Research Progress in the Treatment of Poststroke Depression with Traditional Chinese Medicine

In recent years,the incidence rate of stroke has increased year by year.Post stroke depres‐sion is one of its main complications,which seriously affects the recovery of physiological functions and quality of life of stroke patients.Traditional Chinese medicine has signifi‐cant therapeutic effects in treating this disease.This article provides a classification and review of traditional Chinese medicine treatment methods for post-stroke depression,and looks forward to the current problems.

Effects of Progressive Muscle Relaxation Training Combined with Emotion Nursing of Traditional Chinese Medicine on Motor Function and Quality of Life in Patients with Cerebral Stroke Complicated with Hemiplegia

OBJECTIVE: To explore the effects of progressive muscle relaxation training combined with emotion nursing of traditional Chinese medicine(TCM) on the motor function and quality of life in patients with cerebral stroke complicated with hemiplegia. METHODS: A total of 100 cases of patients with cerebral stroke complicated with hemiplegia who were admitted to Rehabilitation Medicine Department of Suzhou Municipal Hospital from May 2016 to May 2017 were selected and randomly divided into study group(50 cases) and control group(50 cases), and they were nursed for 1 month. Control group was given routine nursing, and study group was given progressive muscle relaxation training combined with TCM emotion nursing on the basis of routine nursing. The scores of all items were obtained by nurses through questionnaires, and the motor function and quality of life were analyzed and compared between the 2 groups. RESULTS: After nursing, the scores of muscle strength, Barthel index(BI) and Fugl-Meyer motor function scales in study group were higher than those in control group(P < 0.05). The facing scores of coping style in study group were higher than those in control group, and the avoidance score and yielding score were lower than those in control group(P < 0.05). The scores of depression and anxiety in study group were lower than those in control group(P < 0.05). The scores of items in SF-36 life scale in study group were higher than those in control group(P < 0.05). CONCLUSION: Progressive muscle relaxation training combined with TCM emotion nursing is conducive to the recovery of motor function and improvement of quality of life in patients with cerebral stroke complicated with hemiplegia.

Advances in the application of optical coherence tomography in the assessment of ischemic stroke

Ischemic stroke has high morbidity,mortality,disability rate and recurrence.It is the one of the main diseases that threaten people's health in China.Its etiology,pathogenesis,and reaction mechanism has been the research hotspot and difficulty of related studies have shown that the optical coherence tomography technology is an effective measure to evaluate ischemic cerebral apoplexy.Optical coherence tomography(OCT)is a gradually developed and mature imaging technology in recent years,and there are related studies on internal carotid artery,retina and coronary artery.Based on the above background,this paper reviews the research progress of optical coherence tomography in the assessment of the etiology,pathogenesis and response mechanism of ischemic stroke.

CZL-80,a novel caspase-1 inhibitor,pro⁃motes functional recovery after progressive ischemic stroke

