精神分裂症神经系统软体征及其相关因素的研究

目的 搪塞精神分裂症神经系统软体征的发生率及其与临床关系。方法 入院时对符合入组标准的精神分裂症患者进行ＢＰＲＳ评分及了２项软件体征检查。于疗后１月、２月时各进行一镒ＢＰＲＳ评分及国欠体征检查。结果 精神分裂症神经系统软体征发生率为６８％;与文化程度、起病急缓、病期主分型无关,而家族史阳性及病情较重者神经系统软体征发生率显著增高。软体征出现平均项数,随主病情改善也显著减少。结论神经系统软体征的研究     

长期使用抗精神病药患者血清游离脂肪酸水平与有关因素研究

目的:探讨长期(1年以上)使用抗精神病药患者的血清游离脂肪酸(FFAs)水平,及其与空腹血糖和胰岛素抵抗之间的关系. 方法:调查308例长期使用抗精神病药住院患者,用比色法检测患者空腹血清FFAs,用放射免疫法测定患者血清胰岛素和瘦素. 结果:与长期使用抗精神病药有关的体质量(体重)增加或肥胖、糖耐量降低和糖尿病患者的血清FFAs水平显著高于对照组(P值分别为0.04, 0.01和0.022),且与空腹血糖、胰岛素抵抗均呈显著正相关(P值分别为0.005和0.04). 结论:长期使用抗精神病药的精神分裂症患者的高血清FFAs水平影响患者的糖代谢,并参与胰岛素抵抗乃至糖尿病的发生,是代谢紊乱综合征的重要特征之一.     

脑源性神经营养因子Val66Met功能基因多态性与环境因素对抗抑郁剂临床疗效的影响

Objective To explore the effect of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism,environmental factor and their interactions on antidepressant treatment.Methods 340 patients of major depressive disorder (MDD) who met the diagnosis criteria of MDD ( DSM-Ⅳ Axis Ⅰ) were recruited.280 patients of them were finished 12 weeks antidepressant treatment.The severity of depression was measured with the Hamilton Depression Rating Scale (HDRS) before and after 12 weeks antidepressant treatment.Childhood Trauma Questionnaire,28-item Short Form (CTQ-SF) and Life Events Scale (LES) were used to evaluate childhood adverse and life stress before onset.Genotyping of BDNF Val66Met polymorphism was detected by Illumina GoldenGate assays.Results Male patients proportion were significantly higher in non-remitters than remitters (P =0.008 ).After adjusting by gender, the frequencies of genotype and allele for the BDNF Val66Met polymorphism were no significant difference between remitters (AA: AG: GG = 28: 79: 40, A:G = 135:159 ) and non-remitters (AA: AG: GG = 29:81:23 ,A: G = 139:127 ) (P ＞0.05 ).There was no significant difference of CTQ scores and LES scores between the two groups (P＞0.05 ).The regression analysis showed that social intercourse problem and age were the risk factor for the severity of depression.The gender, HDRS baseline scores and mental disorder family history were associated with the efficacy of 12 weeks antidepressant.However,there was no significantly relationship between the interaction of BDNF Val66Met polymorphism and environment with the antidepressant treatment.Conclusion The older men with the mental disorder family history, severe depression symptom would be less-response to antidepressant treatment.However, BDNF Val66Met polymorphism, childhood trauma, life events stress and the interaction of BDNF Val66Met polymorphism and environment have no significantly effect on the 12 weeks antidepressant treatment.     

血清瘦素与抗精神病药源性肥胖及糖尿病的相关性研究

目的　调查和探讨长期使用抗精神病药患者血瘦素水平及其与服用抗精神病药后体重 增加、肥胖及糖尿病之间的关系。方法　对符合入组标准的308例长期服用抗精神病药的精神分裂症 患者分为对照组、肥胖组、糖耐量减低组及糖尿病组,比较血清瘦素水平、胰岛素抵抗指数、血清甘油三 酯及总胆固醇水平。结果　(1)肥胖组、糖耐量减低组及糖尿病组患者的血清瘦素水平、胰岛素抵抗指 数、血清甘油三酯及总胆固醇水平均显著高于对照组(P<0.05)。(2)长期应用抗精神病药患者血瘦 素水平与体重指数、简易胰岛素抵抗指数、空腹血糖、血甘油三酯及胆固醇均呈极显著正相关(P<0.01 ～0.0001),而与餐后2h血糖水平及用药时间无相关性。结论　长期应用抗精神病药患者血瘦素水 平在肥胖、糖耐量降低及糖尿病患者中显著升高,且与体重指数、简易胰岛素抵抗指数、空腹血糖水平等 均呈显著正相关,提示高血清瘦素水平是长期应用抗精神病药所致的代谢紊乱综合征的重要指征之一。     

社会支持对抑郁症病人生活质量的影响

抑郁症是一种常见的精神疾患,据世界卫生组织(WHO)2001 年的健康报告,预计到2020年将成为全球第二大疾病负担源,又被称为"心理杀手",严重影响病人的生活质量.目前临床上对抑郁症病人生活质量状况尤其是社会支持状况及二者之间的相关性研究报道不多.故对33例抑郁症病人的社会支持及生活质量状况进行调查,并探讨二者之间的关系,为病人提供恰当的护理措施,以提高抑郁症病人的生活质量.现将研究结果报道如下.     

