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697例急性脑梗死统计分析
为了了解急性脑梗死发病率,病死率与年龄、性别的关系,现对脑梗死患者的年龄、性别与发病率、病死率进行统计分析.
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Twenty-one cases of acute cerebral infarction secondary to NIDDM were treated with acupuncture and conventional therapy, and compared with 16 cases treated with conventional therapy alone. The results showed that acupuncture was more effective in reducing insulin and glucagon levels (P<0.001) and improving hypercoagulability (P<0.05) of blood.
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The aim of this study is to investigate the effect of electro-acupuncture treatment in acute phase of cerebral infarction on the motor functions. In this randomly controlled trial, 86 patients were allocated to two groups, the experimental group given clinical and electro-acupuncture treatments for a period of 4 weeks, and the control group given clinical treatment plus active and/or passive functional exercise. The result showed that the level of impairment and disability in both groups were improvement according to the Chinese Stroke Scale, Brunnstrom-Fugl-Meyer score, and Barthel Index throughout the study and 3 months after. The motor functions and the activities of daily living (ADL) were improved significantly in the electro-acupuncture group as compared with the control group (P<0.05). Also, the results showed greater reduction of neurological deficit in the electro-acupuncture group than in the control group. Conclusion: Early acupuncture treatment for acute stroke patients may improve motor functions, and consequently the activities of daily living.
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动脉溶栓后辅以中药治疗急性脑梗死的短期疗效观察
缺血性脑血管病是目前造成人类死亡和残疾的常见病,约占脑血管病的80%.经动脉内溶栓治疗超早期的急性脑梗死,被认为是目前治疗急性脑梗死有效的方法之一.而中医药对缺血性脑血管病的治疗有丰富的理论基础和临床治疗经验,亦是目前中医药领域研究的热点.我们对急性脑梗死患者早期进行动脉溶栓后,联合中药治疗,现将临床疗效报道如下.
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Previous studies have demonstrated the protective effect of hypoxic preconditioning on acute ce-rebral infarction, but the mechanisms underlying this protection remain unclear. To investigate the protective mechanisms of hypoxic preconditioning in relation to its effects on angiogenesis, we in-duced a photochemical model of cerebral infarction in an inbred line of mice (BALB/c). Mice were then exposed to hypoxic preconditioning 30 minutes prior to model establishment. Results showed significantly increased vascular endothelial growth factor and CD31 expression in the ischemic penumbra at 24 and 72 hours post infarction, mainly in neurons and vascular endothelial cells. Hy-Hypoxic preconditioning increased vascular endothelial growth factor and CD31 expression in the ischemic penumbra and the expression of vascular endothelial growth factor was positively related to that of CD31. Moreover, hypoxic preconditioning reduced the infarct volume and improved rological function in mice. These findings indicate that the protective role of hypoxic preconditioning in acute cerebral infarction may possibly be due to an increase in expression of vascular endothelial growth factor and CD31 in the ischemic penumbra, which promoted angiogenesis.
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康莱特注射液相关急性脑梗死2例
1 病例病例1:患者,男,61岁.2007年6月初经腹部计算机断层扫描(computer tomography,CT)、肿瘤标记物及肝脏转移病灶穿刺活检病理诊断为"胰腺癌肝脏及腹膜后淋巴结转移".
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脑梗死急性期脱水治疗之浅见
脑水肿是脑梗死常见的继发性损害,而脱水治疗是减轻脑水肿的重要措施之一.然而,目前临床工作中因使用不当、甚至滥用脱水治疗而致患者病情恶化的情况仍时有发生,脑梗死的脱水治疗应进一步规范化.我们认为脱水治疗应以脑梗死临床病理类型和继发性脑水肿的病理生理进程为基础,建议应用个体化为核心的脱水治疗方案.为正确理解和掌握脑梗死脱水治疗的适应证、时机、疗程、常用药物的机制和具体方法,我们必须对脑梗死的临床病理类型和继发性脑水肿的机制进行深入分析,对各种脱水药物的药代学和药效学等应有正确认识,也需要结合患者的全身情况进行整体综合评价.
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急性脑梗死合并脑心综合征患者血糖水平对预后的影响
?脑心综合征(BHS)是由各种急性颅脑病变引起的继发性心脏损伤,文献报道BHS发生率高达62%~90%[1],且发病急、进展快,若得不到及时纠正终可导致死亡。因此,及早发现并处理非常重要。糖代谢水平与急性脑梗死关系密切[2-3],并在血管并发症中扮演了重要的角色[4-6]。本研究以血糖水平与血管并发症的相关性为切入点,回顾性分析脑梗死继发BHS患者血糖水平,以期探讨血糖水平与脑梗死继发BHS患者预后的关系。
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急性脑梗死的早期影像学诊断
对缺血半暗带的病理生理学研究表明,脑梗死的有效治疗主要在发病早期,而选择正确的诊断方法和对疾病的准确判断是保证各种治疗有效性的一个必要前提,目前临床上主要依靠神经影像学技术来实现这一目标.发病早期进行神经影像学诊断的意义:(1)准确诊断脑梗死,鉴别脑出血.(2)明确梗死灶的大小、位置以及血管分布范围.(3)影响早期和远期治疗决策.(4)判断缺血性损害的可逆程度.(5)了解颅内血管和脑血流动力学的状态.
