对94例慢性酒精中毒病人的临床分析

本文通过对９４例慢性酒精中毒病人的临床分析，发现酒中毒的病人中男性多于女性，低文化水平者高于高文化水平者。初次饮酒年龄１６－２５ａ，占６５．９６％，从初次饮酒到形成依赖的时间以１－３ａ，最多，占４５．７４％。酒中毒后出现多种躯体症状，肝功能异常步４７．８７％，性功能异常占４２．５５％，脑萎缩占２０．２１％，脑电图和末梢神经炎的发生率为１３．８３％；酒中毒后还可出现多种精神症状，平均每例有２．６种，     

酒精中毒性精神障碍104例临床分析

收治酒精中毒性精神障碍１０４例，男９２例８８．５％、女１２例１１．５％。饮酒史均在五年以上，每日饮酒量以０．６—２．５斤为多见，饮酒方式具有群体化，饮酒原因以夫妻不和、失恋、升学受挫最多，工作失意、经济困难次之、受酒广告误导而饮酒者８例。饮酒后出现各种不同程度的精神障碍和躯体症状及脑部形态学改变并形成酒依赖以饮酒史１０—２０年为最多，占６７％。表现酒和苯二氮类药物等多药依赖并存者１７例。女性在酒中毒人群中有明显增多趋势。应积极开展全民酒卫生教育，提高全民文化水平，加强正面酒广告引导，对酒依赖高危人群采取综合性预防措施。     

肺癌早期诊断的困难和改善方法思考

本文对一组经病证实的４８５例肺部的延误进行分析。提示自出现症状至初次就诊时间为１６－１６８天，平均８５天。初次就诊至本院首诊时间为３２－１６０天，平均８７城。误诊的病种达１３种之多。Ⅰ期病人仅占２．８９％，Ⅲ－Ⅳ期病人达７８．４％。作者分析了肺癌早期诊断的困难所在，并提出改善方法思考。     

纳洛酮治疗酒精、地西泮及氯氮卓急性中毒

纳洛酮０．４－１２ｍｇ加５０％葡萄糖４０ｍＬ，１次ｉｖ，抢救因饮酒（４０－６０度）１５０－１０００ｍＬ而致急性中毒２９例（男性１９例，女性１０例，年龄３２±ｓ２４ａ），其中２８例在给药后３０ｍｉｎ内清醒。抢救服地西泮、氯氮中毒９例（男性１例，女性８例，年龄４０±３２ａ），在给病人洗胃后，用纳洛酮０．８ｍｇ加５０％葡萄糖４０ｍＬｉｖ，每２ｈ１次，共２次，病人在用药后１－６ｈ内清醒。     

口服舒马曲坦治疗偏头痛83例

偏头痛患者８３例，男性１７例，女性６６例，年龄４０±ｓ９ａ，有１１９例次发作。口服舒马曲坦１００ｍｇ，４ｈ内显效率为７６．５％，好转率１３．４％，总有效率８９．９％。对偏头痛伴随症状恶心、呕吐和畏光、声的缓解率分别为９４％，９６％和９４％。出现较轻不良反应（１６％）。故舒马曲坦治疗偏头痛安全可行。     

胸腺切除治疗重症肌无力疗效观察

对３８例中老年各型重症肌无力患者（ＭＧ）行胸腺切除术治疗。病理结果显示，胸腺异常率为９４．７％（３６／３８），并发胸腺瘤占６５．８％（２５／３８），其中恶性胸腺瘤占胸腺瘤的６４．０％（１６／２５）。其他胸腺异常为２８．９％（１１／３８），正常胸腺２例，２８例中４７．４％（１８／３８）术后发生ＭＧ危象，以Ⅱｂ和Ⅲ型病例及合并有胸腺瘤者多见。围手术期病死率为１０．５％（４／３８）。术后随访３４例，症状     

口服舒马曲坦治疗偏头痛83例

偏头痛患８３例，男性１７例，女性６６例，年龄４０±ｓ９ａ，有１１９例次发作。口服舒马曲坦１００ｍｇ，４ｈ内显效率为７６．５％，好转率１３．４％，总有效率８９．９％。对偏头痛伴随症状恶心，哎吐和畏光、声的缓解率分别为９４％，９６％和９４％。出现较轻不良反应（１６％）。故舒马典坦治疗偏头痛安全可行。     

