90后大学生上网过度对睡眠质量的影响

目的 了解大学生的睡眠质量及其与大学生网络过度使用、网络成瘾状况的关系.方法 通过整群随机抽样选取305名大学生为调查对象,采用匹兹堡睡眠质量指数(PSQI)和相关量表评定大学生的睡眠质量及相关关系.结果 大学生睡眠障碍发生率13.4%.大学生网络过度使用、网络成瘾状况与睡眠质量显著相关.结论 大学生睡眠质量问题应引起重视,适当控制上网,采取综合措施改善大学生的睡眠问题,可促进其身心健康.     

阻塞性睡眠呼吸暂停低通气综合征合并夜间多尿患者尿动力学改变情况分析

目的 观察存在夜间多尿的OSAHS患者的尿动力学变化.方法 前瞻性纳入武汉大学人民医院2002年9月至2008年6月存在夜间多尿、并经多导睡眠监测(PSG)诊断的OSAHS患者,共入选患者23例,其中男19例,女4例,年龄46～81岁,中位年龄68岁.记录患者夜晚及持续气道正压(CPAP)压力滴定夜晚的夜尿次数、夜尿量、夜尿渗透压和尿钠浓度,于研究当夜11时和次晨7时留取静脉血测定脑钠肽及心房利钠肽(ANP)水平.同时对每位患者进行尿动力学检查,包括尿流率,充盈期膀胱压,压力-流率及尿道压测定,并在使用CPAP治疗3个月后再次进行尿动力学检查.结果 PSG检查结果显示,本组患者均存在中重度OSAHS,平均睡眠呼吸暂停低通气指数(AHI)为(48±15)次/h.OSAHS患者夜间尿量明显增多,尿钠浓度增加,尿渗透压降低,次晨7时ANP水平升高,CPAP治疗3个月后可恢复正常.患者行CPAP压力滴定当夜排尿次数明显少于PSG监测当夜排尿次数.尿动力学检查显示本组患者尿动力学主要特征是逼尿肌收缩无力、膀胱感觉迟钝、低顺应性膀胱、逼尿肌尿道外括约肌协同失调.CPAP治疗后,逼尿肌收缩力增强,并恢复膀胱顺应性.结论 CPAP可有效减少OSAHS患者的夜间多尿症状,OSAHS患者夜尿量增多、尿渗透压下降及尿钠浓度增高症状可能与ANP升高有关,OSAHS病程可能损害膀胱逼尿肌功能.CPAP治疗可减少ANP分泌,同时改善膀胱逼尿肌收缩力.

Abstract：

Objective To investigate the urodynamic changes in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and nocturnal polyuria. Methods From Sept. 2002 to Jun. 2008, 23 patients with nocturnal polyuria were diagnosed as having OSAHS by polysomnography(PSG). The number and output of nocturia, the osmotic pressure and the excretion of Na + were recorded during both the PSG night and CPAP titrating night. Plasma levels of brain natriuretic peptide (BNP) and atrial natriuretic peptides (ANP) were also measured at IIPM in the 2 nights and 7AM in the next mornings. Urodynamic studies including urine flow, bladder pressure during filling, pressure-flow study during voiding and urethral pressure were carried out in these patients. Urodynamic studies were performed again after treatment with CPAP for 3 months. Results PSG showed that the patients with nocturnal polyuria had moderate to severe OSAHS, in which the apnea-hypopnea index (AHI) being 48 ± 15 events per hour. The number of nocturnal voiding during the PSG night was more than that during the CPAP titrating night. During the PSG night, the output of nocturia, the nocturia excretion of Na+, ANP levels (at 7am in the next morning after PSG night)increased and the osmotic pressure of nocturia decreased. CPAP therapy could reverse these abnormalities.The main characteristics of urodynamics in these patients included weak detrusor contraction, hypoesthesia in filling cystometry, and decreased bladder compliance, and detrusor ex-ternal sphincter dyssynergia. After 3 months of CPAP treatment, both the myotility of the detrnsor of bladder and the bladder compliance improved. Conclusions CPAP therapy can effectively reverse the nocturnal polyuria in OSAHS patients. In OSAHS patients, the features of nocturia, including the changes of output, osmotic pressure and the excretion of Na+ , may be related to the secretion of high-level of ANP. During the course of chronic progressively OSAHS pathophysiology, detrusor function of bladder may be damaged. CPAP therapy could decrease the nocturnal excretion of ANP, and improve the myotility of the detrusor of bladder.     

90后大学生上网过度对睡眠质量的影响

目的了解大学生的睡眠质量及其与大学生网络过度使用、网络成瘾状况的关系。方法通过整群随机抽样选取305名大学生为调查对象,采用匹兹堡睡眠质量指数（PSQI）和相关量表评定大学生的睡眠质量及相关关系。结果大学生睡眠障碍发生率13．4％。大学生网络过度使用、网络成瘾状况与睡眠质量显著相关。结论大学生睡眠质量问题应引起重视,适当控制上网,采取综合措施改善大学生的睡眠问题,可促进其身心健康。     

118例高血压性脑出血的临床分析

目的 掌握高血压合并脑出血患者的临床特点,有效的预防脑出血的发生,提高治愈率,减少病死率.方法 将118例患高血压合并脑出血的患者的临床资料进行临床分析.结果 患病高发年龄40～70岁,平均61岁;死亡67例,占56.77%,病死率与年龄成正比.结论 脑出血是高血压病最常见的并发症之一,并有高致残率和高病死率,避免脑出血的发生主要措施是防治高血压病.     

118例高血压性脑出血的临床分析

目的 掌握高血压合并脑出血患者的临床特点,有效的预防脑出血的发生,提高治愈率,减少病死率.方法 将118例患高血压合并脑出血的患者的临床资料进行临床分析.结果 患病高发年龄40～70岁,平均61岁;死亡67例,占56.77%,病死率与年龄成正比.结论 脑出血是高血压病最常见的并发症之一,并有高致残率和高病死率,避免脑出血的发生主要措施是防治高血压病.     

西米替丁预防重症脑出血并消化道出血的效果观察

西米替丁预防重症脑出血并消化道出血的效果观察涂作胜，汪道存，陈运平重症脑出血患者易并发消化道出血，我们应用西米替丁静脉给药预防消化道出血，收到了一定的效果，现报告如下。临床资料病例选择我们将经头颅ＣＴ确诊的１６０例重症脑出血住院病人随机分成西米替丁组...