OBJECTIVE Progressive isch⁃emic stroke is characterized by aggravation of neurological dysfunction and poor prognosis.Neuroinflammation is involved in the pathological process of cerebral ischemia.Inflammasomes-activated caspase-1 has thus been considered a promising target for stroke therapy.However,it remains not fully understood how caspase-1 ag⁃gravates progressive functional impairment.We previously identified a novel caspase-1 inhibitor CZL-80,the present study is to explore whether CZL-80 protects against progressive ischemic stroke.METHODS Male C57/BL6 mice and cas⁃pase-1-/-mice were subjected to photothrombotic(PT)-induced cerebral ischemia.CZL-80 was in⁃traperitoneally injected daily during 1-7 d,1-4 d,4-7 d after PT.The grid-walking task and the cyl⁃inder task were used to determine the motor function.RESULTS Mice developed primary and the secondary neurological dysfunction at 1 d and 4-7 d after PT onset.The activation of cas⁃pase-1 peaked at 7 d after ischemic stroke and caspase-1 was mainly derived from activated microglia.Treatment with CZL-80(30 mg·kg-1)during 1-7 d significantly improved motor func⁃tion.Administration of CZL-80 during 1-4 d could not ameliorate motor function loss while administration during 4-7 d after PT onset signifi⁃cantly reduced foot faults and forelimb symme⁃try.Remarkably,treatment with CZL-80 during 4-7 d showed no significant difference in efficacy compared with the its administration during 1-7 d,which indicated a key therapeutic window.More⁃over,the neuroprotective effect of CZL-80 during 4-7 d was available at least until 43 d after isch⁃emic stroke,indicating CZL-80 can improve the long-term neurological function after cerebral ischemia.Furthermore,administration of CZL-80(30 mg·kg-1)during 4-7 d after PT onset in cas⁃pase-1-/-mice failed to improve the motor func⁃tion,which suggested that the neuroprotective effect of CZL-80 was caspase-1-dependent.The results showed that CZL-80 did not inhibit the expression of GSDMD and failed to reduce neu⁃ronal loss after ischemia.These results indicated the effect of CZL-80 was not attributable to inhib⁃it pyroptosis.We further found that CZL-80 signif⁃icantly reduced the number of activated microglia in the peri-infarct brain cortex after ischemic stroke,which might be involved in its neuropro⁃tective effect.CONCLUSION CZL-80,a novel caspase-1 inhibitor,improved motor function after progressive ischemic stroke in mice.The effective therapeutic window of CZL-80 would be 4-7 d after ischemia,when the secondary neuro⁃logical dysfunction occurred.Therefore,the inter⁃vention by targeting caspase-1 in this window phase provides a novel strategy for the function⁃al recovery of stroke survivors.

Research Advances in Acupuncture in the Acute Phase of Ischemic Stroke

In recent years,the incidence of ischemic stroke has been increasing.Patients are prone to many complications after half a year of onset or has slow recovery of neuromotor function of one limb on one side of hemiplegia.The clinical effect of acupuncture in treating this disease is remarkable.According to research,acupuncture combined with medication and rehabilitation can reduce the degree of nerve defects in the early stage of the disease,improve daily life,and improve prognosis.This article summarizes the research on acupuncture in the treatment of acute ischemic stroke for future reference.

Wnt/β-catenin信号通路参与脑缺血后神经血管单元调控及相关药物的研究进展

Wnt信号通路广泛存在于各种生物中,参与调控细胞增殖、分化、凋亡等多种生理病理过程。近年来的研究发现,Wnt/β-catenin信号通路在缺血性脑中风神经血管单元保护中可能发挥重要调控作用。舒林酸、雌二醇等化药,红景天等含苷类成分的中药,姜黄等含挥发油的中药以及丹龙醒脑方等复方可通过调控该通路发挥神经血管保护作用。该文拟对近年来Wnt/β-catenin信号通路在缺血性脑中风后神经血管单元保护中的调节作用等相关研究进展以及目前通过调控该信号通路发挥神经血管保护作用的化学药及中药予以综述,以期为缺血性脑中风的药物改善机制提供方法学基础,同时为研究降低中风后遗症致残率新药提供思路。

