BACKGROUND By comprehensively analyzing the blood flow parameters of the umbilical and middle cerebral arteries,doctors can more accurately identify fetal intrauterine distress,as well as assess its severity,so that t...BACKGROUND By comprehensively analyzing the blood flow parameters of the umbilical and middle cerebral arteries,doctors can more accurately identify fetal intrauterine distress,as well as assess its severity,so that timely interventions can be implemented to safeguard the health and safety of the fetus.AIM To identify the relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine distress.METHODS Clinical data of pregnant women admitted between January 2021 and January 2023 were collected and divided into the observation and control groups(n=50 each),according to the presence or absence of intrauterine distress.The ultrasound hemodynamic parameters of the uterine artery(UtA),fetal middle cerebral artery(MCA),and umbilical artery(UmA)were compared with neonatal outcomes and occurrence of intrauterine distress in the two groups.RESULTS Comparison of ultrasonic hemodynamic parameters,resistance index(RI),pulsatility index(PI),and systolic maximal blood flow velocity of UmA compared to diastolic blood flow velocity(S/D),revealed higher values of fetal MCA,PI,and S/D of UmA in pregnant women with UtA compared to controls(P<0.05),while there was no difference between the two groups in terms of RI(P<0.05)The incidence of a neonatal Apgar score of 8-10 points was lower in the observation group(66.7%)than in the control group(90.0%),and neonatal weight(2675.5±27.6 g)was lower than in the control group(3117.5±31.2 g).Further,cesarean section rate was higher in the observation group(70.0%)than in the control group(11.7%),and preterm labor rate was higher in the observation group(40.0%)than in the control group(10.0%).The incidence of fetal distress,neonatal growth restriction and neonatal asphyxia were also higher in the observation group(all P<0.05).CONCLUSION Fetal MCA,UmA,and maternal UtA hemodynamic abnormalities all develop in pregnant women with intrauterine distress during late pregnancy,which suggests that clinical attention should be paid to them,and monitoring should be strengthened to provide guidance for clinical intervention.展开更多
Objective:To investigate the effects of electro-acupuncture preconditioning on focal cerebral blood flow(CBF)in artery and vein of rats with middle cerebral artery occlusion(MCAO),and to provide experimental evidences...Objective:To investigate the effects of electro-acupuncture preconditioning on focal cerebral blood flow(CBF)in artery and vein of rats with middle cerebral artery occlusion(MCAO),and to provide experimental evidences for primary prevention of ischemic stroke.Method:Eighteen male Sprague-Dawley rats(two months old)were divided into 3 groups:electro-acupuncture preconditioning group(EA group),ischemia group(Is group)and Dazhui and Baihui sham group(six rats per group).The rats in the EA group were given electro-acupuncture preconditioning at Dazhui and Baihui with 2/15 density wave current for 30 minutes per day,5 days consecutively.After preconditioning,enhanced laser speckle contrast analysis was implemented to get false color images before making middle cerebral ischemia occlusion model.Then getting false color images two hours during ischemia by laser speckle contrast analysis again.Result:④Relative CBF in focal cortical artery:There were significant differences at every time point in EA group and Is group(P<0.01,P<0.05)comparing with that before occlusion respectively.Compared with that before ischemia,there was significant difference at 120 min after ischemia in sham group(P<0.05);compared with that at 30 min after occlusion,there was significant difference at every time point in EA group from the time point 60 min after occlusion;there was significant difference at every time point in EA group and Is group(P<0.05)comparing with sham group;Compared with sham group,there was significant difference at 30min and 60 min after ischemia in EA group(P<0.05).