目的:探讨脑微出血(CMB)对小动脉闭塞型急性缺血性卒中患者rt-PA静脉溶栓后出血转化及预后的影响。方法:选择2018年1月至2020年2月在贵州医科大学附属医院神经内科进行rt-PA溶栓的小动脉闭塞型急性缺血性卒中患者作为研究对象,按有无CM...目的:探讨脑微出血(CMB)对小动脉闭塞型急性缺血性卒中患者rt-PA静脉溶栓后出血转化及预后的影响。方法:选择2018年1月至2020年2月在贵州医科大学附属医院神经内科进行rt-PA溶栓的小动脉闭塞型急性缺血性卒中患者作为研究对象,按有无CMB分为CMB阳性组与CMB阴性组,其中CMB阳性组根据CMB的个数分为低负荷组(1〜4个)和高负荷组CMB(≥5个)。所有患者均在时间窗内进行rt-PA静脉溶栓,并记录患者的一般临床资料。根据患者rt-PA静脉溶栓后7d的出血转化及90d的功能结局情况,判断CMB是否对小动脉闭塞型急性缺血性卒中rt-PA静脉溶栓产生影响。结果:共收集到CMB阳性组患者36例(40%),CMB阴性组患者53例(59%)。通过对患者溶栓后功能预后的单因素分析发现,CMB阳性组(χ^(2)=7.456,P=0.024),CMB高负荷组(χ^(2)=13.95,P=0.000)的患者有更高的功能结局不利和(或)不良。通过多因素有序Logistic回归分析发现,CMB阴性(OR=0.307,95%CI—2.340——0.021)以及既往无高血压病史(OR=0.193,95%CI,—3.054——0.234)较C M B阳性的及合并高血压病史的患者rt-PA静脉溶栓后功能预后不利和(或)不良的发生率更低。比较发现CMB阳性组与阴性组之间7d出血转化差异无显著意义。结论:①CMB的存在及CMB的负荷程度不增加小动脉闭塞型卒中患者rt-PA静脉溶栓后出血转化的风险;但可增加rt-PA静脉溶栓后功能结局不利和(或)不良的发生率;②虽然CMB的存在可导致小动脉闭塞型卒中患者静脉溶栓后更高的90 d功能结局不利和(或)不良率,但总体比例是比较低的,故对小动脉闭塞型卒中患者,在溶栓前行多模式的颅脑MRI检查可能是不必要的,因为这可能导致DNT时间的延长,从而降低静脉溶栓的效果。展开更多
Purpose:To assess the influence of glaucoma filtration surgery on anatomical and functional tests for glaucoma evaluation.Methods:Twenty-five eyes(25 patients)with primary openangle glaucoma were evaluated,prospective...Purpose:To assess the influence of glaucoma filtration surgery on anatomical and functional tests for glaucoma evaluation.Methods:Twenty-five eyes(25 patients)with primary openangle glaucoma were evaluated,prospectively.Data were collected on vision acuity,intraocular pressure,standard automated perimetry,frequency doubling technology perimetry,scanning laser polarimetry(GDx)and confocal scanning laser ophthalmoscopy(HRT II)before and 3-6 months after surgery.Results:Mean(± SD)pre-and postoperative visual acuities(logMAR)were 0.28(± 0.18)and 0.30(± 0.17),respectively(P=0.346).In a mean time of 4.5(± 1.1)months after surgery,the mean preoperative intraocular pressure of 20.7(± 5.4)mmHg decreased to 11.04(± 2.52)mmHg(P < 0.001).The results of the standard automated perimetry,frequency doubling technology perimetry,scanning laser polarimetry and confocal scanning laser ophthalmoscopy diagnostic methods revealed no significant difference(P > 0.162)between pre and postoperative values and no significant correlation(P > 0.296)between intraocular pressure reduction and value changes.Conclusion:No significant change on any test variable was detected after glaucoma filtration surgery.Trabeculectomy does not appear to influence standard automated perimetry,frequency doubling technology perimetry,scanning laser polarimetry and confocal scanning laser ophthalmoscopy(HRT II)results after a 4.5-month period of surgery in early to moderate glaucoma.展开更多
