目的 探讨血管性痴呆(VD)患者性别、严重程度与血浆同型半胱氨酸(Hcy)、C反应蛋白(CRP)、D-二聚体、生活方式的相关性.方法 VD患者443例采用自制调查量表对一般临床资料、生活方式等进行统计;利用简易精神状态检查表(MMSE)进行不同病情程度的分组,并检测Hcy、CRP及D-二聚体水平.结果 不同病情程度间VD患者的Hcy、CRP、D-二聚体水平差异显著(P<0.05),程度越重,Hcy、D-二聚体水平越高,CRP水平越低;单因素分析显示,不同年龄、性别、职业间VD的分布比例差异显著(P<0.05);不同生活方式中,社会活动、每年旅游、棋牌、食用不饱和脂肪酸、使用鱼类及海产品、使用蔬菜等对患者发生VD的影响较大;多元Logistic回归显示,高龄、女性、家庭妇女是VD发病的危险因素,社会活动、每年旅游、棋牌、食用不饱和脂肪酸、使用鱼类及海产品、使用蔬菜等是VD发病的保护因素.结论 改善高Hcy血症,检测血清CRP等炎症反应标志物及D-二聚体对VD的鉴别诊断具有一定参考意义;养成良好的生活方式有助于改善VD患者病情并延缓病程.

目的 研究血管性痴呆(VaD)患者痴呆程度与血清同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)和D-二聚体相关性,探讨Hcy、hs-CRP和D二聚体在血管性痴呆中的作用机制.方法 实验分为2组,正常对照组和血管性痴呆组,用散射比浊法检测每份样本中C反应蛋白及D-二聚体含量,采用荧光标记免疫检测法检测血清Hcy水平.结果 与正常对照组相比,血管性痴呆组Hcy、hs-CRP、D二聚体浓度显著增高,差异有统计学意义(P＜0.05).直线相关分析结果提示,Hs-CRP、Hcy与MMSE评分之间呈负相关性.D-二聚体水平与MMSE评分无相关性.结论 同型半胱氨酸、高敏C反应蛋白和D-二聚体参与了VaD的发病机制.血管性痴呆严重程度与Hcy和Hs-CRP呈显著相关性.

目的：总结抗NMDA受体脑炎的临床表现、诊断、治疗及预后等特点，以期提高对该病的认识。方法分析3例抗NMDA受体脑炎患者的临床表现、实验室检查、影像学检查、对免疫治疗的反应及预后。结果3例患者均表现有显著的精神症状，难治性癫痫和自主神经功能障碍，部分患者伴有运动障碍；脑脊液及血清抗 NMDA 受体阳性；免疫治疗有效。结论无精神病史的患者出现不明原因的精神症状伴痫性发作、记忆丧失、意识水平降低、运动障碍甚至出现中枢性通气不足，特别是伴有卵巢畸胎瘤者应警惕抗NMDA受体脑炎，及时诊断和治疗有助于抗NMDA受体脑炎患者的恢复。

<正>冠心病心绞痛是因冠状动脉病变导致心肌缺血后,引起的短时间发作性胸部压迫感及疼痛。本病多发于40岁以后,男性多于女性,在我国随着人民生活水平的提高,冠心病发病率逐年上升。西医常规治疗多采用硝酸酯类或配合钙通道阻滞剂及β受体阻滞剂等药物,其目的是增加冠状动脉血流量,降低心肌耗氧来缓解冠心病心绞痛的疼痛程度、频率及时间。笔者自2009年10月至2012年10月应用脑心通胶囊治疗冠心病心绞痛患者48例,取得了临床较满意的效果,现将结果报道如下。

目的 观察米氮平联合乌灵胶囊治疗老年卒中后抑郁患者的疗效.方法 将150例老年脑卒中后抑郁患者随机分为米氮平联合乌灵胶囊组52例,米氮平组48例,对照组50例,疗程3个月.治疗前后分别应用汉密尔顿抑郁量表(Hamilton rating scale for depression,HAMD)评估抑郁症状改善情况,应用匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评估睡眠改善情况,应用TESS副反应量表(treatment emergent symptom scale,TESS)评估药物不良反应.结果 米氮平联合乌灵胶囊组、米氮平组汉密尔顿抑郁量表评分较对照组明显降低,差异有统计学意义(P<0.05);米氮平联合乌灵胶囊组匹兹堡睡眠质量指数评分均较其余2组明显降低,差异有统计学意义(P<0.05);TESS副反应量表评分3组组间比较差异无统计学意义(P>0.05).结论 米氮平联合乌灵胶囊治疗老年卒中后抑郁有效,不良反应少,值得推广.