④Relative CBF in focal cortical vein:There was significant difference at every time point in sham group comparing with that before occlusion(P<0.05);compared with that before occlusion,there was significant difference from 45 min after occlusion in EA group(P<0.05);compared with that before occlusion,there was significant difference from 105 min after occlusion in sham group(P<0.05);there was significant difference at 120 min after occlusion comparing with 60 min after occlusion in EA group;compared with sham group,there was significant difference at every time point in EA group and Is group(except 30 min after occlusion)(P<0.05),respectively;compared with Is group,there was significant difference at 30,45,60 min after occlusion in EA group(P<0.05).④The infarct brain volume detected 24 h after reperfusion in EA group was significantly smaller comparing with that in Is group(P<0.05).Conclusion:Electro-acupuncture preconditioning could increase CBF velocity in artery and vein of focal cortex in rats with MCAO,which also had time-dependence.Additionally,electro-acupuncture preconditioning could decrease the infarct volume detected 24h after reperfusion,which possibly was correlated with the blood supply in ischemic penumbra.展开更多
Acupuncture is regarded as an effective therapy for cerebral ischemia. Different acupuncture ma- nipulations and durations may result in different therapeutic effects. In the present study, the Neig uan （PC6） acupoi...Acupuncture is regarded as an effective therapy for cerebral ischemia. Different acupuncture ma- nipulations and durations may result in different therapeutic effects. In the present study, the Neig uan （PC6） acupoint of rats with occluded middle cerebral arteries was needled at a fixed frequency （3 Hz） with different durations, i.e., 5, 60 and 180 seconds under a twisting-rotating acupuncture method. Results showed that different durations of acupuncture had different therapeutic effects, with 60 seconds yielding a better therapeutic effect than the other two groups. This duration of treatment demonstrated rapid cerebral blood flow, encouraging recovery of neurological function, and small cerebral infarct volume. Experimental findings indicated that under 3 Hz frequency, the treatment of needling Neiguan for 60 seconds is effective for ischemic stroke.展开更多
Electroacupuncture has been shown to improve cerebral blood flow in animal models of stroke. However, it is unclear whether electroacupuncture alters mi RNA expression in the cortex. In this study, we examined changes...Electroacupuncture has been shown to improve cerebral blood flow in animal models of stroke. However, it is unclear whether electroacupuncture alters mi RNA expression in the cortex. In this study, we examined changes in the cerebral cortical mi RNA profile, cerebral blood flow and neurological function induced by electroacupuncture in a rat model of stroke. Electroacupuncture was performed at Renzhong（GV26） and Neiguan（PC6）, with a frequency of 2 Hz, continuous wave, current intensity of 3.0 m A, and stimulation time of 1 minute. Electroacupuncture increased cerebral blood flow and alleviated neurological