抗精神病药物治疗精神分裂症前后的甲皱微循环观察

用加权积分法观察２６例抗精神病药物治疗精神分裂症前后甲皱微循环的变化，发现精神分裂症患者甲皱微循环异常率为８４％。抗精神病药物治疗后，微循环异常率降到３０％，观察指标均有显著性改变。提示精神分裂症患者存在着交感神经系统过度兴奋，血管舒缩功能障碍，抗精神病药物通过阻断α受体作用，改善其微循环。     

帕金森病交感神经皮肤反应的临床研究

Objective To assess the value of detecting sympathetic skin response (SSR) in the diagnosis of autonomic dysfunction in patients with Parkinson disease (PD). Methods SSR measurement was performed in 47 PD patients and 20 healthy control subjects and the results were compared. The SSR was also comparatively analyzed between patients with and those without autonomic dysfimction. Results Compared with the healthy controls, the PD patients showed significantly lowered mean amplitude (2.56±1.47 vs 1.87±0.26, P<0.05) and prolonged latency (1.42±0.29 vs 1.55± 0.18, P<0.05) of the SSR in the upper limbs, with also lowered mean amplitude (0.76±0.39 vs 0.49±0.21, P<0.05) and prolonged latency (2.04±0.27 vs 2.13±0.16, P<0.05) in the lower limbs. Compared with the PD patients without autonomic dysfunction, those having autonomic dysfunction showed significantly lowered mean amplitude (1.89±0.33 vs 1.75±0.21, P<0.05) and prolonged latency (1.53±0.15 vs 1.56±0.17, P<0.05) of SSR in the upper limbs and lowered mean amplitude (0.51±0.17 vs 0.46±0.20,P<0.05) and prolonged latency (2.08±0.24 vs 2.17±0.18, P<0.05) in the lower limbs. Conclusion The results of SSR measurements are consistent with the clinical manifestations of the PD patients. SSR can be of value in the diagnosis of autonomic nerve dysfunction in PD.     

高频重复经颅磁刺激对帕金森病患者情绪障碍及P300电位的影响

研究背景以往研究显示高频重复经颅磁刺激可以明显改善帕金森病患者运动功能,但帕金森病晚期非运动性症状给患者带来更为严重的影响,因此研究高频重复经颅磁刺激治疗帕金森病患者情绪和认知功能障碍等非运动性症状的临床疗效具有重要意义。方法共纳入65例诊断明确的帕金森病患者,根据统一帕金森病评价量表(UPDRS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)和P300波,评价高频重复经颅磁刺激对患者精神行为和情绪、日常生活活动能力及运动功能的改善作用。结果与治疗前相比,帕金森病患者UPDRS总评分(t=10.872,P=0.000)和UPDRSⅠ(t=4.538,P=0.023)、UPDRSⅡ(t=8.846,P=0.012)、UPDRSⅢ(t=9.114,P=0.000)评分降低。患者焦虑和抑郁发生率由治疗前的52.46%(32/61)降至29.51%(18/61),认知功能障碍发生率由治疗前的42.62%(26/61)降至32.79%(20/61),HAMA(t=3.692,P=0.000)和HAMD(t=4.241,P=0.000)评分显著降低,但幻觉发生率由治疗前的18.03%(11/61)升至29.51%(18/61)。P300波潜伏期(t=5.924,P=0.000)和波幅(t=8.512,P=0.000)与治疗前比较,差异均有统计学意义。结论高频重复经颅磁刺激能够减轻帕金森病患者焦虑和抑郁状态,改善其认知功能。     

甲硫达嗪致粒细胞缺乏1例报告

甲硫达嗪致粒细胞缺乏１例报告解放军常州１０２医院神经科（２１３００３）于苏文，赵汉清甲硫达嗪（Ｔｈｉｏｒｉｄａｚｉｎｅ）为酚噻嗪类抗精神病药物，目前已广泛应用于临床。本文报道１例口服甲硫达嗪治疗一氧化碳中毒后的精神障碍患者，导致粒细胞缺乏，现报告如下...     