心理护理结合生物反馈治疗在焦虑症康复中的疗效观察

目的：比较与探讨心理护理结合生物反馈治疗与单纯生物反馈治疗两种方法在促进焦虑症患者康复中的效果。方法将入组的焦虑症患者按随机分组法分为心理护理结合生物反馈治疗观察组(30例)和单纯生物反馈治疗对照组(30例),观察6周,分别于治疗前及治疗后第2、6周采用汉密顿焦虑量表( HAMA)评定两组临床疗效。结果观察组治疗后第2、6周末HAMA评分均较治疗前显著下降( P<0.01),而对照组治疗6周末差异有显著性( P<0.01);治疗6周末两组间评分差异无显著性( P>0.05)。结论两组方法治疗焦虑症均有显著疗效,心理护理结合生物反馈治疗对近期焦虑情绪的改善效果明显优于单纯生物反馈治疗,减轻了患者的躯体化症状,增强了疗效。     

脑源性神经营养因子Val66Met功能基因多态性与环境因素对抗抑郁剂临床疗效的影响

Objective To explore the effect of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism,environmental factor and their interactions on antidepressant treatment.Methods 340 patients of major depressive disorder (MDD) who met the diagnosis criteria of MDD ( DSM-Ⅳ Axis Ⅰ) were recruited.280 patients of them were finished 12 weeks antidepressant treatment.The severity of depression was measured with the Hamilton Depression Rating Scale (HDRS) before and after 12 weeks antidepressant treatment.Childhood Trauma Questionnaire,28-item Short Form (CTQ-SF) and Life Events Scale (LES) were used to evaluate childhood adverse and life stress before onset.Genotyping of BDNF Val66Met polymorphism was detected by Illumina GoldenGate assays.Results Male patients proportion were significantly higher in non-remitters than remitters (P =0.008 ).After adjusting by gender, the frequencies of genotype and allele for the BDNF Val66Met polymorphism were no significant difference between remitters (AA: AG: GG = 28: 79: 40, A:G = 135:159 ) and non-remitters (AA: AG: GG = 29:81:23 ,A: G = 139:127 ) (P ＞0.05 ).There was no significant difference of CTQ scores and LES scores between the two groups (P＞0.05 ).The regression analysis showed that social intercourse problem and age were the risk factor for the severity of depression.The gender, HDRS baseline scores and mental disorder family history were associated with the efficacy of 12 weeks antidepressant.However,there was no significantly relationship between the interaction of BDNF Val66Met polymorphism and environment with the antidepressant treatment.Conclusion The older men with the mental disorder family history, severe depression symptom would be less-response to antidepressant treatment.However, BDNF Val66Met polymorphism, childhood trauma, life events stress and the interaction of BDNF Val66Met polymorphism and environment have no significantly effect on the 12 weeks antidepressant treatment.     

氯氮平罕见副反应临床分析(附6例报告)

氯氮平是一疗效很好的并被广泛应用的非经典抗精神病药,但如应用不慎,则会带来各种各样副反应,有的甚至危及生命。笔者通过所遇几例氯氮平罕见副反应,从中汲取一定教训:1、首发病人及首次应用者,均应从小剂量开始,万勿因病人行为乱或急于控制病人而从较大剂量开始。2、应遵循缓慢加药原则。3、氯氮平疗效并非与剂量成正比。4、详细了解病史及入院前在家服药剂量、应用时间等对住院继续治疗提供参考至关重要。5、锂盐与氯氮平合用,并不能减少氯氮平致粒细胞缺乏的危险性。6、撤药应缓慢。7、要依据药物作用谱、副作用选用药物。     

精神分裂症神经系统软体征与临床、治疗初探

精神分裂症神经系统软体征与临床、治疗初探王从杰，柯士凤，稽利亚神经系统软体征（ＳＯｆｔＳｉｇｆｌ以下缩写ｊｊＳＳ）作为检查脑损害的敏感指标之一，多年来受到广泛注意。有关该研究国外报道较多，而国内报道较少。本文就神经系统软体征在精神分裂症患者中的发生率...     

脑血管科患者医院感染目标性监测结果的分析

目的 目标性监测脑血管科医院感染情况,了解医院感染的特点及相关危险因素,以便采取相应的干预措施,有利于预防和控制医院感染的发生.方法 制定目标监测方案,对2009年4月-2010年3月住脑血管科＞48 h的患者进行前瞻性监测.结果 住院患者505例,医院感染率为2.18％,例次感染率为3.17％;比未开展目标监测前同期脑血管科平均医院感染率的3.80％相比明显下降.结论 通过目标性监测,及时分析脑血管科医院感染的动态,采取相应的干预措施,有效降低了医院感染发生率.