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特发性常压脑积水分流术的安慰剂控制效果:一项随机试点试验

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中华神经外科疾病研究杂志 2024年第1期18卷 5-5页

多项前瞻性非随机研究显示,60%至70%的特发性正常压脑积水(iNPH)患者在分流术后得到改善,但需要多中心安慰剂对照试验数据来确定其有效性。

关键词：安慰剂对照特发性脑积水分流术 NPH 试验数据非随机研究常压脑积水控制效果

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特发性常压脑积水患者脑直径与步态障碍的关系

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世界核心医学期刊文摘（神经病学分册） 2005年第12期1卷 35-36页

作者： Phil H.L. Suk W.Y. Young H.A. Huh K. 史利利 Dr.Dept. of Neurology College of Medicine Ajou University Woncheon-dong San 5 Paldal-ku Suwon Kyungki-do 442-749 South Korea

Background and purpose: Although gait disturbance is an important feature of idiopathic normal pressure hydrocephalus (NPH), only tentative theories have been offered to explain its pathophysiology. It has been suggested that the mesencephalic locomotor region is the anatomical substrate for the development of the hypokinetic NPH gait. To investigate this possibility, we evaluated the correlation between gait disturbance and midbrain diameter. Methods: We enrolled 21 patients with NPH and 20 age-matched control subjects for the study. The maximal diameter of the midbrain and pons, and the width of the lateral and third ventricles were measured using midsagittal T1-weighted MRI and axial T2-weighted MRI, respectively. Gait disturbance, cognitive dysfunction, and incontinence were semiquantified. Results: The maximal midbrain diameter was significantly smaller in the NPH group than in the controls (14.8 ±0.9 vs. 17.1 ±0.7mm, p < 0.001). There were inverse correlations between the midbrain diameter and the widths of the two ventricles (r = -0.562, p = 0.008 for the third ventricle, and r = -0.510, p = 0.018 for the lateral ventricle). The severity of gait disturbance was negatively correlated with the midbrain diameter (r = -0.598, p = 0.004), but the degree of cognitive dysfunction and incontinence showed no significant correlation with midbrain diameter or ventricular width. Conclusions: This study suggests that midbrain atrophy is significantly associated with gait disturbance in NPH.

关键词：常压脑积水运动区域第三脑室运动功能减退侧脑室解剖学基础正中矢状面病理生理学假设性脑萎缩

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血管紧张素Ⅰ转换酶多态性对常压脑积水综合征患者术前、术后的影响

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世界核心医学期刊文摘（神经病学分册） 2005年第8期1卷 44-44页

作者： Del Mar Matarn M. Poca M.A. Bartrés-Faz D. 赵正卿 Dept. de Psiq. i Psicobiologia Clin. Universitat de Barcelona IDIBAPS Casanova 143 08036Barcelona Catalunya Spain Dr.

Previous reports have suggested an association between the insertion/deletion (I/D) polymorphism of the angiotensin- converting enzyme (ACE), cardiovascular disease, and cognitive performance. No rmal pressure hydrocephalus (NPH) is considered to be an example of reversible d ementia although the clinical improvement after shunting varies from subject to *** association has been suggested between vascular risk factors and the development of NPH. The ACE plays a major role in vascular pathology and physiol ogy. In the present study we investigated the distribution of an ACE gene insert ion/deletionpolymorphism in 112 patients diagnosed with NPH and in 124 controls. We also evaluated the role of this geneticpolymorphism in cognitive functioning before and following surgery in a subgroup of 72 patients. No differences in ge neticor allele distributions were found between patients and healthy subjects, b ut among patients, carriers of D/D or D/I genotypes obtained less cognitive bene fit following shunt surgery, especially on measures of memory and frontal functi on. Our data support previous findings in other conditions indicating that posse ssion of at least one D allele is associated with poorer cognitive performance.

关键词：常压脑积水酶多态性血管紧张素Ⅰ 认知功能血管危险因素可逆性痴呆基因多态性术后症状心血管疾病健康受试者

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