Objective:To correlate homocysteine (Hcy) and blood lipid levels with neurological function in patients with progressive ischemic stroke.Methods:A total of 400 patients with ischemic stroke who received treatment between June 2018 and June 2020 in Linhai Second People's Hospital were included in this study. Progressive ischemic stroke ( n = 126) and non-progressive ischemic stroke ( n = 274) groups were designated. Hcy level was determined by enzyme-linked immunosorbent assay. High-density lipoprotein cholesterol, triacylglycerol, low-density lipoprotein cholesterol and cholesterol levels were measured using a biochemical analyzer. Hcy and blood lipid levels as well as National Institute Health of Stroke Scale (NIHSS) score were determined in each group. Hcy and blood lipid levels were correlated with NIHSS score. Results:Hcy level in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(28.39 ± 4.36) μmol/L vs. (20.17 ± 3.24) μmol/L, t = 18.894, P < 0.05]. Low-density lipoprotein cholesterol , triacylglycerol and TC levels in the progressive ischemic stroke group were (3.29 ± 0.45) mmol/L, (2.08 ± 0.34) mmol/L and (4.82 ± 0.79) mmol/L, respectively, which were significantly higher than those in the non-progressive ischemic stroke group [(2.48 ± 0.37) mmol/L, (1.56 ± 0.29) mmol/L and (4.08 ± 0.43) mmol/L, t = 17.644, 14.859, 9.860, P < 0.05]. High-density lipoprotein cholesterol level in the progressive ischemic stroke group was significantly lower than that in the non-progressive ischemic stroke group [(1.03 ± 0.13) mmol/L vs. (1.19 ± 0.14) mmol/L, t =11.158, P < 0.05]. NIHSS score in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(21.72 ± 4.35) points vs. (15.52 ± 2.89) points, t = 14.582, P < 0.05]. Hcy, low-density lipoprotein cholesterol, cholesterol and triacylglycerol levels were linearly and positively correlated with NIHSS score ( r = 0.846, 0.724, 0.718, 0.765, all P < 0.05), while igh-density lipoprotein cholesterol level was linearly and negatively correlated with NIHSS score ( r = -0.710, P < 0.05). Conclusion:In patients with progressive ischemic stroke, Hcy level is increased and blood lipid level is obviously abnormal. Hcy and blood lipid levels are greatly correlated with neurological function.

目的:对比分析慢性酒精中毒患者的临床和电生理特点.方法:将2018年1月至2020年12月时段的临床资料调取出来,从中随机抽取50例慢性酒精中毒患者作为观察组,再随机抽取50例在我院进行肌电图检查的健康人员作为对照组,进行对比试验,对比两组人员检查后的电生理特点.结果:(1)正中神经、尺神经、胫后神经、腓总神经、腓肠神经、腓浅神经的传导速度和波幅数值,观察组明显低于对照组,差异具有统计学意义(P<0.05);(2)慢性酒精中毒患者的主要临床症状为肢体麻木、头痛、肢体乏力、头晕、走路不稳、记忆力下降、计算力下降、意识障碍、小便失禁、四肢抽搐等,主要电生理特点为周围性感觉障碍现象、腱反射减低或者消失的现象、双手震颤.结论:肌电图能够敏锐地检测出慢性酒精中毒患者的神经状态,结合临床症状及电生理特点,能够帮助医生判断患者的病情变化,以便更好地进行治疗,具有较高的临床应用价值.

目的 探讨多巴丝肼治疗帕金森病(PD)和血管性帕金森综合征(VP)的疗效及对血浆维生素B12(Vit B12)、叶酸(FA)、同型半胱氨酸(Hcy)、载脂蛋白B100(ApoB100)及脂蛋白-α(LPα)等的影响.方法 回顾性分析55例PD患者(PD组)、50例VP患者(VP组)和50例同期健康体检者(对照组)的临床资料,比较PD组、VP组采用多巴丝肼治疗8周后的临床疗效和治疗前后血清Vit B12、FA、Hcy、ApoB100及LPα水平变化.结果 治疗8周后,PD组和VP组的临床总有效率差异无统计学意义(P＞0.05).治疗前,VP和PD组的VitB12、Hcy、ApoB100、LPα水平均高于对照组(均P＜0.05);治疗8周后,PD组Vit B12、ApoB100水平较治疗前高,Hcy、LPα水平较治疗前低,VP组ApoB100水平较治疗前高,Hcy水平较治疗前低(均P＜0.05).结论 多巴丝肼治疗PD的机制可能与升高VitB12、ApoB100,降低Hcy、LPα有关,治疗VP的机制可能与升高ApoB100,降低Hcy有关.