Systematic review of risk factors for progressive ischemic stroke

OBJECTIVE： To determine the risk factors for progressive ischemic stroke, and to prevent onset and make a prognosis of disease, the present study systemically evaluated 19 cohort studies and 10 case-controlled studies of progressive ischemic stroke. SEARCH STRATEGY： A computer-based, online, literature search of PubMed （1966/2007）, China Biological Medicine Database （CBM-disc, 1979/2007） and CNKI （www.cnki.net, 1979/2007） was performed to screen for related studies. DATA SELECTION： Cohort or case-controlled studies that focused on risk factors of progressive ischemic stroke were selected for review. Two reviewers independently extracted data and assessed study quality according to Cochrane Collaboration guidelines. Statistical analysis was performed using RevMan software. MAIN OUTCOME MEASUREMENT： Risk factors for progressive ischemic stroke. RESULTS： Using the inclusion criteria, 29/781 studies published in English and Chinese were initially reviewed, including 19 cohort studies and 10 case-control studies. Despite variations in determination of progressive ischemic stroke and the intervals between 2 evaluations, all studies described the diagnostic criteria for progressive ischemic stroke. Logistic analysis was employed in 20 of the studies. Meta-analysis of primary data in the related studies determined that the following factors that significantly correlated with progressive ischemic stroke： fever [risk ratio （RR） = 2.26, 95% confidence interval （CO： 1.20-4.26, P = 0.01; odds ratio （OR） = 2.85, 95% CI： 1.64-4.98, P 〈 0.01 ）]; diabetes （RR = 1.38, 95% CI： 1.18-1.61, P 〈 0.01 ; OR = 2.48, 95% Ch 1.93-3.19, P 〈 0.01 ）; coronary heart disease （RR = 1.22, 95% CI： 1.08-1.38, P 〈 0.01）; neuroimaging transformation （RR= 1.55, 95%CI： 1.34-1.80, P〈 0.01; OR= 2.29, 95% CI： 1.47-3.58, P〈 0.01）; and hyperglycemia （RR = 2.62, 95% CI： 1.86-3.68, P 〈 0.01 ; OR = 3.49, 95% CI： 1.92-6.35, P 〈 0.01）. CONCLUSION： Fever, diabetes, coronary heart disease, neuroimaging transformation, and hyperglycemia are important risk factors for progressive ischemic stroke. Interventions for these risk factors could effectively prevent occurrence of progressive ischemic stroke.

Risk factors for progressive ischemic stroke: A retrospective analysis

BACKGROUND： Progressive ischemic stroke has higher fatality rate and disability rate than common cerebral infarction, thus it is very significant to investigate the early predicting factors related to the occurrence of progressive ischemic stroke, the potential pathological mechanism and the risk factors of early intervention for preventing the occurrence of progressive ischemic stroke and ameliorating its outcome. OBJECTIVE： To analyze the possible related risk factors in patients with progressive ishcemic stroke, so as to provide reference for the prevention and treatment of progressive ishcemic stroke. DESIGN： A retrospective analysis. SETTING： Department of Neurology, General Hospital of Beijing Coal Mining Group. PARTICIPANTS： Totally 280 patients with progressive ischemic stroke were selected from the Department of Neurology, General Hospital of Beijing Coal Mining Group from March 2002 to June 2006, including 192 males and 88 females, with a mean age of （62±7） years old. They were all accorded with the diagnostic standards for cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995, and confired by CT or MRI, admitted within 24 hours after attack, and the neurological defect progressed gradually or aggravated in gradients within 72 hours after attack, and the aggravation of neurological defect was defined as the neurological deficit score decreased by more than 2 points. Meanwhile, 200 inpatients with non-progressive ischemic stroke （135 males and 65 females） were selected as the control group. METHODS： After admission, a univariate analysis of variance was conducted using the factors of blood pressure, history of diabetes mellitus, fever, leukocytosis, levels of blood lipids, fibrinogen, blood glucose and plasma homocysteine, cerebral arterial stenosis, and CT symptoms of early infarction, and the significant factors were involved in the multivariate non-conditional Logistic regression analysis. MAIN OUTCOME MEASURES： Results of the univariate analysis of variance of the factors related to progressive ischemic stroke; Results of the multivariate regression analysis. RESULTS： All the 480 patients were involved in the analysis of results. ① Results of the univariate analysis variance： There were significantly more patients with fever, leukocytosis, history of diabetes mellitus, cerebral arterial stenosis and CT symptoms of early infarction in the progressive ischemic stroke group than in the control group （P 〈 0.01）; The levels of blood glucose and fibrinogen in the progressive ischemic stroke group were significantly higher than those in the control group, while the level of blood pressure was significantly lower than that in the control group （P 〈 0.05 - 0.01）. ② Results of the multivariate Logistic regression analysis： The independent predicting factors for progressive ischemic stroke were history of diabetes mellitus, fever, leukocytosis, cerebral arterial stenosis, CT symptoms of early infarction, blood glucose and blood pressure （OR =2.61,2.96, 3.79, 1.03, 3.57, 2.68, 95% CI 0.92 - 3.59, P 〈 0.05 - 0.01）. CONCLUSION： History of diabetes mellitus, fever, leukocytosis, levels of blood pressure, blood glucose, cerebral arterial stenosis and CT symptoms of early infarction are the risk factors for progress ischemic stroke