63例慢性酒精中毒性精神障碍的临床分析

为探讨大量长期饮酒对人体的危害，本文作者对６３例慢性酒精中毒性精神障碍的住院病例进行分析，发现从初次饮酒到出现精神症状平均年限１５．８±５．９年，所有病例均存在停酒后的戒断症状。对慢性酒精中毒性精神障碍病人的脑ＣＴ改变，肝脏损害进行讨论。     

小剂量卡托普利佑治急性病毒性心肌炎

急性病毒主肌炎病人４５例（男性２８例，女性１７例；年龄３５±ｓ７ａ），在传统治疗的基础上加服卡托普利６．２５－１２．５ｍｇ，ｐｏ，ｔｉｅｄ，４ｗｋ；与无加服卡托普利的４５例（男性２５例，女性２０例；年龄３３±８ａ）对照。症状改善方面，显效率和总有效率前为６９％和８９％，后４７％和６７％，均为Ｐ＜０．０５；ＥＣＧ改善方面，前为７５％和９３％，后４７％和６５％，均为Ｐ＜０．０１。     

肺癌早期诊断的困难和改善方法思考（附485例延误分析）

本文对一组经病理证实的４８５例肺癌的延误进行分析。提示自出现症状至初次就诊时间为１６～１６８天，平均８５天（病人延误）。初次就诊至到本院首诊时间为３２～１６０天，平均８７天（基层医生延误）。误诊的病种达１３种之多。１期病人仅占２．８９％，Ⅲ～Ⅳ期病人达７８．４％。作者分析了肺癌早期诊断的困难所在，并提出改善方法思考。     

维生素E在改善慢性酒精中毒性精神障碍中的作用

目的分析慢性酒精中毒性精神障碍发病的内在规律,寻找该类疾病的有效防治措施。方法分析笔者所在医院近10年来收治的152例慢性酒精中毒性精神障碍患者饮酒量、持续饮酒年限、酒品质量优劣、患者精神症状、躯体伴发疾病及维生素E辅助治疗等方面,找出规律加以统计分析。结果慢性酒精性精神障碍患者精神严重程度与饮酒年限、饮酒量及脑部并发症密切相关。饮酒年龄越早,一次性引入酒精量越多,合并高血压、糖尿病等并发症患者精神症状比其他类患者严重。戒酒期在大致同样的条件下,农村患者症状较城市患者更加严重,提示可能与酒质量有关。治疗中辅以维生素E抗氧化治疗,可显著提高治愈率及有效率。结论长期慢性酒精中毒会导致包括精神障碍在内的一系列精神及躯体性疾病。早期戒酒及维生素E辅助治疗会有效提高治愈率。     

慢性酒精中毒性精神障碍患者周围神经系统临床电生理研究

目的:探讨慢性酒精中毒性精神障碍患者周围神经系统的电生理改变。方法:对178例慢性酒精中毒性精神障碍患者进行电生理检查,观察肌电图(EMG)、运动神经传导速度(MCV)和感觉传导速度(SCV)的变化情况。结果:178例患者电生理检查结果提示有神经源性损害,上下肢EMG异常差异无显著性(P>0.05),SCV和MCV较对照组均有不同程度的减慢,而SCV的改变更加明显;SCV异常率为81.83%,且异常程度与饮酒年限呈正相关(P<0.05);28例双上肢无临床症状的患者中,12例尺神经MCV、SCV有改变。结论:慢性酒精中毒性精神障碍患者的周围神经有神经源性损害。     