impairment in the rats. mi RNA microarray profiling revealed that the vascular endothelial growth factor signaling pathway, which links cell proliferation with stroke, was most significantly affected by electroacupuncture. Electroacupuncture induced changes in expression of rno-mi R-206-3p, rno-mi R-3473, rno-mi R-6216 and rno-mi R-494-3p, and these changes were confirmed by quantitative real-time polymerase chain reaction. Our findings suggest that changes in cell proliferation-associated mi RNA expression induced by electroacupuncture might be associated with the improved cerebral blood supply and functional recovery following stroke.展开更多
目的浅析椎动脉型颈椎病(cervical spondylotic vertebral arteriopathy,CSA)患者实施基于“筋骨平衡”理论针刺推拿疗法对其中医症状积分、颈性眩晕症状与功能评估量表(cervical vertigo symptom and function assessment scale,ESCV)...目的浅析椎动脉型颈椎病(cervical spondylotic vertebral arteriopathy,CSA)患者实施基于“筋骨平衡”理论针刺推拿疗法对其中医症状积分、颈性眩晕症状与功能评估量表(cervical vertigo symptom and function assessment scale,ESCV)评分、颈椎曲度及脑血流参数的影响。方法选择该院2019年12月—2021年12月就诊的CSA患者86例实施研究,随机数字表法分作观察组与对照组,各43例;其中对照组脱落2例,剔除1例,共完成40例;观察组脱落1例,剔除1例,共完成41例;对照组予以常规牵引疗法,观察组予以基于“筋骨平衡”理论针刺推拿疗法;比较两组治疗前与治疗后中医症状积分、ESCV评分、颈椎曲度及脑血流参数的变化,并对比两组疗效。结果治疗后,观察组中医症状积分皆显著低于对照组(P<0.05)。治疗后,观察组ESCV评分和颈椎曲度皆明显高于对照组(P<0.05)。治疗后,观察组椎底动脉及左、右椎动脉的Vs与Vd水平均显著高于对照组(P<0.05)。观察组总有效率显著高于对照组[95.12%(39/41)vs 80.00%(32/40),P<0.05]。结论基于“筋骨平衡”理论针刺推拿疗法对CSA患者疗效显著,有效改善中医症状积分、ESCV评分以及颈椎曲度,增强脑血流参数。展开更多
目的观察不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响。方法回顾性选取2020年1月—2022年8月收治的116例大脑中动脉供血区急性脑梗死患者的临床资料进行分析,根据针灸介入时机分为两组。两组均进行静脉溶栓及常规...目的观察不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响。方法回顾性选取2020年1月—2022年8月收治的116例大脑中动脉供血区急性脑梗死患者的临床资料进行分析,根据针灸介入时机分为两组。两组均进行静脉溶栓及常规药物治疗,观察组61例患者于发病72 h内给予针灸治疗,对照组55例患者于发病2周时给予针灸治疗。检测两组不同时间点侧支循环代偿情况、脑损伤标志物的水平,评估两组不同时间点简易精神状态检查(Mini-mental state examination,MMSE)评分、神经功能评分、Barthel指数(Barthel index,BI)评分、肢体运动功能评分、中医症状评分的差异,统计两组疗效。结果治疗前,两组侧支循环代偿情况比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组患侧大脑前动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow ve⁃locity of the affected anterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVACA/cVM⁃CA)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组患侧大脑后动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow velocity of the affected posterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVPCA/cVMCA)与治疗前比较,差异无统计学意义(P>0.05)。治疗前,两组脑损伤标志物比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组钙结合蛋白β(Calcium binding proteinβ,S100β)、神经胶质纤维酸性蛋白(Glial fibrillary acid protein,GFAP)较治疗前下降,观察组同时间点较对照组更低(P<0.05)。治疗前,两组Fugl-Meyer评分、中医症状评分等相关评分比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组MMSE评分、BI评分及上肢和下肢Fugl-Meyer评分较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组美国国立卫生院神经功能缺损(National institutes of health stroke scale,NIHSS)评分、中医症状评分较治疗前下降,观察组同时间点较对照组更低(P<0.05)。观察组总有效率为88.52%(54/61)高于对照组的72.73%(40/55),差异有统计学意义(P<0.05)。结论发病72h内采用针灸治疗可改善大脑中动脉供血区急性脑梗死脑损伤标志物的表达,改善脑血流,促进神经功能的恢复,有利于疾病的康复。展开更多
目的探讨超声监测脐动脉和大脑中动脉搏动指数(PI)、阻力指数(RI)、收缩期与舒张期流速比(S/D)和主动脉峡部收缩指数(ISI)、峡部血流指数(IFI)与胎儿生长受限(FGR)的关系及对不良围产结局的预测价值。方法选择120例孕晚期孕妇,年龄21~41...目的探讨超声监测脐动脉和大脑中动脉搏动指数(PI)、阻力指数(RI)、收缩期与舒张期流速比(S/D)和主动脉峡部收缩指数(ISI)、峡部血流指数(IFI)与胎儿生长受限(FGR)的关系及对不良围产结局的预测价值。方法选择120例孕晚期孕妇,年龄21~41岁,平均年龄27.20岁(标准差5.19岁);孕周32~41周,平均孕周35.33周(标准差1.69周);产次1~3次,平均产次1.41次(标准差0.29次);高血压54例,糖尿病62例。将超声确诊为FGR的孕妇作为研究组(n=58),宫内胎儿正常发育孕妇作为对照组(n=62)。应用彩色多普勒超声监测子宫动脉、脐动脉及主动脉峡部血流参数。统计两组孕妇的妊娠结局。根据不同妊娠结局再次将研究组分为正常结局组和异常结局组,比较两组大脑中动脉、脐动脉及主动脉血流参数,并分析以上血流参数与新生儿体质量及新生儿Apgar评分的相关性。运用受试者工作特性(ROC)曲线分析血流参数对不良围产结局的预测价值。结果研究组脐动脉参数PI、RI及S/D值均较对照组明显偏高(1.23±0.15 vs 0.71±0.11、0.89±0.14 vs 0.52±0.08、3.67±0.33 vs 2.73±0.26。P<0.05)。