中国实用医刊杂志   部级期刊

摘要：目的 探讨血清基质金属蛋白酶-9(MMP-9)水平在脑出血后不同时间点的动态变化在脑水肿形成过程中的作用.方法 采用放射免疫法检测90例符合纳入标准的急性脑出血患者及80例正常对照者24 h、72 h、7 d 和14 d时血清MMP-9水平,分析其在脑水肿形成过程中的作用.结果 脑水肿在入院72 h时达高峰,之后缓慢下降.在发病24 h 内患者血清MMP-9含量已明显升高,发病后72 h达高峰,与脑水肿高峰一致;7 d下降明显,与对照组比较均明显升高(P＜0.01),第14天接近正常水平.血清MMP-9水平在脑出血后24 h、72 h与水肿体积、水肿比值呈正相关(P＜0.01).结论 脑出血后血清MMP-9随着时间动态变化,MMP-9与脑水肿体积相关,与相对水肿体积相关性更强. Abstract： Objective To study the effect of dynamic expression at different time points of metallo proteinase-9 on brain edema after cerebral hemorrhage. Methods Serum levels of MMP-9 in 90 patients with brain hemorrhage and 80 normal patients were detected by radioimmunoassay on 24 h、72 h、7 d and 14 d.The relationship between levels of MMP-9 and brain edema after cerebral hemorrhage.Results Brain edema went up to the peak at 72 h and slowly decline after it. At 24 h, the serum level of MMP-9 were significantly higher, and reached the peak at 72 h according to the peak of cerebral edema, and then decreased significantly after 7 d. Cerebral hemorrhage group compared with the control group were significantly higher(P＜0.01). The level of MMP-9 close to normal levels on 14 d. MMP-9 was positive correlated with edema volume and edema ratioat 24 h and 72 h (P=0.01).Conclusions Serum MMP-9 dynamic changes over time after cerebral hemorrhage. The level of MMP-9 was correlated with the brain edema volume and had more stronger correlation with relative size of brain edema. MMP-9 was correlated with inflammation after cerebral hemorrhage.

摘要：目的 研究猪空肠占位模型64层CT仿真内窥镜技术(CTVE)对小肠模拟占位显示的可行性.方法 制作4段新鲜离体猪小肠占位性病变模型,每段长约36 cm,每段用猪髂腰肌修剪制作6枚模拟占位(直径0.5 cm、1.0 cm、1.5 cm各2枚),4段共24枚.一端结扎封闭,另一端通过16F双腔气囊导尿管与注射器相连.在完全充气状态下进行64层CT检查.用轴位、MPR和CTVE技术观察,应用4分级法评价模拟占位的显示情况,并与模型进行比较.结果 4段猪小肠均充盈饱满,图像清晰.24个模拟占位,轴位结合MPR能全部显示,显示率为100%,其中2个直径为0.5 cm的模拟占位显示效果为Ⅰ级,其余22个模拟占位显示效果为Ⅲ级;CTVE能全部显示,显示率为100%,显示效果均为Ⅲ级.结论 用猪小肠模拟占位进行64层CT扫描是可行的,在充分的气体充盈状态下,MPR结合仿真内窥镜技术能清晰显示直径小至0.5 cm的模拟占位. Abstract： Objective To study the feasibility of detection for simulated occupying lesions in porcine jejunum with a 64-MSCT virtual endoscopy. Methods Four fresh porcine jejunum segments(each 36 cm in length)were cleaned and 6 occupying lesions were simulated on the mucous surface in each segment for total of 24 lesions. Their diameters were 0.5 cm, 1.0 cm and 1.5 cm. The segments were then tied on one end and the other end were connected to an injector through a double cavity-Foley catheter for gas filling. The porcine jejunum segments was scanned with a 64-MSCT scanner under complete gas filling. The date was analyzed at the workstation. The simulated occupying lesions were observed in axial imaging and MPR imaging and CTVE. A 4-class system was used to quantify the lesion display class(LDC). To compare the source and the pattern of simulated occupying lesions. Results The four porcine jejunum segments were well-filling and the imaging were clear. 24 of simulated occupying lesions were all detected by axial and MPR and the rate of detection was 1