Introduction: The aim of this study was to analyse 1-and 2-year outcomes aft er photodynamic therapy (PDT) in clinical routine outside of the TAP [treatment of age-related macular degeneration (AMD) with PDT] study. W...Introduction: The aim of this study was to analyse 1-and 2-year outcomes aft er photodynamic therapy (PDT) in clinical routine outside of the TAP [treatment of age-related macular degeneration (AMD) with PDT] study. We analysed the func tional results, possible influencing factors and the rate of side effects. Metho ds: We analysed the medical records of 210 consecutive patients between 50 and 9 3 years of age (73±9 years) who had been treated with PDT for active ≥50%clas sic CNV resulting from AMD. Only patients with a minimum follow-up of 1 year (1 27) were included; 52 patients completed 2 years of follow-up. Juxta-and extra foveal CNV were also analysed. Treatment was given in accordance with TAP parame ters and regular follow-up examinations were performed with standardised ETDRS visual acuity (VA) measurements and fluorescein angiography. Results: In the sub foveal group, in 63.6%(70/110) a loss of VA ≥3 lines could be prevented after 1 year, and in 51.1%(23/45) after 2 years. An improvement of ≥1 line was found in 31.8%(1 year) and in 22.2%of eyes (2 years). Severe VA loss of ≥6 lines o ccurred in 10.9%of cases after 1 year and in 15.6%after 2 years. Themean chang e of VA was-1.7±3.4 lines (1 year) and-2.5±3.9 lines (2 years). For the grou p ofCNV with juxta-/extrafoveal localisation, themean change ofVAwas +0.8±2.5 lines after 1 year and +1.0±4.2 lines after 2 years. With regard to different CNV localisations, the results for juxta-/extrafoveal CNV are statistical sign ificantly better (p=0.005 and p=0.035 after 1 and 2 years, respectively). A mean of 2.6 treatments were performed in the first year and 0.5 in the second year. Conclusions: The results obtained in a single institution compare favourably wit h the results of the TAP study. The results regarding functional visual outcome could be obtained with a lower number of treatments in clinical practice. Juxta -and extrafoveal CNV showed significantly better results than a subfoveal local isation of the CNV. In this subgroup a mean improvem展开更多
文摘目的:探讨脑微出血(CMB)对小动脉闭塞型急性缺血性卒中患者rt-PA静脉溶栓后出血转化及预后的影响。方法:选择2018年1月至2020年2月在贵州医科大学附属医院神经内科进行rt-PA溶栓的小动脉闭塞型急性缺血性卒中患者作为研究对象,按有无CMB分为CMB阳性组与CMB阴性组,其中CMB阳性组根据CMB的个数分为低负荷组(1〜4个)和高负荷组CMB(≥5个)。所有患者均在时间窗内进行rt-PA静脉溶栓,并记录患者的一般临床资料。根据患者rt-PA静脉溶栓后7d的出血转化及90d的功能结局情况,判断CMB是否对小动脉闭塞型急性缺血性卒中rt-PA静脉溶栓产生影响。结果:共收集到CMB阳性组患者36例(40%),CMB阴性组患者53例(59%)。通过对患者溶栓后功能预后的单因素分析发现,CMB阳性组(χ^(2)=7.456,P=0.024),CMB高负荷组(χ^(2)=13.95,P=0.000)的患者有更高的功能结局不利和(或)不良。通过多因素有序Logistic回归分析发现,CMB阴性(OR=0.307,95%CI—2.340——0.021)以及既往无高血压病史(OR=0.193,95%CI,—3.054——0.234)较C M B阳性的及合并高血压病史的患者rt-PA静脉溶栓后功能预后不利和(或)不良的发生率更低。比较发现CMB阳性组与阴性组之间7d出血转化差异无显著意义。结论:①CMB的存在及CMB的负荷程度不增加小动脉闭塞型卒中患者rt-PA静脉溶栓后出血转化的风险;但可增加rt-PA静脉溶栓后功能结局不利和(或)不良的发生率;②虽然CMB的存在可导致小动脉闭塞型卒中患者静脉溶栓后更高的90 d功能结局不利和(或)不良率,但总体比例是比较低的,故对小动脉闭塞型卒中患者,在溶栓前行多模式的颅脑MRI检查可能是不必要的,因为这可能导致DNT时间的延长,从而降低静脉溶栓的效果。