脊髓损伤后胶原代谢产物排泄量预报相关的骨、皮肤并发症

脊髓损伤(SCT)后,病人很快出现胶原合成增加,但胶原分解增加更甚.骨质中胶原的丢失,伴有钙的缺失,与尿路结石、骨质疏松和异位骨化的病因有关。皮肤胶原蛋白的缺失,导致易于发生皮肤溃疡。为了研究胶原蛋白分解与SCI 中相关的骨、皮肤并发症发病率之间的关系、测定尿中二种胶原蛋白代谢产物的浓度,记录相关骨、皮肤并发症的发     

帕金森病患者治疗前后运动诱发电位的临床研究

目的：观察帕金森病（PD）患者经重复经颅磁刺激（rTMS）和恩他卡朋添加治疗前后运动诱发电位（MEP）的改变。方法：用rTMS及恩他卡朋添加治疗PD患者,记录治疗前后患者UPDRS评分,并行运动诱发电位检查。结果：经rTMS及恩他卡朋添加治疗后,PD患者UPDRS评分较治疗前明显改善（P〈0．05）,其RMT明显增高,CL、CSP明显延长,差异有统计学意义（P〈0．05）。结论：MEP有助于PD的诊断、治疗及疗效观察。     

经眼上静脉途径栓塞海绵窦区硬脑膜动静脉瘘

目的 探讨经眼上静脉途径栓塞治疗海绵窦区硬脑膜动静脉瘘的临床效果. 方法 对27例海绵窦区硬脑膜动静脉瘘患者行经眼上静脉途径栓塞治疗,通过脑血管造影及临床随访来评价临床疗效. 结果 术后即刻造影示瘘口完全闭塞15例,瘘口处血流速度明显减慢12例.11例患者术后眼球水肿一过性加重.随访3月～4年,临床症状消失17例,症状明显缓解10例. 结论 经眼上静脉途径栓塞治疗海绵窦区硬脑膜动静脉瘘对部分患者是一种有效的治疗方法 .     

帕金森病交感神经皮肤反应的临床研究

Objective To assess the value of detecting sympathetic skin response (SSR) in the diagnosis of autonomic dysfunction in patients with Parkinson disease (PD). Methods SSR measurement was performed in 47 PD patients and 20 healthy control subjects and the results were compared. The SSR was also comparatively analyzed between patients with and those without autonomic dysfimction. Results Compared with the healthy controls, the PD patients showed significantly lowered mean amplitude (2.56±1.47 vs 1.87±0.26, P<0.05) and prolonged latency (1.42±0.29 vs 1.55± 0.18, P<0.05) of the SSR in the upper limbs, with also lowered mean amplitude (0.76±0.39 vs 0.49±0.21, P<0.05) and prolonged latency (2.04±0.27 vs 2.13±0.16, P<0.05) in the lower limbs. Compared with the PD patients without autonomic dysfunction, those having autonomic dysfunction showed significantly lowered mean amplitude (1.89±0.33 vs 1.75±0.21, P<0.05) and prolonged latency (1.53±0.15 vs 1.56±0.17, P<0.05) of SSR in the upper limbs and lowered mean amplitude (0.51±0.17 vs 0.46±0.20,P<0.05) and prolonged latency (2.08±0.24 vs 2.17±0.18, P<0.05) in the lower limbs. Conclusion The results of SSR measurements are consistent with the clinical manifestations of the PD patients. SSR can be of value in the diagnosis of autonomic nerve dysfunction in PD.     

精神分裂症患者血浆精氨酸加压素含量的变化

应用放射免疫分析法测定了３７例精神分裂症患者血浆精氨酸加压素（ＡＶＰ）的含量，并对１５例患者的含量进行动态观察。结果表明：精神分裂症患者血浆ＡＶＰ水平明显低于正常对照组，随着症状的好转，ＡＶＰ含量逐渐升高，接近于正常对照组。结果提示，ＡＶＰ可能参与了精神分裂症的发病机制。