氯吡格雷治疗对SIP患者恢复期颈部血管狭窄度、血浆纤维蛋白原变化影响

目的研究氯吡格雷治疗对进展性缺血性脑卒中(stroke in progression,SIP)患者恢复期颈部血管狭窄度、血浆纤维蛋白原(fibrinogen,FIB)变化影响。方法选取2014年3月到2015年3月收治的SIP患者80例,按照随机数字表法将患者分为研究组和对照组,每组40例,对照组给予常规治疗,研究组在常规治疗的基础上给予氯吡格雷,应用颈动脉彩色多普勒评价颈部血管狭窄度,应用美国国立卫生研究院卒中量表(NIHSS)和日常生活能力评分(ADL)评价患者神经功能和生活能力,测量2组FIB和超敏C反应蛋白(hs-CRP)水平,比较2组不良反应情况。结果治疗前2组颈总动脉、颈内动脉、颈外动脉内径宽度比较,差异无统计学意义,治疗后2组颈总动脉、颈内动脉、颈外动脉内径宽度均显著增加,且研究组宽于对照组(P<0.05);治疗前2组NIHSS评分和ADL评分比较无统计学意义,治疗后2组NIHSS评分和ADL评分均显著改善,且研究组优于对照组(P<0.05);2组治疗前FIB和hs-CRP比较,差异无统计学意义,治疗后2组FIB和hs-CRP水平显著降低,研究组显著低于对照组(P<0.05);2组不良反应比较,差异无统计学意义。结论氯吡格雷治疗SIP患者恢复期能显著改善患者神经功能,改善颈部血管狭窄度,降低FIB水平。

全球V2X技术进展概述——第5届SIP-adus大会(SIP-adus Workshop 2018)车联网综述

SIP-adus Workshop是自动驾驶领域代表世界先进水平的大会,由日本跨部委战略革新促进计划SIP自动驾驶系统推进委员会和日本内阁府科学技术创新会议共同主办,其内容体现了自动驾驶以及相关领域的理论、技术及应用的最新进展。首先本文对第5届SIP-adus大会(SIP-adus Workshop 2018)概况进行了描述,其次通过对大会录用论文进行分析,探讨了当前学界和产业界在自动驾驶及相关领域方面的核心技术(区域活动与现场运行试验(FOT)、动态地图、网联汽车、网络安全、影响评估、下一代运输、人为因素)上的研究热点,并阐述上述理论及技术的应用情况。最后,总结V2X理论研究和应用的特点,并展望未来发展趋势。

分层递进式教学在国家卒中血管超声示范中心培训中的应用

目的探索分层递进式教学模式在血管超声专业对进修医师的培训效果。方法纳入2021年1月—2023年3月于首都医科大学宣武医院血管超声科进修的医师124人,根据入科时医师对血管超声和TCD技术的掌握水平进行分层,分为单技术组和颈-脑一体化技术组,采用分层递进式教学模式培训满6个月后,进行理论及实践考核。结果单技术组及颈-脑一体化技术组在入科时理论考核成绩和上机操作考核成绩差异无统计学意义。通过分层递进式教学培训后,单技术组的理论考核成绩[(83.8±6.9)分vs.(65.2±9.6)分,P<0.001]和上机操作考核成绩[(93.2±4.5)分vs.(91.4±4.3)分,P<0.001]均有提高。颈-脑一体化技术组理论考核成绩提高[(86.9±7.7)分vs.(67.7±6.4)分,P<0.001]。结论分层递进式教学模式在血管超声专业对进修医师具有较好的教学效果和较高的教学满意度。