大脑中动脉参数PI、RI及S/D值和主动脉峡部血流参数IFI、ISI值均明显低于对照组(1.11±0.13 vs 1.72±0.18、0.53±0.12 vs 0.87±0.14、2.43±0.26 vs 4.67±0.15、0.23±1.03 vs 1.26±0.05,-0.39±0.03 vs-0.39±0.03。P<0.05);研究组主动脉峡部舒张血流消失或反向发生率为34.48%,高于对照组(4.84%)(P<0.05)。研究组根据不同妊娠结局分为正常结局组31例和异常结局组27例,异常结局组新生儿体质量及Apgar评分均较正常结局组明显偏低[(3.18±0.35)分vs(3.97±0.34)分、(7.21±0.34)分vs(8.67±0.65)分。P<0.05]。异常结局组新生儿大脑中动脉PI、RI、S/D及IFI和ISI等血流参数均较正常结局组明显偏低(1.02±0.1 vs 1.33±0.17、0.53±0.07 vs 0.64±0.15、2.42±0.23 vs 2.52±0.14、0.08±0.01 vs 1.12±0.04、1.12±0.14 vs-0.32±0.01。P<0.05);异常结局组新生儿脐动脉PI、RI及S/D等血流参数显著高于正常结局组(1.46±0.17 vs 1.18±0.12、0.86±0.11 vs 0.72±0.03、3.91±0.45 vs 3.43±0.26。P<0.05)。新生儿大脑中动脉PI、RI及S/D值及主动脉IFI、ISI均与新生儿体质量和新生儿Apgar评分呈正相关,脐动脉PI、RI、S/D值与新生儿体质量和Apgar评分呈负相关(P<0.05)。ROC曲线分析显示,子宫中动脉、脐动脉及主动脉峡部血流参数联合诊断的曲线下面积最高,为0.968(95%CI 0.917~1.000)。结论子宫动脉、脐动脉及主动脉峡部血流参数异常均与FGR的发生密切相关,可辅助临床诊断FGR,联合检测3项血流参数诊断FGR的效能最高。超声监测脐动脉和大脑中动脉PI、RI、S/D和主动脉ISI、IFI可有效提高临床预测FGR预后的准确度。展开更多
目的探讨超声检查在胎儿大脑中动脉及脐动脉血流在胎儿宫内缺氧及分娩结局诊断中的应用价值。方法选取2020年8月—2022年2月广东省中山市东凤人民医院收治的孕妇60例,根据是否出现宫内缺氧分为缺氧组(31例)与正常组(29例),再根据围产儿...目的探讨超声检查在胎儿大脑中动脉及脐动脉血流在胎儿宫内缺氧及分娩结局诊断中的应用价值。方法选取2020年8月—2022年2月广东省中山市东凤人民医院收治的孕妇60例,根据是否出现宫内缺氧分为缺氧组(31例)与正常组(29例),再根据围产儿是否出现不良妊娠结局分为正常结局组(32例)与不良结局组(28例)。比较超声检查大脑中动脉(middle cerebral artery,MCA)及脐动脉(umbilical artery,UmA)血流情况,并对脉动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、收缩期峰值/舒张末期流速(systolic peak value and the end-diastolic velocity of blood flow,S/D)指标。结果孕30周时正常组MCA的PI、RI、S/D高于缺氧组,UmA的PI、RI、S/D低于缺氧组(P<0.05);正常结局组MCA的PI、RI、S/D高于不良结局组,UmA的PI、RI、S/D低于不良结局组(P<0.05)。结论应用超声检查可有效诊断胎儿大脑中动脉及脐动脉血流宫内缺氧和分娩结局,为胎儿宫内缺氧情况采取早期预防措施提供可靠依据,可有效避免围产儿出现不良结局,临床上可借鉴及推广。展开更多
文摘BACKGROUND By comprehensively analyzing the blood flow parameters of the umbilical and middle cerebral arteries,doctors can more accurately identify fetal intrauterine distress,as well as assess its severity,so that timely interventions can be implemented to safeguard the health and safety of the fetus.AIM To identify the relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine distress.METHODS Clinical data of pregnant women admitted between January 2021 and January 2023 were collected and divided into the observation and control groups(n=50 each),according to the presence or absence of intrauterine distress.The ultrasound hemodynamic parameters of the uterine artery(UtA),fetal middle cerebral artery(MCA),and umbilical artery(UmA)were compared with neonatal outcomes and occurrence of intrauterine distress in the two groups.RESULTS Comparison of ultrasonic hemodynamic parameters,resistance index(RI),pulsatility index(PI),and systolic maximal blood flow velocity of UmA compared to diastolic blood flow velocity(S/D),revealed higher values of fetal MCA,PI,and S/D of UmA in pregnant women with UtA compared to controls(P<0.05),while there was no difference between the two groups in terms of RI(P<0.05)The incidence of a neonatal Apgar score of 8-10 points was lower in the observation group(66.7%)than in the control group(90.0%),and neonatal weight(2675.5±27.6 g)was lower than in the control group(3117.5±31.2 g).Further,cesarean section rate was higher in the observation group(70.0%)than in the control group(11.7%),and preterm labor rate was higher in the observation group(40.0%)than in the control group(10.0%).The incidence of fetal distress,neonatal growth restriction and neonatal asphyxia were also higher in the observation group(all P<0.05).CONCLUSION Fetal MCA,UmA,and maternal UtA hemodynamic abnormalities all develop in pregnant women with intrauterine distress during late pregnancy,which suggests that clinical attention should be paid to them,and monitoring should be strengthened to provide guidance for clinical intervention.