Objective To investigate the clinic efficacy of trazodone and alprazolam on depression patients with insomnia.Methods Forty-three cases of depression patients with insomnia,randomized to trazodone group and alprazolam group,were given the paroxetine treatment,and were given trazodone and alprazolam,respectively.All the patients completed 4 weeks of treatment.Results Before and after treatment,the total sleep time,wake-up early delay time and the frequency of nocturnal arousals were significantly improved(P<0.05).After treatment in two groups of patients with Ⅰ and Ⅱ sleep period shorten,Ⅲ and Ⅳ sleep,the REM latency were significantly prolonged,as compared with before treatment,there were significant differences(P<0.05).As compared with alprazolam group,Ⅲ and Ⅳ sleep period of trazodone group was prolonged,there was a significant difference(P<0.05).Conclusion Trazodone and alprazolam can significantly improve the insomnia of depression patients,and trazodone can significantly improve the deep sleep of depression patients.

Objective To investigate the effects of early application of low-dose mirtazapine in prevention of post stroke depression in first stroke patients.Methods There were 132 first stroke patients were administrated with regular treatment alone or combined with mirtazapine(15 mg/d) respectively for a month period,and their effects on prevalence of depression,scores in neurological deficits and activities of daily living(ADL) were detected.Results The prevalence of PSD in mirtazapine group(18.31%) was significantly decreased as compared with that of control group(53.73%).The MESSS scores were significantly lower in mirtazapine group(17.13±1.32) than in control group(22.87±3.42) and the ADL scores were significantly higher in mirtazapine group(98.10±15.16) than in control group(88.00±36.23).Conclusion Early application of low-dose mirtazapine can decrease the prevalence of post stroke depression,reduce the neurologicimpirment and improve the activity of daily living.

<正>帕金森病(Parkinson disease,PD)起病较缓慢,属于渐进式发展过程,可引发很多并发症,近年来国外较多研究发现抑郁情绪亦是PD的常见症状〔1～3〕。帕罗西汀(Paroxetine)是一种选择性血清再吸收抑制剂(SSRI)型抗抑郁药,在临床上常用于抑郁症和强迫症的治疗〔4〕。

Objective To investigate the relationship between acute cerebral infarction and homocysteine(Hcy),high-sensitivity C-reactive protein(Hs-CRP).Methods To determin the levels of serum Hcy and Hs-CRP by ELISA and scattering turbidity in the patients between 126 cases of acute cerebral infarction and 108 cases of healthy control.126 cases of acute cerebral infarction patients were divided into three groups by the degree of impairment:A,B and C group.And the three groups were compared with each other.Results The levels of Hcy and Hs-CRP in acute cerebral infarction group were significantly higher than that of healthy control group(P0.01),The more severe of impairment,the higher of Hcy and Hs-CRP level,the difference was significant(P0.05).Conclusion Serum Hcy and Hs-CRP as independent risk factors of acute cerebral infarction are correlated with the degree of the severity.

Objective To approach the relationship between vascular dementia(VD)and homocysteine(Hcy)level.Methods One hundred and forty-eight cases were divided into three groups:50 VD cases,50 cerebral infarction cases and 48 normal cases.Applying ELISA to investigate the level of Hcy and comparing the Hcy level among those three groups.Results The Hcy level of VD group was higher than cerebral infarction group(P<0.01)and higher than normal group(P<0.05).Conclusions Homocysteine-emia is a new risky factor of VD.

AIM:To evaluate the effects of butylphthalide in treating acute ischemic stroke.METHODS: One hundred and nineteen patients with acute ischemic stroke were randomized divided into two groups,59 patients treated by butylphthalide and 60 patients as normal control group.All selected patients were undertaken activities of daily life(ADL)test and evaluation of nervous functional deficiency degree before treatment and at d 11 and d 21 after the treatment.RESULTS:At d 11 and d 21 after treatment,there was a significant differ- ence in ADL between treatment group and control group(P＜0.05 or 0.01);and also a significant difference in the nervous functional deficiency degree between the two groups(P＜0.05 or 0.01).There was significant dif- ference in ADL and nervous functional deficiency between before treatment and after 11-day or 21-day treatment (P＜0.01)in treatment group,respectively.There was no significant difference in the two parameters between before treatment and after 11-day treatment in the control group(P＞0.05),while there was significant differ- ence between pre-treatment and after 21-day treatment(P＜0.05).Concerning no significant difference between the two groups in ADL and nervous functional deficiency degree at d 11 after treatment(P＞0.05),there was significant difference in the two parameters at d 21 after treatment(P＜0.05).CONCLUSION:Butylphthalide is safe and effective in treating acute ischemic stroke.

