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Objective To investigate the changes of cardiac structure and function in patients with hepatolenticular degeneration (HLD).Methods From March 2010 to February 2011,90 HLD patients who did not receive formal treatment (observation group) and 30 healthy people (control group) were collected and analyzed with color Doppler echocardiography in the Institute of Neurology,Affiliated Hospital of Anhui University of Traditional Chinese Medicine.Based on the clinical manifestations,cases were divided into hepatic type group (n =31),brain type group (n =42) and brain-visceral type group (n =17).According to the Child-Pugh classification,patients were divided into Child A group (n =71),Child B group (n =10) and Child C group (n =9).Results (1) The left atrial diameter ((28.00 ± 3.11),(29.62 ± 3.44) mm) and left ventricular diameter ((45.69 ± 3.75),(47.10-± 4.73) mm) of HLD patients in brain-visceral type group and hepatic type group were larger than that of the control group ((24.86 ± 2.63),(41.93 ±3.56) mm;t =3.143,4.761,P=0.018,0.000;t=3.764,5.167,P=0.018,0.000).The left atrial diameter and left ventricular diameter of hepatic type group were significantly larger than the brain type group (26.06 ± 3.68,43.34 ± 3.88;t =3.557,P =0.000;t =3.751,P =0.001).The value of E/A in the hepatic type group (1.57 ± 0.37) was significantly lower than the control group (1.93 ± 0.20;t =-0.352,P =0.006).(2) The left atrial diameter ((31.29 ± 1.70),(34.67 ± 1.97) mm) and left ventricular diameter ((48.29 ± 2.81),(53.67 ± 2.67) mm) of Child B and C groups were significantly larger than the control group ((24.86 ± 2.63),(41.93 ± 3.56) rm;t =6.429,9.810,P =0.000,0.000;t =6.357,10.738,P =0.000,0.000),and the Child A group ((26.42 ± 3.05),(43.89 ± 3.76) rm;t=4.871,8.252,P=0.000,0.000;t =4.399,8.780,P=0.003,0.000).The value of E/A of Child B and C groups (1.58 ± 0.32,1.26 ± 0.39) was lower than that of the control group (t =-0.347,0.662,P=0.020,0.000);At the same time,the value of E/A of Child C group was significantly lower than that of Child A group (1.80 ± 0.33;t =-0.530,P =0.000).Conclusions The HLD patients may have cardiac structural and functional changes,mainly manifested as left atrial and left ventricular enlargement and cardiac diastolic dysfunction,whereas a serious impact has not yet been found in systolic function.And the changes of cardiac structure and function were related to the degree of liver cirrhosis in patients with HLD.
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@#Stroke is the disease which caused by many risk factors.The relationship between insulin resistance(IR) and young adult stroke is one of the focuses now in the neurological field.IR refered to the series of pathological and physiological changes,it happens when the response of the target tissue organ to insulin is depressing or losing.There are many ways of detection of IR,the insulin sensitivity index(ISI) is one of the most satisfied indexes to reflect the sensitivity to insulin.IR could cause a series of pathological and physiological changes,which caused hyperinsulinemia,hyperglycemia,hyperpiesia,blood-fat derangement,fibrinolytic system anomaly,blood vessel endothelium change,artherosclerosis,et al,maybe in ways of many metabolic risk factors.Atherosclerosis is the main etiopathogenisis factor in young adult stroke,as a conclusion,IR is also existed in young adult stroke.But,does IR exist in all types of young adult stroke? What is the mechanism? Is the level of IR related with the pathogenetic condition and prognosis? These questions are still not clear at present,and the study on the relationship between IR and young adult stroke is important to prevent young adult stroke.
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@#目的了解急性脑卒中后抑郁症的发病情况及治疗效果。方法回顾性分析316例脑卒中患者的一般情况、病灶部位、治疗结果等。结果316例脑卒中患者的抑郁症发病率为29.1%,病灶位于前半球者比后半球者易发生抑郁,左半球损害比右半球损害易发生抑郁;抗抑郁治疗有效。结论脑卒中后抑郁发病率高,病灶部位影响抑郁症的发生,抗抑郁治疗有效。