颅内动脉粥样硬化是缺血性卒中(Ischemic stroke, IS)的主要原因之一,其致死率和致残率较高。颅内血管病变的发病机制通常始于血管壁,因此,早期识别斑块成分及其易损性对临床诊疗和患者预后至关重要。颅内血管传统影像学评价方法,如DSA...颅内动脉粥样硬化是缺血性卒中(Ischemic stroke, IS)的主要原因之一,其致死率和致残率较高。颅内血管病变的发病机制通常始于血管壁,因此,早期识别斑块成分及其易损性对临床诊疗和患者预后至关重要。颅内血管传统影像学评价方法,如DSA、CTA、MRA,主要评价病变血管管腔狭窄程度,不能评价管壁情况并具有电离辐射危害或有创性。高分辨率血管壁成像(High-resolution magnetic resonance vessell wall imaging, HR-VWI)作为一项新兴的无创检查技术,可以清晰地显示颅内动脉管壁情况,精准对斑块进行定量及定性分析,进而识别斑块的易损性特征。本文旨在深入探讨HR-VWI在评估颅内动脉粥样硬化斑块影像学特征与缺血性卒中之间的相关性,为患者早期发现及诊疗提供可行性方向。Intracranial atherosclerosis, a major cause of ischemic stroke (IS), carries high mortality and morbidity. Early detection of plaque composition and vulnerability is crucial due to its vessel wall origin. Traditional imaging (DSA, CTA, MRA) focuses on lumen stenosis, lacking wall assessment and with radiation or invasive risks. HR-VWI (High-resolution magnetic resonance vessell wall imaging), an emerging non-invasive technique, visualizes intracranial arterial walls, precisely analyzing plaques and identifying their vulnerability. This article aims to delve into the correlation between HR-VWI in assessing intracranial atherosclerotic plaque imaging features and ischemic stroke, providing a feasible direction for early detection, diagnosis, and treatment of patients.展开更多
文摘目的探讨短程团体认知行为治疗(Group Cognitive Behavioral Therapy,GCBT)对青少年抑郁症患者的疗效,观察短程GCBT和计算机化认知行为治疗(Computerized Cognitive Behavioral Therapy,CCBT)联合对青少年抑郁治疗疗效。方法随机选取2022年8月—2023年8月福建省福州神经精神病防治院精神科门诊及医学心理咨询中心门诊收治的90例青少年抑郁症患者为研究对象,通过随机数表法分为CCBT组(n=30,因未完成5次治疗脱落19例,最终11例)、GCBT组(n=30,因未完成5次团体治疗脱落3例,最终27例)及CCBT+GCBT组(n=30)。在服用抗抑郁药物基础上,CCBT组合并5周的CCBT,GCBT组合并5周的GCBT,CCBT+GCBT组合并5周的GCBT及CCBT。治疗频率均为1次/周。比较3组治疗前、后汉密尔顿抑郁量表(24 Items Hamilton Depression Scale,HAMD-24)评分及减分率,中学生心理健康量表(Mental Health Scale for Middle School Students,MSSMHS)总均分及各因子分。结果5周治疗后,3组HAMD-24评分[CCBT组16(9,18)分、GCBT组18(13,21)分、CCBT+GCBT组13.5(8,20.25)分]均有明显下降,差异有统计学意义(Z=-2.847、-4.545、-4.784,P均<0.05)。3组HAMD减分率比较,差异无统计学意义(P=0.069)。CCBT+GCBT组MSSMHS总均分及强迫、敌对、人际关系敏感、抑郁、焦虑、情绪不平衡及心理不平衡等因子分与治疗前比较,差异有统计学意义(P均<0.05);GCBT组MSSMHS总均分及强迫、敌对、抑郁及情绪不平衡等因子分与治疗前比较,差异有统计学意义(P均<0.05)。CCBT+GCBT组MSSMHS人际关系敏感及心理不平衡因子分较GCBT组明显改善,差异有统计学意义(P均<0.05)。结论短程CCBT及GCBT等治疗能有效改善青少年患者的抑郁症状,且CCBT与GCBT联合治疗疗效更优于单纯GCBT,且能有效降低CCBT高脱失率。
文摘颅内动脉粥样硬化是缺血性卒中(Ischemic stroke, IS)的主要原因之一,其致死率和致残率较高。颅内血管病变的发病机制通常始于血管壁,因此,早期识别斑块成分及其易损性对临床诊疗和患者预后至关重要。颅内血管传统影像学评价方法,如DSA、CTA、MRA,主要评价病变血管管腔狭窄程度,不能评价管壁情况并具有电离辐射危害或有创性。高分辨率血管壁成像(High-resolution magnetic resonance vessell wall imaging, HR-VWI)作为一项新兴的无创检查技术,可以清晰地显示颅内动脉管壁情况,精准对斑块进行定量及定性分析,进而识别斑块的易损性特征。本文旨在深入探讨HR-VWI在评估颅内动脉粥样硬化斑块影像学特征与缺血性卒中之间的相关性,为患者早期发现及诊疗提供可行性方向。Intracranial atherosclerosis, a major cause of ischemic stroke (IS), carries high mortality and morbidity. Early detection of plaque composition and vulnerability is crucial due to its vessel wall origin. Traditional imaging (DSA, CTA, MRA) focuses on lumen stenosis, lacking wall assessment and with radiation or invasive risks. HR-VWI (High-resolution magnetic resonance vessell wall imaging), an emerging non-invasive technique, visualizes intracranial arterial walls, precisely analyzing plaques and identifying their vulnerability. This article aims to delve into the correlation between HR-VWI in assessing intracranial atherosclerotic plaque imaging features and ischemic stroke, providing a feasible direction for early detection, diagnosis, and treatment of patients.