基金supported by the Natural Science Foundation of China(NSFC,NO.81171856,81171855)the Development Program of China(863 program,NO.2007AA02Z482)the Key projects of Shanghai Science and Technology on Biomedicine(NO.10DZ1950800)
文摘Objective:To investigate the effects of electro-acupuncture preconditioning on focal cerebral blood flow(CBF)in artery and vein of rats with middle cerebral artery occlusion(MCAO),and to provide experimental evidences for primary prevention of ischemic stroke.Method:Eighteen male Sprague-Dawley rats(two months old)were divided into 3 groups:electro-acupuncture preconditioning group(EA group),ischemia group(Is group)and Dazhui and Baihui sham group(six rats per group).The rats in the EA group were given electro-acupuncture preconditioning at Dazhui and Baihui with 2/15 density wave current for 30 minutes per day,5 days consecutively.After preconditioning,enhanced laser speckle contrast analysis was implemented to get false color images before making middle cerebral ischemia occlusion model.Then getting false color images two hours during ischemia by laser speckle contrast analysis again.Result:④Relative CBF in focal cortical artery:There were significant differences at every time point in EA group and Is group(P<0.01,P<0.05)comparing with that before occlusion respectively.Compared with that before ischemia,there was significant difference at 120 min after ischemia in sham group(P<0.05);compared with that at 30 min after occlusion,there was significant difference at every time point in EA group from the time point 60 min after occlusion;there was significant difference at every time point in EA group and Is group(P<0.05)comparing with sham group;Compared with sham group,there was significant difference at 30min and 60 min after ischemia in EA group(P<0.05).④Relative CBF in focal cortical vein:There was significant difference at every time point in sham group comparing with that before occlusion(P<0.05);compared with that before occlusion,there was significant difference from 45 min after occlusion in EA group(P<0.05);compared with that before occlusion,there was significant difference from 105 min after occlusion in sham group(P<0.05);there was significant difference at 120 min after occlusion comparing with 60 min after occlusion in EA group;compared with sham group,there was significant difference at every time point in EA group and Is group(except 30 min after occlusion)(P<0.05),respectively;compared with Is group,there was significant difference at 30,45,60 min after occlusion in EA group(P<0.05).④The infarct brain volume detected 24 h after reperfusion in EA group was significantly smaller comparing with that in Is group(P<0.05).Conclusion:Electro-acupuncture preconditioning could increase CBF velocity in artery and vein of focal cortex in rats with MCAO,which also had time-dependence.Additionally,electro-acupuncture preconditioning could decrease the infarct volume detected 24h after reperfusion,which possibly was correlated with the blood supply in ischemic penumbra.
