SPECT对老年人缺血性脑血管病诊断价值的探讨

本文对21例老年人缺血性脑血管病患者进行SPECT检查,并对SPECT对老年人缺血性脑血管病的诊断价值进行探讨。结果发现SPECT诊断老年人缺血性脑血管病的阳性率为95%,明显高于头颅CT。     

周期性麻痹合并感觉障碍2例报告

周期性麻痹是以发作性横纹肌弛缓性瘫痪为特点的一种肌病。常见为低钾型,发作时伴有血清钾浓度改变和心电图异常。未见文献报道合并客观感觉障碍。最近我院收治2例低钾型周期性麻痹病人均并有不同分布类型的感觉障碍。现报道如下。     

失语检查法设计的评述

本文采用两种失语检查法分别检查了母语为粤语的健康中老年人共60例,通过其结果对失语检查法的设计进行评述。     

基底节区梗塞失语机制的探讨

本文通过分析四例病人的临床表现、头颅CT、SPECT和TCD,认为基底节区梗塞产生失语的机制与皮层语言功能区供血障碍有关。     

中老年人普通话与粤语语量测定

本文对30例讲粤语和30例讲普通话的40岁以上的中老年人进行语量测定和比较,结果普通话与粤语两者间无显著差异(P>0.05),提示普通话的语量标准同样也适用于粤语语量分析。     

Effect of cilostazol on cerebral arteries in secondary prevention of ischemic stroke

Objective

To compare the effects of cilostazol on cerebral arteries and cerebrovascular blood flow in secondary prevention of ischemic stroke, with those of aspirin.

Methods

Sixty-eight patients who had ischemic stroke during the recent 1–6 months were recruited and randomized into cilostazol or aspirin group. Cerebrovascular condition was assessed by magnetic resonance angiography (MRA) and transcranial doppler ultrasonography (TCD) at the beginning of the study and after 12-month medication.

Results

During the clinical follow-up, ischemic stroke recurred in 2 patients in cilostazol group, while in aspirin group, one case of ischemic stroke recurrence and one case of acute myocardial infarction were found. MRA revealed that in aspirin group, the percentages of patients experiencing aggravation and attenuation of cerebrovascular condition were 3.3% and 6.7%, respectively, while in aspirin group, they were 3.3% and 10%, respectively. Moreover, TCD revealed that 26.9% of the patients in aspirin group and 14.3% of the patients in cilostazol group experienced aggravation of cerebrovascular condition. However, the systolic peak flow velocity of the previously abnormal arteries increased by 42.9% after 12-month medication of cilostazol, which was significantly higher than that after aspirin medication (27.5%) (P = 0.04). Furthermore, as a major side effect of antiplatelet therapy, the frequrency of bleeding was much less in cilostazol group (0 case in cilostazol group vs 5 in aspirin, P < 0.05).

Conclusion

Cilostazol is as effective as aspirin in preventing the aggravation of cerebral arteries in secondary prevention of ischemic stroke. Besides, it is more safe. Cilostazol can increase the systolic peak flow velocity of cerebral arteries, which may improve the blood supply of focal ischemia.     

非进行性共济失调综合征的致病机理和预防

本文复习了有关婴儿和儿童非进行性共济失调性脑性瘫痪综合征的资料,描述了三个综合征:①单纯性共济失调(共济不能病征),②共济失调性双瘫(共济失调伴痉挛性双瘫)③平衡不良综合征(维持姿势和平衡困难).讨论了上述每个综合征的可能病因,对单纯性共济失调,胎儿期早期因素最重要,难以发现病因的病例比例高,遗传学因素起很大作用.遗传方式通常是染色体隐性遗传,其次是有先兆子痫的妊娠毒血症、脑出血、病毒感染、抗代谢药物、X线和营养     

变异型腓骨肌萎缩症一例

患者,叶某,女,已婚,34岁,工人。因"双膝关节疼痛伴双下肢乏力10~ 年,加重2~ 年"于1987年10月22日入院。患者10~ 年前无明显诱因开始出现右膝关节疼痛,行走后加重。3年后,累及左膝关节,但无红、肿,曾按"风湿性关节炎"治疗无效。病情缓慢进展,渐渐出现行路不稳,久坐后出现双下肢麻木感。行走虽困难,但昼夜无差异。近2年双膝关节疼痛加重,行走非常费力,勉强可行数百米远。发病后患者从未出现过视力障碍及二便障碍,患者既往体健,同胞一妹有轻度弓形足,"O"型腿。体检:内科检查正常。言语清晰。见双膝反张,轻度足内翻,弓形足。眼球各向运     

传导性失语的康复途径

本文通过四例传导性失语病人的康复研究认为：听觉言语短时记忆（A－STM）系统及言语信息，从A－STM到言语运动区的传递损害，是传导性失语的主要环节．视→说语言训练有助于语音的建立及消除听觉语言痕迹的相互抑制，促进传导性失语的康复。     

SPECT对失语的定位诊断价值

本文通过对37例失语病人进行SPECT及CT对比研究，发现SPECT对失语病人的定位诊断有重要价值，特别对CT定位不能解释的失语类型有确切的帮助，并对各种失语类型进行初步定位探讨。