degree of stenosis was calculated. Results DSA confirmed that 103 patients had MCA stenosis or occlusion, in which 12 were mild stenosis, 22 were moderate stenosis, 40 were severe stenosis, and 39 were occlusion. Compared to DSA, the sensitivity of TCD in detection of moderate and severe MCA stenosis or occlusion was 78. 8%, the specificity was 96. 0%, and the accuracy was 93. 0%, the missed diagnosis rate was 21. 2%, and the misdiagnosis rate was 4. 0%. As to the blood flow velocity, there was no significant difference between the mild stenosis and normal groups; while there was significant difference between the moderate stenosis and normal groups (P <0. 001). In addition, there was no significant difference in blood flow velocity between the moderate stenosis and severe stenosis groups. Determining the cut-off value of the best peak systolic velocity of the moderate stenosis was 163. 5 cm/s, while the best cut-off value of the mean velocity was 108. 5 cm/s. Conclusions TCD has certain advantages in the diagnosis of the MCA stenosis or occlusion, and it can be used as a safe and inexpensive screening means before DSA examination. 相似文献
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以双下肢截瘫为主要表现的布氏杆菌病1例 总被引:1,自引:0,他引:1
1资料患者男,36岁,司机,因头晕、视物成双10个月,伴双下肢无力9个月于2009年4月28日入院。患者于2008年6月无明显诱因出现头晕、视物成双、双耳听力下降,未正规就诊治疗。1个月后出现双下肢无力、行走不稳,在当地医院经药物治疗后 相似文献
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逯英 《中国实用神经疾病杂志》2005,8(4)
1病例资料男,67岁,因“右上肢疼痛6天”入院。患者6d前出现右上肢疼痛、麻木,以右上肢臂内侧为主,为阵发性针刺样疼痛,夜间睡眠时疼痛加剧,以“颈椎病(神经根型)”收入院。入院时神经系统查体:右上肢神经根牵拉试验阳性,余无阳性体征。入院后查血白细胞5·99×109/L,中性粒细胞0·58,淋巴细胞0·34。颈椎正侧位片及双斜位片示:颈椎骨质轻度增生。右上肢神经传导速度检查示:右桡神经感觉传导速度减慢,右尺神经、正中神经感觉传导正常,右尺神经、正中神经、桡神经运动传导正常。入院后主要给予营养神经、扩血管及止痛剂治疗,患者疼痛症状明显… 相似文献
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颅内动脉粥样硬化性狭窄是缺血性卒中的重要病因之一.采用影像学方法诊断颅内动脉狭窄并精确评价狭窄程度,对于指导临床治疗至关重要.文章综述了经颅多普勒、经颅彩色双功超声、血管内超声、血管内镜、磁共振血管造影、CT血管造影和数字减影血管造影在诊断颅内动脉狭窄方面的优缺点、研究进展和临床应用价值,为临床医生选择理想的检查工具提供参考. 相似文献
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颅内动脉粥样硬化性狭窄是缺血性卒中的重要病因之一.采用影像学方法诊断颅内动脉狭窄并精确评价狭窄程度,对于指导临床治疗至关重要.文章综述了经颅多普勒、经颅彩色双功超声、血管内超声、血管内镜、磁共振血管造影、CT血管造影和数字减影血管造影在诊断颅内动脉狭窄方面的优缺点、研究进展和临床应用价值,为临床医生选择理想的检查工具提供参考. 相似文献
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颅内动脉粥样硬化性狭窄是缺血性卒中的重要病因之一.采用影像学方法诊断颅内动脉狭窄并精确评价狭窄程度,对于指导临床治疗至关重要.文章综述了经颅多普勒、经颅彩色双功超声、血管内超声、血管内镜、磁共振血管造影、CT血管造影和数字减影血管造影在诊断颅内动脉狭窄方面的优缺点、研究进展和临床应用价值,为临床医生选择理想的检查工具提供参考. 相似文献
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