丽珠脑力隆是以哌嗪类钙通道阻滞剂-脑益嗪和田七提取物等组成的中西复方缓释制剂.作为一种上市新药,其对缺血性脑卒中治疗,国内文献报道极少[1,2],表明其有选择性扩张病理性痉挛之脑血管,增加脑缺血区血流量;抑制血小板聚集,降低血液粘度,改善心脑等组织的微循环,增加冠脉流量,降低血压,减慢心率,降低心肌耗氧量,提高心脑细胞耐受缺氧的能力,从而防治脑梗死的发生和发展;此外,还具有抗组胺5-HT的作用.现对丽珠脑力隆治疗缺血性脑卒中随访3月以上的患者,用ADL[3]评估方法及神经功能缺损评分标准进行对比分析报道如下.

目的评价血栓心脉宁胶囊治疗急性脑梗塞的疗效.方法 80例病人无禁忌症,随机分为治疗组和对照组各40例;对照组给予低分子右旋糖酐500ml加胞二磷胆碱750mg,5%葡萄糖250ml加维脑路通1.0g,每日静滴,疗程2周;治疗组,在对照组基础上应用血栓心脉宁胶囊,4粒/次,3次/d,口服,治疗结束时统计神经功能缺损积分、血脂和血流变的变化.结果治疗组用药后神经功能缺损积分较用药前减少(P＜0.01),对照组亦减少,但无统计学意义(P＞0.05),治疗组用药后血脂、血液流变学各指标较治疗前下降显著(P＜0.05).结论血栓心脉宁胶囊治疗急性脑梗塞疗效满意,有应用价值.

为观察中西医结合治疗骨质疏松症的效果,寻求骨质疏松症更有效的治疗方法,运用中药抑减胶囊配合小剂量甲状腺激素治疗骨质疏松症48例,并与葡萄糖酸钙片30例作对照.结果显示:治疗组有效率97.92%,对照组有效率86.67%,两组比较治疗组明显优于对照组(P＜0.05),骨密度增加值比较,治疗组也明显高于对照组(P＜0.05).认为中药配合小剂量甲状腺激素是治疗骨质疏松症的有效方法之一.

近年来我们选用SNF-10C型生物能量辐射治疗仪配合静脉滴注低分子右旋糖酐加胞二磷胆碱治疗急性脑梗死,与单纯低分子右旋糖酐加胞二磷胆碱对照观察,疗效满意,报道如下.

椎-基底动脉供血不足性眩晕(VIBV)临床非常多见,现将我们近两年收治的36例患者,用复方莪棱口服液治疗,效果满意,兹报告如下:

国内有关灯盏细辛注射液对缺血性脑卒中短期治疗疗效的文献表明[1,2],其有降血脂、降纤维蛋白、减少红细胞压积、降低血粘度、显著改善甲襞微循环等血液流变学指标的作用,故其可以防治脑梗死的发生和发展.本文对灯盏细辛注射液治疗缺血性脑卒中随访1年以上的患者,用ADL[3]评估方法及神经功能缺损评分标准进行对比分析,现报道如下.

生物能量辐射治疗仪(SNF),采用可同时发射多个特定的有生物刺激效应的光波,对血液进行光辐射、氦-氖激光照射及充氧治疗.我们用SNF-10C生物能量辐射治疗仪治疗脑梗死患者50例,疗效满意,现报告如下.

小脑出血以往都是由尸检确诊,近20年随着CT、MRI应用于临床,小脑出血得以及时诊断和治疗.现将我们医院经CT确诊的25例小脑出血,结合文献分析报道如下:

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">对２１例多发性硬化患者和２３例健康志愿者进行了韦氏成人智力量表测查和体感刺激诱发的事件相关脑诱发电位研究。结果表明，多发性硬化患者可出现不同程度的智能障碍，其中语言智商（３８％）、操作智商（４８％）和全量智商（３３％）在边界以下。本组患音表现为皮层下痴呆的特征。其认知电位Ｐ３００的潜伏期与对照组相比明显延长（Ｐ＜０．００１），波幅明显降低（Ｐ＜０．００１）</span>