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血管性与非血管性肢体肿胀的临床研究

【摘要】 目的 分析肢体肿胀的血管性与非血管性因素，探讨超声多普勒检查对其的诊断价值。 方法 2005年1月-2009年1月，应用彩色多普勒超声检查，对40例下肢肿胀患者的声像图特征进行总结分析。 结果 下肢肿胀中静脉血栓，常因血管壁炎症反应，出现肢体疼痛，部分触痛；肢体肿胀血管性和非血管性因素，超声检查具有不同的声像图特征。 结论 彩色多普勒超声对于肢体肿胀的不同病因具有明确的诊断价值。

荧光素虹膜血管造影联合眼底血管造影在视网膜中央静脉阻塞中的操作方法及诊断价值分析

Risk factor analysis for neovascular glaucoma after vitrectomy in eyes with proliferative diabetic retinopathy

ObjectiveTo investigate the risk factors for neovascular glaucoma (NVG) after vitrectomy in proliferative diabetic retinopathy (PDR) patients. MethodsThree hundred and one patients (301 eyes) with PDR who underwent vitrectomy between January 2008 and December 2013 in our hospital were retrospectively evaluated. Risk factors for NVG after vitrectomy were identified by multivariate Logistic regression analysis. ResultsTwelve of 301 patients (4.0%) developed postoperative NVG in 2 to 18 months after vitrectomy. The incidence of postoperative NVG peaked in 2 to 6 months after vitrectomy (7 eyes, 58.3%). Logistic regression analysis showed that postoperative retinal detachment was a significant risk factor for postoperative NVG in eyes with PDR (P < 0.001). Eyes with postoperative retinal detachment were more likely to develop NVG after vitrectomy than those without postoperative retinal detachment (OR=17.826). Gender, age, duration of diabetes, preoperative serum creatinine levels, glycated hemoglobin levels, preoperative intraocular pressure, preoperative lens status, combined phacoemulsification surgery and tamponade were not associated with postoperative NVG (P > 0.05). ConclusionPostoperative retinal detachment is a major risk factor for NVG after vitrectomy in PDR.

慢性呼吸衰竭COPD 患者血清维生素E 及血管性血友病因子水平测定及意义

目的 探讨慢性呼吸衰竭COPD 患者血清维生素E( VE) 和血管性血友病因子( vWF)水平和临床意义。方法 荧光分光光度计测定50 例慢性呼吸衰竭COPD 患者的血清VE 水平, 免疫比浊法测定其血清vWF水平, 与20 例正常志愿者比较。结果 与正常对照组比较, 慢性呼吸衰竭的COPD 患者血清VE 水平显著降低[ ( 31. 79 ±11. 17) μmol /L 比( 68. 36 ±21. 03) μmol /L, P lt;0. 05] ,而血清vWF 水平明显增高[ ( 81. 79 ±21. 06) U/L比( 41. 98 ±11. 64) U/L, P lt;0. 05] 。结论 慢性呼吸衰竭COPD 患者血氧分压降低, 机体缺氧导致氧自由基清除能力降低, 对血管内皮细胞造成潜在损伤。

系统性红斑狼疮伴抗磷脂综合征致双眼视网膜血管炎及右眼新生血管性青光眼一例

Risk factors associated with neovascular glaucoma after vitrectomy in eyes with proliferative diabetic retinopathy

Objective To investigate the risk factors associated with neovascular glaucoma (NVG) after pars plana vitrectomy (PPV) in eyes with proliferative diabetic retinopathy (PDR). Methods Retrospective study. One hundred and thirty-seven patients (137 eyes) with PDR who underwent PPV were recruited. There were 85 males and 52 females. The average age was (60.1±8.8) years old. The duration of diabetes was (10.2±3.6) years. There were 49 patients with ipsilateral carotid artery stenosis. Fifty-three eyes underwent intravitreal ranibizumab or conbercept injection before PPV. All eyes were treated with 23G standard three-port PPV. The average follow-up time after PPV was 11.5 months. Fundus fluorescein angiography (FFA) was conducted in postoperative 4-6 weeks to observe non-perfused retinal areas. Risk factors, such as ipsilateral carotid artery stenosis, the presence of non-perfusion in retina after PPV and the application of anti-vascular endothelial growth factor (VEGF) drugs before PPV, were identified by logistic regression. Results Twenty of 137 patients (14.6%) developed postoperative NVG after PPV. Ipsilateral carotid artery stenosis [odds ratio (OR) =5.048, 95% confidence interval (CI) 2.057-12.389,P=0.000] and the presence of non-perfusion in retina after PPV (OR=4.274, 95%CI 1.426-12.809,P=0.009) were significant risk factors for postoperative NVG, while the application of anti-VEGF drugs was not (OR=1.426, 95%CI 0.463-4.395,P=0.536). But the time from PPV to the onset of NVG varies significantly between the two groups of injection of anti-VEGF drugs or not (t=−4.370,P=0.000). Conclusions Risk factors associated with NVG after PPV in eyes with PDR included ipsilateral carotid artery stenosis and the presence of non-perfusion in retina after PPV. The application of anti-VEGF drugs before PPV can delay the onset of NVG in PDR eyes after vitrectomy.

遗传性视网膜劈裂继发新生血管性青光眼一例

视网膜中央静脉阻塞并发新生血管性青光眼合并视网膜中央动脉阻塞一例

视网膜动脉阻塞继发新生血管性青光眼四例

Function of Three-point Scoring System for the Clock Drawing Test in Differentiating between Alzheimer’s Disease and Vascular dementia in China

【摘要】　目的　探讨3分法画钟测验（clock drawing test，CDT）对阿尔茨海默病患者（Alzheimer disease，AD）与血管性痴呆患者（vascular dementia，VD）的鉴别作用。　方法　收集四川大学华西医院神经内科门诊及住院部2009年9月-2010年6月就诊的认知功能障碍患者150例，进行病史采集及神经心理测试量表，筛选出AD患者57例及VD患者43例，共计纳入100例。在两者间进行CDT，分析两者间CDT有无差别、CDT与中文版简易智能量表（Chinese version of the mini-mental state examination，MMSE）及临床痴呆评定量表（clinical dementia rating scale，CDR）的相关性。　结果　AD患者及VD患者间CDT差异无统计学意义（Pgt;0.05）；CDT与MMSE及CDR有相关性，Spearman相关系数分别为0.573和-0.542（Plt;0.001）。　结论　3分法画钟测验无法准确区分AD和VD，但对粗略判断AD及VD程度可能有一定效果。【Abstract】　Objective　To investigate the differential function of the three-point scoring system for the clock drawing test (CDT) between Alzheimer’s disease (AD) and vascular dementia (VD). 　Methods　We analyzed the clinical data of 150 patients with cognitive impairment treated in the neurology and inpatient departments of our hospital from September 2009 to July 2010. Medical history of the subjects were collected. Through the assessment by neurological and psychological rating scale, we picked out 57 patients with AD and 43 with VD and tested them with CDT. The difference of CDT results between the two groups, and the correlation of CDT with Chinese version of the mini-mental state examination (MMSE) and clinical dementia rating scale (CDR) were analyzed.　Results　There was no statistical difference of CDT results between AD and VD patients (Pgt;0.005). CDT had a correlations with MMSE and CDR, the Spearman correlation coefficient being 0.573 and -0.542 respectively (Plt;0.001).　Conclusion　The three-point scoring system for the clock drawing test cannot differentiate exactly between Alzheimer Disease and Vascular Dementia, but it can make a gross judgment of the degree of AD and VD.