文摘Purpose:To assess the influence of glaucoma filtration surgery on anatomical and functional tests for glaucoma evaluation.Methods:Twenty-five eyes(25 patients)with primary openangle glaucoma were evaluated,prospectively.Data were collected on vision acuity,intraocular pressure,standard automated perimetry,frequency doubling technology perimetry,scanning laser polarimetry(GDx)and confocal scanning laser ophthalmoscopy(HRT II)before and 3-6 months after surgery.Results:Mean(± SD)pre-and postoperative visual acuities(logMAR)were 0.28(± 0.18)and 0.30(± 0.17),respectively(P=0.346).In a mean time of 4.5(± 1.1)months after surgery,the mean preoperative intraocular pressure of 20.7(± 5.4)mmHg decreased to 11.04(± 2.52)mmHg(P < 0.001).The results of the standard automated perimetry,frequency doubling technology perimetry,scanning laser polarimetry and confocal scanning laser ophthalmoscopy diagnostic methods revealed no significant difference(P > 0.162)between pre and postoperative values and no significant correlation(P > 0.296)between intraocular pressure reduction and value changes.Conclusion:No significant change on any test variable was detected after glaucoma filtration surgery.Trabeculectomy does not appear to influence standard automated perimetry,frequency doubling technology perimetry,scanning laser polarimetry and confocal scanning laser ophthalmoscopy(HRT II)results after a 4.5-month period of surgery in early to moderate glaucoma.
文摘Introduction: The aim of this study was to analyse 1-and 2-year outcomes aft er photodynamic therapy (PDT) in clinical routine outside of the TAP [treatment of age-related macular degeneration (AMD) with PDT] study. We analysed the func tional results, possible influencing factors and the rate of side effects. Metho ds: We analysed the medical records of 210 consecutive patients between 50 and 9 3 years of age (73±9 years) who had been treated with PDT for active ≥50%clas sic CNV resulting from AMD. Only patients with a minimum follow-up of 1 year (1 27) were included; 52 patients completed 2 years of follow-up. Juxta-and extra foveal CNV were also analysed. Treatment was given in accordance with TAP parame ters and regular follow-up examinations were performed with standardised ETDRS visual acuity (VA) measurements and fluorescein angiography. Results: In the sub foveal group, in 63.6%(70/110) a loss of VA ≥3 lines could be prevented after 1 year, and in 51.1%(23/45) after 2 years. An improvement of ≥1 line was found in 31.8%(1 year) and in 22.2%of eyes (2 years). Severe VA loss of ≥6 lines o ccurred in 10.9%of cases after 1 year and in 15.6%after 2 years. Themean chang e of VA was-1.7±3.4 lines (1 year) and-2.5±3.9 lines (2 years). For the grou p ofCNV with juxta-/extrafoveal localisation, themean change ofVAwas +0.8±2.5 lines after 1 year and +1.0±4.2 lines after 2 years. With regard to different CNV localisations, the results for juxta-/extrafoveal CNV are statistical sign ificantly better (p=0.005 and p=0.035 after 1 and 2 years, respectively). A mean of 2.6 treatments were performed in the first year and 0.5 in the second year. Conclusions: The results obtained in a single institution compare favourably wit h the results of the TAP study. The results regarding functional visual outcome could be obtained with a lower number of treatments in clinical practice. Juxta -and extrafoveal CNV showed significantly better results than a subfoveal local isation of the CNV. In this subgroup a mean improvem