症状性前循环颅内动脉重度狭窄患者急性期血管内治疗效果分析

目的观察对症状性前循环颅内动脉重度狭窄患者急性期实施血管内治疗的可行性。方法回顾性纳入2019年6月至2023年6月广东省中医院脑血管病科连续收治的30例症状性前循环颅内动脉重度狭窄患者的临床资料,应用危险分层评分对其进行评估,并探讨实施急性期(≤72.0 h)血管内治疗的安全性及有效性。血管内治疗包括球囊扩张+自膨式支架置入、球囊扩张式支架置入、球囊扩张治疗。危险分层评分为本研究根据临床经验,在短暂性脑缺血发作(TIA)ABCD3-I评分基础上增加对分水岭梗死的评分内容,用于症状性颅内动脉中重度狭窄急性期卒中进展或复发风险的筛选,其中危险分层评分0~3分定义为低危,4~7分定义为中危,8~13分定义为高危。以术后残留狭窄率≤50%且血流拓展脑梗死溶栓(eTICI)分级>2c级判定为血运重建成功。记录接受血管内治疗患者的人口学信息及临床资料,包括年龄、性别、脑血管病危险因素(高血压病、糖尿病、高脂血症、高同型半胱氨酸血症、饮酒史、吸烟史)、起病资料(发病至血管内治疗时间、症状、进展情况)、病变血管、危险分层评分、术前及术后90 d美国国立卫生研究院卒中量表(NIHSS)评分、术后90 d改良Rankin量表(mRS)评分、术中脑血管事件(颅内出血、责任血管闭塞)及术后90 d内脑血管事件(颅内出血、脑梗死、TIA、支架内再狭窄)、死亡事件。结果30例症状性前循环颅内动脉重度狭窄患者中,排除发病至血管内治疗的时间>72.0 h患者3例、因其他疾病需长期服用抗凝药物1例、失访1例、并存其他心源性脑栓塞疾病3例、非动脉粥样硬化导致动脉狭窄4例、拒绝急性期血管内治疗7例,最终纳入符合纳入与排除标准患者11例。(1)11例患者均成功实施血管内治疗,其中男7例;年龄52~76岁,中位数年龄64岁;高血压病9例,糖尿病3例,高脂血症7例,高同型半胱氨酸血症2例(仅9例完善了该项检查),吸烟史2例,饮酒史1例;发病至血管内治疗4.0~72.0 h,中位数时间12.0 h;左、右侧大脑半球梗死分别为3、8例,伴前后分水岭、内分水岭、前内后分水岭梗死分别为4、3、2例,伴内后、前内分水岭梗死各1例。(2)11例患者中,危险分层评分10~13分,中位数评分11分;术前NIHSS评分0~11分,中位数评分7分。(3)11例患者中,10例病变血管位于大脑中动脉,1例位于颈内动脉C7段;术前狭窄率70%~99%,中位数狭窄率86%;术前eTICI分级2a级7例,2b50级4例(存在远端血流缓慢);9例接受球囊扩张+自膨式支架置入,1例接受球囊扩张式支架置入,1例行球囊扩张治疗;术后狭窄率10%~20%,中位数狭窄率15%;术后eTICI分级2c级3例,3级8例。(4)11例患者中,术后第1天发生颅内出血1例,术后第3天新发脑梗死1例。完成术后90 d影像学随访患者8例,其中支架内再狭窄2例;术后90 d NIHSS评分0~20分,中位数评分2分;术后90 d mRS评分0~4分,中位数评分1分。mRS评分≤2分患者8例,未发生死亡事件。结论初步分析表明,症状性前循环颅内动脉重度狭窄实施急性期血管内治具有一定的有效性,但安全性有待继续观察。危险分层评分对高危患者的筛选仍需大样本、多中心研究进一步探讨。