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低血糖昏迷误诊为急性脑梗死一例
1 病例资料患者,女,54岁,以神志不清2 h入我院急诊室,无呕吐,无抽搐及大小便失禁.既往有高血压病7年,冠心病5年,糖尿病4年,规律口服降压及降糖药物.入院查体:血压20.0/11.3 kPa,脉搏85次/min,呼吸20次/min,浅昏迷,无明显颈强,心肺腹查体无明显阳性体征,神经系统查体四肢腱反射正常,双侧巴氏征可疑阳性.
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急性脑梗死介入治疗术后股动脉出血原因分析
急性脑梗死介入溶栓术是将溶栓药物用特殊的导管经股动脉送至颈内动脉甚至更小的栓塞部位的脑血管内,在局部进行药物溶栓,达到快速治疗脑梗死的目的.该方法局部药物浓度高、作用好、副反应小,目前已逐渐成为治疗急性脑缺血的重要手段.但是该手术由于穿刺股动脉以及术中、术后抗凝溶栓药物的使用等原因,如果术后压迫不当、患肢过早屈曲活动以及观察不仔细可导致股动脉穿刺部位出血[1].2000年11月-2003年11月我院行急性脑梗死介入治疗46例,发生股动脉出血8例,现报告如下.
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急性脑梗死患者外周血有关因子变化与神经功能缺损程度的关系
INTRODUCTION Inflammatory reaction induced by cell immunology is the important mechanism of neuron injury, degenertion and progressive necrosis during ischemia- reperfusion course[1- 2].Human leucocyte antigen- II(HLA- II) is mainly expressed by presenting antigen presenting cell(APC).While HLA- DR antigen expressed mainly on the activated T cells and had a highly specificity and played an important role in immunology reaction and immunology adjustment[2].In our experiment,we explored research in CD3/CD(16+ 56) and CD3/HLA- DR by employing monocolonel antibody and immunology fluorescent labeling and FCM technology.
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杏丁注射液改善急性脑梗死患者神经功能的效应
INTRODUCTION Xingding is a compound agent of the fourth edition extract of ginkgo leaf,with addtion of agacore.Its main ingradient are ginkgo seed flavonoid glycoside(24% ), ginkgo seed lactone(3% ),bilobalide(3% ) and agacore(10% ).With ginkgo leaf acid smaller than 5× 10- 6,many clinical and basic research prove it has many biological effects.
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液体高压氧对急性脑卒中患者神经功能缺损恢复的作用
Background:Liquid hyperbaric oxygen therapy is a quickly developed therapy for acute cerebral infarction in recent years.It has characteristics of high safety,low toxicity,easy manipulation,especially good recovering effect on neurological deficit in acute stroke patients.We observed this effect in this paper.
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急性脑梗死动静脉溶栓治疗的对比研究
近年来,由于CT和MRI的广泛应用和对脑梗死病理生理研究的深入,溶栓疗法治疗急性脑梗死重新受到重视.国内的溶栓治疗仍处于探索阶段,用药途径、时间、剂量仍是关键.我们采用尿激酶对急性脑梗塞病人,按不同剂量,随机经颈动脉、肢体静脉进行溶栓治疗,设对照组,三组进行比较,以观察疗效、副作用及对某些血液指标的影响,现将有关资料总结如下.
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急性期脑梗死患者血浆丙二醛与过氧化氢酶活性检测临床对照研究
本篇旨在探讨脑梗死急性期治疗前后血浆中丙二醛(MDA)和过氧化氢酶(CAT)浓度变化.MDA是脂质过氧化物的代谢产物,脑梗死时中枢神经组织中产生自由基的多少与血浆中MDA浓度呈正相关,CAT是具有清除自由基作用的抗氧化剂,当自由基增多时CAT活性下降,本项研究对脑梗死的治疗具有临床实际意义.
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急性脑梗死患者凝血-纤溶系统分子标记物的变化及前列腺素E1对其影响的研究
目的探讨急性脑梗死患者的血管内皮损伤情况、血小板的活化情况、纤溶、抗纤溶及血黏度状态;探讨脂化前列腺素E1(凯时注射液)对脑梗死患者的作用影响及观察临床疗效.方法选择急性期脑梗死患者与健康人,对vWF,GMP-140,FIB,t-PA,PAI指标进行测定并进行对比分析;对脑梗死患者应用凯时治疗,对治疗前后的上述指标进行分析,并进行神经功能缺损评分.结果脑梗死患者存在血管内皮损伤、血小板活化、血液有高凝状态;该状态经凯时治疗后,可以得到明显改善,且脑梗死患者的神经功能缺损评分明显改善.结论凯时可以减轻脑梗死造成的血管内皮损伤、血小板高度活化,降低血黏度,对脑梗死有较好的疗效.
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急性脑梗死的死亡危险因素分析
急性脑梗死(acute cerebralinfarction,ACI)的发病率近年来不断增高.如何更好地预防和处理脑梗死,显得更为重要.单因素对预后的影响已有许多报告,但多因素对预后影响的研究不多.为此,我们将277例脑梗死病例报告,对可能影响发病及预后的因素进行分析.
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急性脑梗塞溶栓疗法的新认识
医学界认识因脑动脉内血凝块阻塞引起的中风已有100多年,但直到1995年才从技术上解决这个问题,急性脑梗塞的溶栓疗法临床研究的成功为我们提供了一些新思路.
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降纤酶治疗急性脑梗死临床研究进展
血浆纤维蛋白原是参与血栓形成的重要因素,流行病学研究结果显示,高纤维蛋白血症是脑动脉硬化的独立危险因素[1],而且血浆纤维蛋白原的升高与缺血性脑血管病的不良预后有关.因此,降低纤维蛋白原治疗缺血性脑血管病具有十分重要的意义[2-3].