目的:以数字减影血管造影(DSA)为手段,分析短暂性脑缺血发作(TIA)患者临床特点及脑供血动脉狭窄或闭塞的发生率。方法:对 2003 年1月至2007 年8 月期间四川大学华西医院神经内科收治且行DSA检查的短暂性缺血发作患者 65 例进行研究。对患者临床特点,动脉病变情况﹑狭窄程度进行分析.结果:65 例TIA患者中发现血管病变有 38 例(58.5%),其中单侧受累 14 例(21.5%),多处受累 24 例(36.9%),中度及重度,闭塞的血管狭窄多见,且多发生在颅外段。结论:DSA可以明确TIA病患者中血管动脉粥样硬化,狭窄程度,这对指导治疗起重要作用。
Purpose To examine the change of optic disc blood flow in primary open angle glaucoma(POAG) patients after cold provocation test and nifedipine administration. Methods Using Heidelberg retinal flowmetry (HRF),the blood flow of optic disc of glaucoma patients and normal control subjects were measured under basal condition, after cold provocation test,and after nifedipine administration. Results The mean optic disc blood volume and flow of POAG patients reduced from 27.1 and 545.4 to 22.3 and 452.4 after cold provocation test (Plt;0.05),and increased to 29.0 and 579.5 after nifedipine adminstration(Plt;0.05).The changes of mean optic disc blood flow of patients with a history of cold extremities show statistic significance compared with whom without such history (Plt;0.05)). Conclusion The changes of blood flow of optic disc in POAG patients may be influenced by cold stimuli and administration of nifedipine,and the history of cold extremities might be connected with the change of optic disc blood flow in POAG patients. (Chin J Ocul Fundus Dis,2000,16:85-87)
Ischemic stroke often leads to cognitive dysfunction, which delays the recovery process of patients. However, its pathogenesis is not yet clear. In this study, the cerebral ischemia-reperfusion model was built as the experimental object, and the hippocampal dentate gyrus (DG) was the target brain area. TTC staining was used to evaluate the degree of cerebral infarction, and nerve cell membrane potentials and local field potentials (LFPs) signals were collected to explore the mechanism of cognitive impairment in ischemia-reperfusion mice. The results showed that the infarcted area on the right side of the brain of the mice in the model group was white. The resting membrane potential, the number of action potential discharges, the post-hyperpolarization potential and the maximum ascending slope of the hippocampal DG nerve cells in the model mice were significantly lower than those in the control group (P < 0.01); the peak time, half-wave width, threshold and maximum descending slope of the action potential were significantly higher than those in the control group (P < 0.01). The time-frequency energy values of LFPs signals in the θ and γ bands of mice in the ischemia and reperfusion groups were significantly reduced (P < 0.01), and the time-frequency energy values in the reperfusion group were increased compared with the ischemia group (P < 0.01). The signal complexity of LFPs in the ischemia and reperfusion group was significantly reduced (P < 0.05), and the signal complexity in the reperfusion group was increased compared with the ischemia group (P < 0.05). In summary, cerebral ischemia-reperfusion reduced the excitability of nerve cells in the DG area of the mouse hippocampus; cerebral ischemia reduced the discharge activity and signal complexity of nerve cells, and the electrophysiological indicators recovered after reperfusion, but it failed to reach the healthy state during the experiment period.
As a risk factor for vascular diseases and inflammatory diseases, fibrinogen has received more and more attention. Hyperfibrinogenemia is associated with the occurrence, development, and poor outcome of artery-venous ischemic stroke (acute ischemic stroke, transient ischemic attack and cerebral venous thrombosis). Therefore, fibrinogen may be a potential therapeutic target for the prevention and management of artery-venous ischemic stroke. However, there has been controversy regarding the defibrinogen therapy in artery-venous ischemic stroke. Therefore, this paper introduces the efficacy and safety of defibrinogen therapy alone, combined with antiplatelet or combined with anticoagulant in prevention and management of artery-venous ischemic stroke in detail, in order to re-understand the role of defibrinogen therapy in the prevention and management of artery-venous ischemic stroke.
目的 探讨磁共振扩散加权成像(DWI)、动脉自旋标记技术(ASL)、磁共振血管成像(MRA)联合应用在缺血性脑血管病诊断中的价值。 方法 对2010年3月-2012年5月经临床和影像学诊断的104例缺血性脑血管病患者,行常规MRI、液体衰减反转恢复序列、DWI及ASL、MRA序列检查,分析DWI、ASL、MRA多种技术显示病变的信号特征、面积大小及与血管关系。 结果 DWI对急性及亚急性脑梗死的检出率为100%,对大、小面积梗死病灶检出率无明显差异;ASL对大、小面积的急性及亚急性脑梗死的检出率有差异,对大面积梗死检出率为100%,对小面积梗死的检出率为70%;DWI和ASL对短暂性脑缺血发作的检出率分别为0%、70%,液体衰减反转恢复序列对短暂性脑缺血发作患者大脑皮层下斑状缺血灶检出最敏感。 结论 DWI和ASL均可用于急性脑梗死的早期诊断,ASL对大、小面积的急性及亚急性脑梗死的检出率有差异,DWI、ASL及MRA联合应用可准确评估缺血半暗区及侧支血管情况,在缺血性脑血管病诊断中有重要价值。