Drinking course in alcohol-dependent men from adolescence to midlife

OBJECTIVE: Most studies of alcoholism course are based on clinical populations (characterized by severe and chronic alcohol-related problems) or community samples generally covering a short period of time. The current study assessed variations in drinking behaviors from adolescence to midlife in a community sample, describing age of "drinking firsts" (e.g., first alcoholic drink) as well as frequency and duration of periods of abstinence, alcohol dependence (AD) and nonproblem drinking. METHOD: Participants were 354 males with lifetime diagnoses of AD (mean age 50.35) from the Vietnam Era Twin Registry who were assessed regarding alcohol use, abuse and dependence histories (DSM-IV). Using a modified version of Skinner's Lifetime Drinking History, drinking history was reported in terms of distinct drinking periods (phases). RESULTS: Participants reported, on average, 4.18 phases, each lasting 8.22 years, and 12.78 years of AD. More than 60% experienced increases in AD symptoms at least once in successive phases, but only a third of those increases were extreme. In contrast, extreme decreases in AD symptoms were reported by more than 50% of participants. Further, half indicated that they had transitioned from both fewer to greater and from greater to fewer AD symptoms during their drinking years; 8.2% reported no changes in AD symptoms. CONCLUSIONS: Results reflect a wide variation in drinking behaviors among AD men as well as frequent fluctuations in course within individuals' drinking histories. Findings do not support a universal developmental model of alcoholism; notably, they provide counterevidence to the disease model concept of alcoholism course as progressive and chronic.     

慢性酒精中毒患者36例复饮状况分析

目的探讨和分析引发慢性酒精中毒患者复饮的各类因素,为解除慢性酒精中毒患者的心理依赖提供有效手段和依据。方法针对该院36例慢性酒精中毒患者的复饮状况,采用明尼苏达多项个性调查表(MMPI)和自制量表对其人格特征及社会心理因素进行测试分析。结果 F、Pd、Pa、Sc、Ma评分均显高分(>60分),K分较常模分低(<45分),提示被测试者存在较严重的心理偏离现象,人格改变明显,处于精神病状态和偏执模式。结论慢性酒精中毒者存在较严重的心理卫生问题,其复饮与心理素质、人格特征缺陷、社会心理因素有直接关联。建立健全完善稳固的医疗、家庭、社会综合康复体系,将是有效解除患者心理依赖,防止和减少复发、复饮的关键。     

Drinking patterns and beverage preferences of liver cirrhosis patients in Mexico

The purpose of this study was to investigate the pattern of alcoholism in a special group of alcoholics (alcoholic cirrhotics) in a hospital-based population in west central Mexico and assess the role of regional spirits such as tequila. A complete alcohol drinking history and a structured questionnaire directed at investigating the pattern of alcohol consumption was applied to 124 adult patients with chronic liver disease caused by alcohol during January 1995 to January 1996. The mean age of onset was 27 +/- 3 years in women and 18 +/- 0.5 years in men. The mean alcohol intake per week was 749 +/- 192 g for women and 1113 +/- 151 g for men. On average, patients consumed alcohol for a mean of 24.5 years. The overall patient drinking preference was for tequila followed by 96 degree Gay Lusac (G.L.), alcohol, and beer. In a subset of 70 patients three phases of alcoholism could be identified (prealcoholic, critical, and chronic). Each phase had a mean duration of at least 11 years. Beer was the dominant beverage in the prealcoholic phase while tequila was consumed more often in the other phases. In the critical phase of alcoholism an average of 337 g of alcohol were consumed per week and in the chronic phase 1765 g/week. Tequila was the overall preferred beverage in this group of alcoholics. Other beverages included beer and straight alcohol with a clear trend from less to higher concentration of alcohol throughout the drinking history. Subtle gender differences in the patterns of alcoholism may be suspected. In this group of patients the role of tequila drinking is highlighted.     

Control of alcohol addiction by SKV therapy--its action on water, food intake, brain function and cell membrane composition

Alcohol being easily permeable through cell membrane causes toxic damage to many tissues. Rats drinking aqueous ethanol (25% v/v) for 120 days and 240 days showed an initial rise in body weight. The reduced rate in weight gain in chronic alcoholism is associated with a fall in food intake. Ethanol ingesting animals showed slow response to stimuli and increase in blood ethanol and serum GGTP levels. Liver plasma membrane, kidney brush-border membrane and pancreatic plasma membrane from alcoholic rats showed significant alterations in cholesterol/phospholipid molar ratio and membrane ATPases. Water retention with the enlargement of liver and kidney associated with increased fluid consumption are also seen during alcoholism. SKV by breaking alcohol dependence reduces drinking, lowers blood ethanol level and fluid intake without developing withdrawal symptoms. Restriction of ethanol intake by SKV therapy resulted in the reversal of organ enlargement and membrane composition in alcoholics.     