脑卒中失能患者恐惧疾病进展风险因素最佳临界值的探索

目的探讨脑卒中失能患者恐惧疾病进展现状、导致恐惧疾病进展心理功能失调的风险因素及其影响恐惧疾病进展心理功能失调的最佳临界值,为脑卒中患者恐惧疾病进展干预方案的制定提供依据。方法便利抽取河南大学淮河医院神经内、外科和康复医学科333例脑卒中失能患者,横断面调查患者一般资料、恐惧疾病进展、多维度疲乏、心理韧性和自我感受负担。结果脑卒中失能患者恐惧疾病进展得分为(32.55±8.48)分,发生心理功能失调的患者为170例(51.05%)。logistic回归分析表明医疗费用所占比例、受教育程度、婚姻状况、多维度疲乏、心理韧性和自我感受负担是脑卒中失能患者恐惧疾病进展的影响因素。中介效应分析结果显示疲乏是脑卒中失能患者恐惧疾病进展部分中介效应。最佳临界值分析显示中多维度疲乏得分52.50分,自我感受负担得分36.00分,心理韧性得分50.50分是诱发脑卒中患者恐惧疾病进展心理功能失调状况的最佳临界值。结论应重视脑卒中患者恐惧疾病进展的现状及影响因素,加强脑卒中失能患者病程的随访和高危风险因素评估,对于接近最佳临界值的风险因素及时给予管理,降低因恐惧疾病进展造成的潜在风险,提高脑卒中患者的生活质量及长期生存率。

盐酸替罗非班在进展性大动脉粥样硬化型脑梗死患者中的临床应用

目的观察盐酸替罗非班注射液在治疗进展性大动脉粥样硬化型脑梗死患者中的疗效及其安全性。方法选择68例符合进展性大动脉粥样硬化型脑梗死标准的患者,将其随机分成常规治疗组和盐酸替罗非班治疗组,其中常规治疗组给予强化抗血小板及强化降脂药物等治疗,盐酸替罗非班组在加重24 h内给予盐酸替罗非班注射液(100 mL∶5 mg)静脉泵入[前半小时以0.4μg/(kg·min^(-1))速率泵入,半小时后以0.1μg/(kg·min^(-1))速率泵入],记录进展加重后24 h及7 d内2组患者卒中量表(NIHSS)评分和改良Rankin量表(mRS)评分,并记录药物不良反应、有无出血等情况。结果2组患者在治疗后24 h NIHSS评分比较差异无统计学意义(P>0.05)。盐酸替罗非班组和常规治疗组在治疗后7 d NIHSS评分比较差异有统计学意义(P<0.05),mRS评分比较差异有统计学意义(P<0.05)。结论盐酸替罗非班静脉泵入可能改善进展性大动脉粥样硬化型脑梗死患者的早期神经功能缺损症状,其改善机制有待进一步研究。

针灸治疗中风后遗症的临床研究进展

中风后遗症是指中风发生6个月以上,患者经过积极有效地治疗后,仍遗留某些不适症状或体征,统称为中风后遗症。针灸是中医外治法的重要组成部分,包括针刺、灸法、刺络放血、穴位贴敷、穴位埋针等多种治疗方法,在治疗中风后遗症方面具有独特优势。文章通过检索、梳理近些年关于针灸治疗中风后遗症的文献资料,探讨针灸对中风后遗症的可行性及有效性,期望为中风后遗症患者提供最佳治疗方案以及为临床治疗中风后遗症开拓新思路。

脑卒中高危人群发病风险感知研究进展

从风险感知概念、脑卒中高危人群风险感知评估工具、研究现状等方面进行综述,以分析风险感知对脑卒中高危人群的影响,旨在为国内外开展相关研究提供参考依据。

中风民族医药的研究进展

中风是全球第二大致死性疾病。临床上对中风治疗方法很多,西医治疗方法主要有溶栓药物、神经保护剂、机械取栓及血管成形术等,已经取得很好疗效,但西医治疗不良反应相对较多,且其远期疗效仍有待进一步随访观察。纵观目前的临床文献研究,民族医药对中风的治疗具有独特优势,对许多疾病都有独特的研究价值,尤其在诊治中风方面有着丰富的经验,比如蒙、藏、壮、傣、回、苗、瑶、侗、布依、水族、土家、维、朝鲜族等。文章通过查阅近年临床上关于中风的相关文献,进行归纳总结,就各少数民族医药进行综述,以期为中风进一步的研究与发展提供一些思考,促进民族医药的发展。