基金supported by a grant from the National Program on Key Basic Research Project(973 Program),No.2010CB530506
文摘Acupuncture is regarded as an effective therapy for cerebral ischemia. Different acupuncture ma- nipulations and durations may result in different therapeutic effects. In the present study, the Neig uan （PC6） acupoint of rats with occluded middle cerebral arteries was needled at a fixed frequency （3 Hz） with different durations, i.e., 5, 60 and 180 seconds under a twisting-rotating acupuncture method. Results showed that different durations of acupuncture had different therapeutic effects, with 60 seconds yielding a better therapeutic effect than the other two groups. This duration of treatment demonstrated rapid cerebral blood flow, encouraging recovery of neurological function, and small cerebral infarct volume. Experimental findings indicated that under 3 Hz frequency, the treatment of needling Neiguan for 60 seconds is effective for ischemic stroke.
基金supported by the National Natural Science Foundation of China,No.81173416
文摘Electroacupuncture has been shown to improve cerebral blood flow in animal models of stroke. However, it is unclear whether electroacupuncture alters mi RNA expression in the cortex. In this study, we examined changes in the cerebral cortical mi RNA profile, cerebral blood flow and neurological function induced by electroacupuncture in a rat model of stroke. Electroacupuncture was performed at Renzhong（GV26） and Neiguan（PC6）, with a frequency of 2 Hz, continuous wave, current intensity of 3.0 m A, and stimulation time of 1 minute. Electroacupuncture increased cerebral blood flow and alleviated neurological impairment in the rats. mi RNA microarray profiling revealed that the vascular endothelial growth factor signaling pathway, which links cell proliferation with stroke, was most significantly affected by electroacupuncture. Electroacupuncture induced changes in expression of rno-mi R-206-3p, rno-mi R-3473, rno-mi R-6216 and rno-mi R-494-3p, and these changes were confirmed by quantitative real-time polymerase chain reaction. Our findings suggest that changes in cell proliferation-associated mi RNA expression induced by electroacupuncture might be associated with the improved cerebral blood supply and functional recovery following stroke.
文摘目的观察不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响。方法回顾性选取2020年1月—2022年8月收治的116例大脑中动脉供血区急性脑梗死患者的临床资料进行分析,根据针灸介入时机分为两组。两组均进行静脉溶栓及常规药物治疗,观察组61例患者于发病72 h内给予针灸治疗,对照组55例患者于发病2周时给予针灸治疗。检测两组不同时间点侧支循环代偿情况、脑损伤标志物的水平,评估两组不同时间点简易精神状态检查(Mini-mental state examination,MMSE)评分、神经功能评分、Barthel指数(Barthel index,BI)评分、肢体运动功能评分、中医症状评分的差异,统计两组疗效。