Familial alcoholism and problem drinking in a national drinking practices survey

This study examined the prevalence of alcoholism and problem drinking among the first degree relatives of respondents in a national survey. A stratified area-probability sample of adults 18 years of age or older living in households in the U.S. was used for this analysis. Data were collected on familial alcoholism/problem drinking as well as the prevalence of alcohol problems and depressive symptoms of the respondents themselves. Overall, women reported more alcoholic/problem drinking first degree relatives than men. This relationship was emhanced for women with alcohol problems alone or in conjunction with depressive symptoms. However, rates of reported familial alcoholism/problem drinking among men and women who had depressive symptoms only were quite similar. The implications of these findings are discussed.     

165例酒精中毒所致精神障碍住院病人的流行病学分析

目的:探讨酒依赖及酒精中毒伴发精神障碍的流行病学、临床表现特点、躯体损害及转归。方法:对1995年、2005年北京市三家三级以上精神病专科医院诊断为酒精所致精神障碍/酒相关障碍的病历档案进行回顾性抽样调查分析。结果:三家医院共收集1995年和2005年的酒精所致精神障碍患者165例,男女比例为38∶1。发病年龄为44.5 a±s9.4 a,以依赖综合症和戒断症状出现最多,躯体疾病以肝损害及心血管系统疾病出现最多。两年病例的职业分布有显著不同;入院前平均日饮酒(白酒)量越大,发病率越高(χ2=6.597,P<0.05)。经住院治疗67.3%的病例好转,26.7%的病例痊愈。结论:酒中毒及导致的精神障碍已是一个日趋严重的社会问题,酒的过度滥用极易对人的心身健康造成严重损害,及早干预并制定有关防治措施和法规势在必行。     

Older adult controlled drinkers and abstainers

Little is known about the lifetime course of alcohol problems, especially during late adulthood. Many individuals with a history of alcohol problems achieve remission of their symptoms through abstinence or controlled drinking. This study examined 135 older adults with a prior history of alcohol diagnoses who were symptom free for at least the past year. Two groups were identified based on their alcohol consumption within the past year: abstinent individuals (n = 92) and controlled drinkers (n = 43). The groups did not differ in age, racial composition, education, income, or years since their last alcohol-related symptom, but they did differ in gender composition, indices of alcoholism severity, history of formal and informal treatment, as well as lifetime alcohol consumption patterns. Abstinent individuals had more severe alcohol problems, consumed higher amounts of alcohol on drinking days, had more years of heavy alcohol consumption, and were more likely to have attended alcohol treatment and Alcoholics Anonymous (AA). The controlled drinkers had a longer history of moderate social drinking, and their current consumption habits appeared to be similar to symptom-free older adult drinkers. The results suggest that gender, alcoholism severity, history of formal and informal treatment, and past consumption patterns are associated with whether older adults with histories of alcoholism attain successful outcomes through abstinence or controlled drinking.     

DRINKING PATTERNS AND BEVERAGE PREFERENCES OF LIVER CIRRHOSIS PATIENTS IN MEXICO

The purpose of this study was to investigate the pattern of alcoholism in a special group of alcoholics (alcoholic cirrhotics) in a hospital-based population in west central México and assess the role of regional spirits such as tequila. A complete alcohol drinking history and a structured questionnaire directed at investigating the pattern of alcohol consumption was applied to124 adult patients with chronic liver disease caused by alcohol during January1995 to January 1996.

The mean age of onset was 27 ± 3 years in women and 18 ± 0.5 years in men. The mean alcohol intake per week was 749 ± 192g for women and 1113 ± 151g for men. On average, patients consumed alcohol for a mean of 24.5 years. The overall patient drinking preference was for tequila followed by 96° Gay Lusac (G.L.), alcohol, and beer. In a subset of 70 patients three phases of alcoholism could be identified (prealcoholic, critical, and chronic). Each phase had a mean duration of at least 11 years.Beer was the dominant beverage in the prealcoholic phase while tequila was consumed more often in the other phases. In the critical phase of alcoholism an average of 337g of alcohol were consumed per week and in the chronic phase1765g/week.

Tequila was the overall preferred beverage in this group of alcoholics.Other beverages included beer and straight alcohol with a clear trend from less to higher concentration of alcohol throughout the drinking history. Subtle gender differences in the patterns of alcoholism may be suspected. In this group of patients the role of tequila drinking is highlighted.