卒中相关睡眠障碍中西医诊疗研究进展

卒中相关睡眠障碍(stroke-related sleep disorders,SSD)是指在卒中后首次出现或卒中前已有的睡眠障碍在卒中后持续存在或加重,并达到睡眠障碍诊断标准的一组临床综合征。作为卒中常见的并发症,不仅会影响卒中患者的康复和生活质量,还会增加卒中复发和焦虑、认知能力下降等精神障碍的风险。目前西医治疗SSD主要是运用镇静催眠类药物、抗精神病类药物,见效快的同时存在成瘾性、疗效不稳定等问题。中医药作为治疗SSD的一种有效手段,可减轻患者痛苦,提高生活质量,与西医联合治疗能够达到相得益彰的效果。文章就近年文献中对SSD中西医治疗进展进行论述,为临床SSD的治疗提供参考。

风痰阻络型急性缺血性脑卒中病人血脂、血凝水平与脑卒中进展的关系

目的:研究风痰阻络型急性缺血性脑卒中病人血脂、血凝水平与脑卒中进展的关系。方法:通过采集医院电子病例系统信息和电话随访的方式收集2020年1月1日—2020年12月31日于北京中医药大学东直门医院通州院区脑病科入院治疗的缺血性脑卒中病人453例,分为风痰阻络型组(299例)和非风痰阻络型组(154例)。收集病人的一般资料,统计分析两组进展性脑卒中的发生率。对比分析风痰阻络证进展性脑卒中与非进展性脑卒中病人血脂、凝血指标及与脑卒中进展的相关性。结果:风痰阻络型组进展性脑卒中115例,非进展性脑卒中184例,脑卒中进展发生率为38.5%;非风痰阻络型组进展性脑卒中43例,非进展性脑卒中111例,脑卒中进展发生率为27.9%。风痰阻络证组脑卒中进展发生率明显高于非风痰阻络证组(χ^(2)=4.971,P=0.026)。风痰阻络证进展性脑卒中组与非进展性脑卒中组总胆固醇、低密度脂蛋白比较,差异有统计学意义(P<0.05)。总胆固醇、低密度脂蛋白与风痰阻络型脑卒中进展呈正相关(r=0.145,P=0.016;r=0.127,P=0.034)。结论:风痰阻络证脑卒中进展发生率明显高于非风痰阻络证。总胆固醇、低密度脂蛋白升高是导致脑卒中进展的直接相关因素,在临床诊治风痰阻络型进展性脑卒中病人时需要严格控制好病人胆固醇及低密度脂蛋白水平。

脑卒中患者及其配偶家庭韧性对疾病进展恐惧的主客体互倚模型分析

目的 基于主客体互倚模型分析脑卒中患者及其配偶家庭韧性对疾病进展恐惧的影响。方法 便利抽取脑卒中患者及其配偶(为患者的主要照顾者)各381例/名,采用一般资料调查表、恐惧疾病进展简化量表、配偶恐惧疾病进展简化量表和中文版家庭韧性问卷进行调查,建立家庭韧性对疾病进展恐惧的主客体互倚模型。结果 脑卒中患者的疾病进展恐惧得分(31.59±10.37)显著高于配偶(29.68±11.24)(P<0.05)。主体效应方面,脑卒中患者及其配偶家庭韧性水平可影响自身的疾病进展恐惧程度(均P<0.05);客体效应方面,患者的疾病进展恐惧程度受配偶的家庭韧性水平影响(P<0.05),而配偶疾病进展恐惧程度受患者家庭韧性水平影响(P<0.05)。结论 脑卒中患者及其配偶的疾病进展恐惧程度与两者家庭韧性水平存在交互影响,提示护士可基于二元视角以患者及其配偶的家庭韧性为视角开展干预,从而有效降低双方疾病进展恐惧程度。