目的 探讨老年动脉粥样硬化性脑梗死患者外周血调节性T细胞水平及其与缺血性脑损伤和颈动脉粥样硬化严重程度的相关性.方法 选择老年动脉粥样硬化性脑梗死患者120例作为梗死组和同期体检的老年健康者120例作为对照组,梗死组根据梗死时间分为梗死组1 d、梗死组3 d、梗死组7 d;根据神经功能缺损程度分为轻度组、中度组和重度组;根据梗死灶大小分为小梗死灶组、中梗死灶组、大梗死灶组;根据颈动脉粥样硬化程度分为颈动脉内膜增厚组、颈动脉斑块组、颈动脉狭窄组.测定患者外周血CD4+CD25+调节性T细胞百分比和白细胞、中性粒细胞含量.结果 梗死组外周血调节性T细胞水平明显低于对照组(P<0.05).梗死组1 d外周血调节性T细胞水平明显低于对照组(P<0.05),梗死组3 d与对照组比较无差异(P>0.05),梗死组7 d明显高于对照组(P<0.05);梗死组1 d白细胞和中性粒细胞高于对照组(P<0.05),梗死组3 d白细胞高于对照组(P<0.05),梗死组3 d中性粒细胞和对照组比较无差异(P>0.05),梗死组7 d白细胞和中性粒细胞和对照组比较无差异(P>0.05).重度组外周血调节性T细胞水平低于轻度组和中度组(P<0.05),中度组外周血调节性T细胞水平低于轻度组(P<0.05).大梗死灶组外周血调节性T细胞水平高于小梗死灶组和中梗死灶组(P<0.05),中梗死灶组外周血调节性T细胞水平低于小梗死灶组(P<0.05).颈动脉狭窄组外周血调节性T细胞水平低于颈动脉内膜增厚组和颈动脉斑块组(P<0.05),颈动脉斑块组外周血调节性T细胞水平低于颈动脉内膜增厚组(P<0.05).结论 老年动脉粥样硬化性脑梗死患者外周血调节性T细胞水平降低,外周血调节性T细胞水平与缺血性脑损伤和颈动脉粥样硬化严重程度关系密切.

Objective To observe the treatment effect of early rehabilitation training on acute cerebral infarction patients with hemiplegia,and to explore its possible mechanism.Methods One hundred cases of acute cerebral infarction hemiplegia in our hospital from January 2013 to June 2016 were selected and divided into the rehabilitation training group (50 cases) and control group (50 cases).The control group was given the routine medication therapy and the rehabilitation training group was given early rehabilitation training on the basis of conventional medication therapy.The functional independence assessment (FIM),Fugl-Meyer assessment (FMA) and modified Barthel index (MBI) were used to evaluate the therapeutic effect of early rehabilitation training.The level of stromal cell-derived factor-1α (SDF-1α) in peripheral blood was measured by enzyme linked immunosorbent assay,and the level of CD34+KDR+ in peripheral blood was measured by flow cytometry.Results There was no statistically significant difference in the FIM total score,FIM sports function score,FMA score,MBI score,SDF-1α and CD34+KDR+ levels before treatment between the rehabilitation training group and the control group (P>0.05).After treatment,the FIM total score,FIM sports function score,FMA score,MBI score and SDF-1α and CD34+KDR+ levels of the rehabilitation training group were higher than those of the control group,the differences were statistically significant (P<0.05).Conclusion The effect of early rehabilitation training on acute cerebral infarction patients with hemiplegic is remarkable.The mechanism may be related to promoting the expression of SDF-1α and CD34+KDR+ in peripheral blood.

<正>进展性卒中(stroke in progressive,SIP)的定义在不同文献上有所不同,国外文献一般指发病7 d内临床症状和体征逐渐加重的缺血性卒中;国内认为是发病后48h内神经功能缺损症状逐渐进展或呈阶梯式加重的缺血性卒中[1]。导致脑梗死进展的因素错综复杂,本文围绕进展

目的探讨舒利迭对支气管哮喘患者气道炎症和肺功能的影响,及其治疗支气管哮喘的安全性。方法急性发作期哮喘患者80例随机分为治疗组和对照组各40例。两组患者均酌情给予多索茶碱、酮替芬、复方甲氧那明,按需使用沙丁胺醇气雾剂等治疗。治疗组还加用舒利迭(沙美特罗50μg+丙酸氟替卡松250μg粉吸入剂),经准纳器吸入,每次1吸,每天2次,12周为一疗程。检测两组患者治疗前后诱导痰标本中炎性介质ECP、IL-6、TNF-α的含量和肺功能情况。结果两组患者治疗前诱导痰ECP、IL-6、TNF-α含量基本一致(P>0.05)。治疗12周后,两组患者诱导痰ECP、IL-6、TNF-α含量均明显下降(均P<0.05),但治疗组诱导痰ECP、IL-6、TNF-α含量较对照组明显更低降(均P<0.05)。两组患者治疗前肺功能FEV1占预计值%、PEF占预计值%基本一致(P>0.05)。治疗12周后,两组患者肺功能FEV1占预计值%、PEF占预计值%均明显好转(均P<0.05),但治疗组肺功能FEV1占预计值%、PEF占预计值%好转情况较对照组更明显(均P<0.05)。结论哮喘患者长期气道吸入舒利迭,有利于改善哮喘患者的气道慢性炎症,有利于改善患者的肺功能,安全可靠,值得临床推广使用。

文献报道,IL-4、IL-5、IFN-γ等细胞因子参与了哮喘的病情进展过程,但检索文献迄今为止甚少有关于IL-4、IL-5、IFN-γ含量与支气管哮喘症状评分相关性的探讨.本文通过观察急性发作期的哮喘患者治疗前后日夜间症状评分和外周血IL-4、IL-5、IFN-γ含量变化,探讨外周血IL-4、IL-5、IFN-γ含量与支气管哮喘症状评分的关联性.现报道如下.