目的 评价替格瑞洛治疗氯吡格雷抵抗的大动脉粥样硬化性脑梗死患者的疗效和安全性.方法 选取2019年4月至2020年10月于江苏省江阴市人民医院神经内科就诊并经基因检测证实存在氯吡格雷抵抗的78例急性大动脉粥样硬化性脑梗死患者为研究对象,采用随机数字表法分为对照组和观察组,每组各39例.对照组给予氯吡格雷+阿司匹林,观察组给予替格瑞洛+阿司匹林,连续治疗1个月后两组均改为阿司匹林单一药物长期治疗.比较分析两组患者治疗前后腺苷二磷酸(adenosine diphosphate,ADP)诱导的血小板抑制率、临床疗效以及治疗期间有无严重出血事件发生和不良反应发生情况.结果 治疗前,两组患者ADP诱导的血小板抑制率比较差异无显著性(P>0.05);治疗1个月后两组患者血小板抑制率均较治疗前升高,且观察组血小板抑制率明显高于对照组,差异均有显著性(P<0.05).观察组患者治疗14d、1个月、3个月后的总有效率均显著高于对照组(P<0.05).治疗期间两组患者均无严重出血事件发生,两组患者不良反应发生率比较差异无显著性(P>0.05).结论 对存在氯吡格雷抵抗的大动脉粥样硬化性脑梗死患者,替格瑞洛可有效提高其血小板抑制率,改善神经功能受损程度,且安全性较高.

Objective To investigate the relationship between two single nucleotide polymorphisms (rs356219,rs356165 sites) and cognitive dysfunction in Parkinson disease.Methods 236 patients with Parkinson's disease were randomly selected from November 2014 to November 2017.According to the results of MoCA cognitive function evaluation,the patients were divided into group A (cognitive dysfunction group)and group B (normal cognition group).At the same time,65 patients were randomly selected as group C (Health control group).The allele frequency and genotype distribution of rs356219 and rs356165 were compared,and the differences among the three group were compared.Results In the rs356165 allele frequency,group A (G:57.14％,A:42.86％),group B (G:56.45％,A:43.55％) and group C (G:52.31％,A:47.69％) had no statistical significance (P＞ 0.05).In the rs356165 genotype,G/G (21.43％) and A/A (14.29％) in group A were higher than group C (G/G:4.62％,A/A:1.54％),G/G (22.58％) in group B and A/A (14.52％) were higher than group C G/G (4.62％) and A/A (1.54％) (P＜ 0.05).In the rs356219 allele frequency,group A (G:64.29％,A:64.29％) and group B (G:64.52％,A:35.486％) and group C (G:46.15％,A:53.85％) was statistically significant (P＜0.05),but no statistical significance between group A and group B (P＞0.05);In the rs356219 genotype,group A (G/G:35.71％,A/A:21.43％,A/G:42.86％),group B (G/G:35.48％,A/A:22.58％,A/G:41.94％) and group C (G/G:30.77％,A/A:26.15％,A/G:43.08％) had no statistical significance (P＞ 0.05),and there was no statistical significance between group A and group B (P＞0.05).Conclusions The polymorphism of rs356219 and rs356165 sites in rho-synaptic nucleoprotein plays an important role in the pathogenesis of Parkinson disease.However,there was no correlation with cognitive dysfunction in patients with Parkinson disease.

目的:观察丙泊酚和硫喷妥钠治疗难治性癫痫持续状态临床疗效.方法:回归分析2016年1月至2017年1月期间在我院治疗的56例难治性癫痫持续状态患者临床资料,将其随机分为对照组和观察组,每组28例患者.对照组患者采用硫喷妥钠治疗,观察组患者采用丙泊酚治疗,观察对比两组患者临床治疗疗效.结果:观察组患者发作控制率明显高于对照组,发作控制时间明显短于对照组,差异有统计学意义(P<0.05);观察组患者死亡率、低血压发生率与对照组对比,差异无统计学意义(P>0.05).结论:观察对比丙泊酚和硫喷妥钠治疗难治性癫痫持续状态临床疗效,丙泊酚可快速控制癫痫持续状态,可作为临床治疗难治性癫痫持续状态的有效药物,值得临床推广和应用.