结果治疗前,两组侧支循环代偿情况比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组患侧大脑前动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow ve⁃locity of the affected anterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVACA/cVM⁃CA)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组患侧大脑后动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow velocity of the affected posterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVPCA/cVMCA)与治疗前比较,差异无统计学意义(P>0.05)。治疗前,两组脑损伤标志物比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组钙结合蛋白β(Calcium binding proteinβ,S100β)、神经胶质纤维酸性蛋白(Glial fibrillary acid protein,GFAP)较治疗前下降,观察组同时间点较对照组更低(P<0.05)。治疗前,两组Fugl-Meyer评分、中医症状评分等相关评分比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组MMSE评分、BI评分及上肢和下肢Fugl-Meyer评分较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组美国国立卫生院神经功能缺损(National institutes of health stroke scale,NIHSS)评分、中医症状评分较治疗前下降,观察组同时间点较对照组更低(P<0.05)。观察组总有效率为88.52%(54/61)高于对照组的72.73%(40/55),差异有统计学意义(P<0.05)。结论发病72h内采用针灸治疗可改善大脑中动脉供血区急性脑梗死脑损伤标志物的表达,改善脑血流,促进神经功能的恢复,有利于疾病的康复。
文摘目的探讨超声监测脐动脉和大脑中动脉搏动指数(PI)、阻力指数(RI)、收缩期与舒张期流速比(S/D)和主动脉峡部收缩指数(ISI)、峡部血流指数(IFI)与胎儿生长受限(FGR)的关系及对不良围产结局的预测价值。方法选择120例孕晚期孕妇,年龄21~41岁,平均年龄27.20岁(标准差5.19岁);孕周32~41周,平均孕周35.33周(标准差1.69周);产次1~3次,平均产次1.41次(标准差0.29次);高血压54例,糖尿病62例。将超声确诊为FGR的孕妇作为研究组(n=58),宫内胎儿正常发育孕妇作为对照组(n=62)。应用彩色多普勒超声监测子宫动脉、脐动脉及主动脉峡部血流参数。统计两组孕妇的妊娠结局。根据不同妊娠结局再次将研究组分为正常结局组和异常结局组,比较两组大脑中动脉、脐动脉及主动脉血流参数,并分析以上血流参数与新生儿体质量及新生儿Apgar评分的相关性。运用受试者工作特性(ROC)曲线分析血流参数对不良围产结局的预测价值。结果研究组脐动脉参数PI、RI及S/D值均较对照组明显偏高(1.23±0.15 vs 0.71±0.11、0.89±0.14 vs 0.52±0.08、3.67±0.33 vs 2.73±0.26。P<0.05)。大脑中动脉参数PI、RI及S/D值和主动脉峡部血流参数IFI、ISI值均明显低于对照组(1.11±0.13 vs 1.72±0.18、0.53±0.12 vs 0.87±0.14、2.43±0.26 vs 4.67±0.15、0.23±1.03 vs 1.26±0.05,-0.39±0.03 vs-0.39±0.03。P<0.05);研究组主动脉峡部舒张血流消失或反向发生率为34.48%,高于对照组(4.84%)(P<0.05)。研究组根据不同妊娠结局分为正常结局组31例和异常结局组27例,异常结局组新生儿体质量及Apgar评分均较正常结局组明显偏低[(3.18±0.35)分vs(3.97±0.34)分、(7.21±0.34)分vs(8.67±0.65)分。P<0.05]。异常结局组新生儿大脑中动脉PI、RI、S/D及IFI和ISI等血流参数均较正常结局组明显偏低(1.02±0.1 vs 1.33±0.17、0.53±0.07 vs 0.64±0.15、2.42±0.23 vs 2.52±0.14、0.08±0.01 vs 1.12±0.04、1.12±0.14 vs-0.32±0.01。P<0.05);异常结局组新生儿脐动脉PI、RI及S/D等血流参数显著高于正常结局组(1.46±0.17 vs 1.18±0.12、0.86±0.11 vs 0.72±0.03、3.91±0.45 vs 3.43±0.26。P<0.05)。新生儿大脑中动脉PI、RI及S/D值及主动脉IFI、ISI均与新生儿体质量和新生儿Apgar评分呈正相关,脐动脉PI、RI、S/D值与新生儿体质量和Apgar评分呈负相关(P<0.05)。ROC曲线分析显示,子宫中动脉、脐动脉及主动脉峡部血流参数联合诊断的曲线下面积最高,为0.968(95%CI 0.917~1.000)。结论子宫动脉、脐动脉及主动脉峡部血流参数异常均与FGR的发生密切相关,可辅助临床诊断FGR,联合检测3项血流参数诊断FGR的效能最高。超声监测脐动脉和大脑中动脉PI、RI、S/D和主动脉ISI、IFI可有效提高临床预测FGR预后的准确度。
文摘目的探讨超声检查在胎儿大脑中动脉及脐动脉血流在胎儿宫内缺氧及分娩结局诊断中的应用价值。方法选取2020年8月—2022年2月广东省中山市东凤人民医院收治的孕妇60例,根据是否出现宫内缺氧分为缺氧组(31例)与正常组(29例),再根据围产儿是否出现不良妊娠结局分为正常结局组(32例)与不良结局组(28例)。比较超声检查大脑中动脉(middle cerebral artery,MCA)及脐动脉(umbilical artery,UmA)血流情况,并对脉动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、收缩期峰值/舒张末期流速(systolic peak value and the end-diastolic velocity of blood flow,S/D)指标。结果孕30周时正常组MCA的PI、RI、S/D高于缺氧组,UmA的PI、RI、S/D低于缺氧组(P<0.05);正常结局组MCA的PI、RI、S/D高于不良结局组,UmA的PI、RI、S/D低于不良结局组(P<0.05)。结论应用超声检查可有效诊断胎儿大脑中动脉及脐动脉血流宫内缺氧和分娩结局,为胎儿宫内缺氧情况采取早期预防措施提供可靠依据,可有效避免围产儿出现不良结局,临床上可借鉴及推广。
