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。
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)
ObjectiveTo explore the correlation between -765G/C polymorphism of cyclooxygenase-2 (COX-2) gene and the risk of ischemic stroke (IS). MethodsPubMed, CBM, The Cochrane Library (Issue 3, 2015), CNKI, CBM, VIP and WanFang Data were searched from inception to March 2015 to collect case-control or nested case-control studies about -765G/C polymorphism of COX-2 gene and the risk of IS. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.1 software and Stata 12.0 software. ResultsA total of 10 studies involving 2611 cases and 18589 controls were included. The results of meta-analysis showed that, there was no correlation between -765G/C polymorphism and the risk of IS (GC+CC vs. GG: OR=1.05, 95%CI 0.88 to 1.25, P=0.620; CC vs. GG+GC: OR=1.04, 95%CI 0.83 to 1.30, P=0.730; GC vs. GG: OR=1.04, 95%CI 0.87 to 1.25, P=0.630; CC vs. GG: OR=1.09, 95%CI 0.86 to 1.36, P=0.480; C vs. G: OR=1.03, 95%CI 0.89 to 1.20, P=0.700). Subgroup analysis results showed that, the COX-2 gene -765G/C polymorphism was a risk factor for IS in African-Americans (GC+CC vs. GG: OR=1.42, 95%CI 1.12 to 1.78, P=0.003; GC vs. GG: OR=1.39, 95%CI 1.09 to 1.78, P=0.008; CC vs. GG: OR=1.51, 95%CI 1.04 to 2.18, P=0.030; C vs. G: OR=1.27, 95%CI 1.08 to 1.51, P=0.004), but not in Asians and Caucasians. ConclusionCurrent evidence shows that -765G/C polymorphism of COX-2 gene may be a genetic risk factor for IS in African-Americans, but not in Asians and Caucasians. Due to the limited quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.
目的 观察局灶性脑缺血梗死区周围层粘连蛋白（Laminin）及基质金属蛋白酶（MMP）-9表达，探讨其在脑缺血再灌注损伤发病机制中的作用。 方法 将45只体重250～300 g、4个月龄的Sprague Dawley（SD）雄性大鼠随机分为假手术（Sham）组与局灶性缺血再灌注（MCAO）组。MCAO组又分6、24、72 h及7 d组，每组各9只。光学显微镜下观察脑组织病理改变，免疫组织化学染色检测各组Laminin及MMP-9的表达情况。 结果 再灌注后6 h，即有MMP-9表达明显增高，表达高峰出现在再灌注后24 h，3 d时有所下降，至7 d时仍明显高于基础水平（P＜0.01）。Laminin的表达于再灌注6 h开始降低，24 h降至最低，3 d后开始缓慢回升。 结论 脑缺血再灌注后，病变区MMP-9与Laminin表达变化可反映脑血管壁受损状况，并与脑缺血损伤及修复过程有关。
Objective To systematically evaluate the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke. Methods Databases including PubMed, EMbase, BIOSIS and CNKI were electronically searched from establishment dates of databases to June 2012 to retrieve animal experiments on the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke. The relevant studies were identified according to the predefined inclusion and exclusion criteria, the data were extracted, and the quality was evaluated. Then meta-analysis was performed using RevMan 5.1 software. Results Eight studies were included. The results of meta-analysis showed that no significant difference was found between the alcohol intervention group and the control group (MD=−6.98%, 95%CI −20.38% to 6.43%, P=0.31). However, compared with the control group, low dose of acute alcohol intervention (less than 2 g/kg) improved the prognosis of ischemic stroke with a significant difference (MD=−22.83%, 95%CI −38.77% to −6.89%, P=0.005), and highly-concentrated of chronic alcohol intervention worsened the cerebral ischemic damage of rats and mice with a significant difference (MD=24.06%, 95%CI 10.54% to 37.58%, P=0.000 5). Conclusion Low dose of acute alcohol intervention (less than 2 g/kg) could improve the prognosis of rats and mice with ischemic stroke which has the potential neuro-protective effects. However, highly-concentrated chronic alcohol intervention could worsen the cerebral ischemic damage. Due to the limitations of the included studies such as publication bias, the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke could be overestimated.
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.