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多系统萎缩的帕金森综合征进程
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作者 Seppi K. Yekhlef F. +2 位作者 Diem A. G.K. Wenning 陈云春 《世界核心医学期刊文摘(神经病学分册)》 2005年第6期37-37,共1页
Background: Progression of parkinsonian motor impairment is usually rapid and relentless in multiple system atrophy (MSA)- . However, it may also be subject to considerable variation. Prospective natural history studi... Background: Progression of parkinsonian motor impairment is usually rapid and relentless in multiple system atrophy (MSA)- . However, it may also be subject to considerable variation. Prospective natural history studies using validated rating scales are required to accurately determine the progression of parkinsonism in MSA. Abstract:Objective: To assess the progression of parkinsonism in patients with the Parkinson variant of MSA. Methods Parkinsonian motor impairment was assessed on regular therapy at two time points (mean follow- up 11.8 months, SD 1.4) using the Hoehn and Yahr scale (H& Y), the Schwab and England ADL scale (SES) and the motor examination section of the UPDRS (UPDRS- III) in 38 patients with clinically probable MSA- P. Results We examined 38 patients with probable MSA- P (mean age 63.2 years, SD 7.4; mean disease duration 4.1 years, SD 3.0). The mean difference of UPDRS- III between baseline and follow- up was 10.8 (95% CI 8.6- 12.9), consistent with an average annual 28.3 % increase of UPDRS- III baseline scores. Several variables were associated with faster progression of parkinsonism including low baseline global motor disability as assessed by H& Y and SES, low baseline UPDRS III score, and short disease duration. UPDRS- III progression was unrelated to gender, age at symptom onset, and age at baseline visit. Conclusion: This is the first observational study on UPDRS rates of decline in MSA. The observed 28.6% annual increase of UPDRS- III scores illustrates the rapid progression of motor impairment in MSA. Furthermore, motor progression appeared to be accelerated during the early disease stages. Our data allow sample size calculations that maybe helpful for the planning of future therapeutic trials. 展开更多
关键词 帕金森综合征 多系统萎缩 运动损害 自然病史 ENGLAND 基线值 等级量表 发病年龄 试验数据 整体运动
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动脉瘤性蛛网膜下腔出血患者的重症监护处理:神经危重症监护学会多学科共识会议的推荐意见 被引量:5
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作者 Michael N. Diringer Thomas P. Bleck +22 位作者 J. Claude Hemphill David Menon Lori Shutter Paul Vespa Nicolas Bruder E. Sander Connolly Jr Giuseppe Citerio Daryl Gress Daniel Hanggi Brian L. Hoh Giuseppe Lanzino Peter Le Roux Alejandro Rabinstein, Erich Schmut zhard Nino Stocchetti Jose I. Suarez Miriam Tresgiari Ming-Yuan Tseng Mervyn D. I. Vergouwen Stefan Wolf Gregory Zip fel 田飞(译) 宿 英英(译) 《国际脑血管病杂志》 北大核心 2013年第5期324-347,共24页
蛛网膜下腔出血(subarachnoidhemorrhage,SAH)是一种可对中枢神经系统造成毁灭性打击并对其他多个器官产生显著影响的急性脑血管病。SAH患者被常规收入重症监护病房并由多学科团队进行治疗。由于高质量研究证据的缺乏,使得治疗方法... 蛛网膜下腔出血(subarachnoidhemorrhage,SAH)是一种可对中枢神经系统造成毁灭性打击并对其他多个器官产生显著影响的急性脑血管病。SAH患者被常规收入重症监护病房并由多学科团队进行治疗。由于高质量研究证据的缺乏,使得治疗方法各异,可供选择的指导意见不多。现有的指南主要强调危险因素、预防、自然史以及再出血的预防,很少涉及SAH患者的重症监护问题。美国神经危重症监护学会组织了一次国际性多学科共识会议来探讨SAH的重症监护处理。根据发表的文章和研究领域,此次会议召集了来自欧洲和北美地区的神经重症监护科、神经外科、神经内科、介入神经放射科和神经麻醉科方面的专家。根据临床经验和制定实践指南方面的经验,选择4名经验丰富的神经重症监护专家组成评判委员会。应用推荐分级的评估、制定与评价(GradesofRecommendationsAssessment,DevelopmentandEvaluation,GRADE)系统进行文献回顾,结合参会者的经验、评判委员会的审评以及文献讨论产生推荐意见。应用GRADE系统制定推荐意见,其制定原则不仅强调研究资料的质量,而且还重视利弊权衡与实践转化。对SAH患者日常处理过程中面临的所有问题均提供指导和推荐意见,即使缺乏高质量的证据。 展开更多
关键词 蛛网膜下腔出血 重症监护 动脉瘤 血管痉挛 抗惊厥药 低钠血症 血管内 发热
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