【摘要】 目的 探讨肌萎缩性侧索硬化（amyotrophic lateral sclerosis，ALS）的临床特点和诊断。 方法 分析2005年1月-2009年1月收治的57例ALS患者，对其临床特点进行统计分析。 结果 ALS以50～60年龄段发病为主，男性多见。患者平均发病年龄52岁，男女发病年龄无差别，男女比例1.7∶1，死亡23例（40.4%），平均生存时间22个月。 结论 发病年龄越晚，病后存活时间越短。临床表现隐袭起病，逐渐进展。其诊断主要依据临床表现，肌电图检查对早期诊断有重要的价值。【Abstract】 Objective To analyze clinical features and diagnosis of patients with ALS. Methods Fifty-seven patients with ALS were consecutively followed up, and their clinical characteristics were collected from January 2005 to January 2009. Results The average age of onset of patients with ALS was about 50-60 years, and the male was predominant. The mean age of onset was 52 years, and there was no significant difference in the mean age of onset regarding to gender. The ratio of male and female was 1.7. Twenty-three patients (40.4%) died during the period of follow-up, and the mean disease duration was 22 months. Conclusion The older the onsetage is, the more rapid the progression of the disease and shorter the survival time ane. ALS is characterized by onset slowly and progressive muscular paralysis. The diagnosis is primarily based on clinical characteristics, and electromyography examin7ation in early diagnosis has important value.
Objective To explore the status of smoking and passive smoking of the population with the high risk of stroke in the community and their attitude towards smoking control. Methods In March 2015, under the direction of Stroke Screening and Prevention Projection, the residents with the high risk of stroke were sought out in Longfeng Community, Suining City, Sichuan Province. And then their status of smoking and passive smoking and their attitude towards smoking control was investigated by Passive Smoking Questionnaire for Adults from National Smoking Control Office. Results A total of 354 residents with the high risk of stroke were sought out, in whom 152 (42.9%) were smokers, and the smoking rate of males (70.1%) and females (1.4%) was significantly different (P<0.001). Those aged 40-49 had the highest smoking rate (55.0%), followed by those aged 50-59 (51.7%), and smokers of the two age groups accounted for 73.0% of all smokers. There was significant difference in smoking rate among different age groups (P<0.001). The smoking rate of those with a lower education level of primary school (57.9%) was the highest, and there were significant differences in smoking rates among the population with different education levels (P<0.001). The smoking rate of the solitary (95.7%) was higher than that of the non solitary (34.9%) (P<0.001). In 202 non-smokers, 67 (33.2%) was suffered from passive smoking, and the rate of passive smoking was 31.3% in males and 62.3% in females with a significant difference (P<0.001). The proportion of the female non-smokers against passive smoking (84.1%) was higher than that of the male non-smokers (57.8%). According to the participants report, 79.9% of participants approved completely non-smoking in hospital, school and public transport, 66.4% approved non-smoking in the office and traffic station, and only 10.2% approved non-smoking in the restaurants. Conclusions The rates of smoking and passive smoking among the population with the high risk of stroke are high, and most of the population are supportive to smoke prohibition in public places except restaurants. The population with a low cultural level is short of smoking harm knowledge.
ObjectiveTo analyze insulin resistance in patients with cerebral infarction and its correlation with plasma homocysteine level. MethodsA total of 100 cerebral infarction patients diagnosed between July 2013 and August 2014 and 100 healthy physical examination subjects were included in our research. The plasma homocysteine level was detected; the levels of fasting plasma glucose and fasting insulin were detected at the same time. ResultsPlasma homocysteine level (34.95±14.55) μmol/L in patients with cerebral infarction was significantly higher than that of the control group (8.84±2.27) μmol/L (P<0.05). Insulin resistance index (6.24±3.15) in patients with cerebral infarction was significantly higher than that of the control group (2.19±0.63) (P<0.05). The plasma homocysteine level in the infarction group with insulin resistance was significantly higher than that in the infarction group without insulin resistance (P<0.05). The plasma homocysteine level in the infarction group without insulin resistance was significantly higher than that of the patients with insulin resistance in the control group (P<0.05). In the cerebral infarction group, insulin resistance index was positively correlated with plasma homocysteine level (r=0.600, P<0.01). ConclusionInsulin resistance and plasma homocysteine level play important roles in clinical cerebral infarction. Improving insulin resistance and decreasing plasma homocysteine level may be effective ways to reduce the incidence of cerebral infarction.