摘要：目的 探讨靶向survivin的短发夹RNA(shRNA)对人结肠癌SW480细胞的基因下调效应和细胞生长的抑制作用.方法 构建靶向survivin的shRNA质粒载体,然后转染入结肠癌SW480细胞.用逆转录聚合酶链反应(RT-PCR)和免疫印迹法(Western Blot)检测survivin的mRNA和蛋白的表达情况,MTT实验评价转染后各组细胞的增殖情况.结果 靶向survivin的shRNA能够明显下调survivin mRNA和蛋白质表达(P＜0.05),其抑制率分别是41.49%和40.82%.MTT实验提示转染了特异性靶向survivin shRNA的SW480细胞在转染48 h后开始呈现随着时间延长而进行性生长抑制的现象.在转染后72 h该细胞存活率仅为43.6%,与空白对照组相比有显著性的降低(P＜0.05).结论 靶向survivin的特异性shRNA对结肠癌SW480细胞能够明显地下调survivin基因表达,并且显著抑制细胞的增殖. Abstract： Objective To observe the inhibitory effect of survivin gene expression and cell proliferation of the human colon cancer cell line SW480 caused by surviving-shRNA. Methods The survivin-shRNA was constructed and transfected into SW480 cells with LipofectamineTM2000. The down-regulations of survivin expressions were detected by RT-PCR and western blot analysis. The cell proliferation inhibitions were determined by MTT assay. Results The survivin-shRNA successfully and efficiently suppressed the expression of survivin mRNA and protein(P＜0.05).The expression inhibition rates were 41.49% and 40.82% at the mRNA and protein level respectively. The MTT assay indicated that the specific shRNA resulted in significant inhibition of cell growth on the culture plates on a time-dependent manner since 48 hours post-transfection. The cell viability of SUR group was 47.8% at 72 h,which was of statistical significance compared with that of blank control group (P＜0.05).Conclusions The specific survivin-shRNA could down-regulate the expression of survivin gene and inhibit the growth of SW480 cells.

摘要：目的 研究脑梗死患者从到达医院到开始正确治疗的时间(院内延迟),分析导致延迟的相关因素及对策.方法 回顾性研究了进入医院就诊的急性脑梗死患者的院内延迟情况及其影响因素.结果 院内延迟中位数时间为66 min,60 min内接受治疗者68例(60.71%).单因素分析显示院内延迟与下列变量之间关系密切:无常见病因,成人,首发症状为传统症状,由120救护车进行运送.性别及有、无医疗保险对院内延迟无显著影响.多因素回归模型显示仅常见病因的有无、年龄、首发症状以及运送方式与院内延迟有明显相关性.结论 急性脑梗死患者院内延迟严重阻碍超早期溶栓治疗,需进一步提高医生脑梗死诊治水平;加强急救系统建设,尽可能使脑梗死患者使用急救车转运至医院. Abstract： Objective To study the causes of hospital delays of thrombolysis in our hospital.Methods We prospectively studied the hospital delay of acute cerebral infarction(ACI)patients in our hospital and establish some countermeasures.Results The hospital delay time for all patients was 66(34～82)minutes.The present study shows that 68 patients(60.71%)accepted thrombolysis within 60 minutes after arrival. Univariate analysis showed that the reason of the hospital delays:no common cause of disease,adult,traditional symptoms of stroke and 120 ambulance transportation.Sex,medical insurance had no significant effect on early treatment.A multivariate regression model demonstrated that the most significant factors associated with early treatment were having or no common cause of disease,age,methods of transportation and type of symptoms of stroke.Conclusions Hospital delays of ACI patients have a significant influence on the effect of thrombdysis in superacute stage.To reduce the hospital delay time,doctors' professional ability should be improved.And also,it is necessary to improve emergency system, reduce transportation time.

摘要：目的 探讨不同孕期凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)、纤维蛋白原(Fg)、凝血酶时间(TT)和纤维蛋白(原)降解产物(FDP)等凝血指标变化的临床意义.方法 采用美国BECKMAN COUTER公司ACL7000全自动血凝仪检测200例正常早孕、中孕、晚孕妇女和50例正常非孕妇女的PT、APTT、Fg、TT和FDP,并对检测结果进行比较.结果 孕中期、孕晚期与对照组比较,PT、APTT、TT明显缩短,差异有统计学意义(P＜0.05),Fg、FDP明显增高,差异有统计学意义(P＜0.05)；孕早期与对照组比较,APTT、Fg差异明显,有统计学意义(P＜0.05),PT、TT、FDP差异不明显,无统计学意义(P＞0.05)；孕中期与孕晚期比较,Fg、FDP明显增高,差异有统计学意义(P＜0.05),PT、APTT、TT变化不明显,差异无统计学意义(P＞0.05).结论 PT、APTT、TT可作为出凝血疾病的筛选指标；Fg是凝血重要底物,与血液流动学及血小板聚集有关,FDP表明血液纤溶活性总水平,这5项检测基本能保证手术前凝血因子的筛查要求. Abstract： Objective To explore coagulation indices clinical variation and significance of prothrombin time(PT).Activated partial thromboplastin time(APTT),Fibrinogen (Fg),thrombin time(TT) and fibrinogen/fibrin degradation products (FDP) during the different pregnacy. Methods By the ACL 7000 from the company of Americian BECKMAN COULTER,the samples of 200 women of early,Middle and late pregnancy and 50 unpregnant women were tested and the results were compared. Results PT,APTT,TT were apprently shortened in the middle and late pregnacy than that in controls,the difference was statistically significant (P＜0.05),Fg and FDP were obviously higher than that in controls,there were notable difference in APTT and Fg,Which was significantly different(P＜0.05). While PT,TT and FDP had no obvious difference,without statistical significance(P＞0.05). During the middle and later period of pregnancy,the indices of Fg and FDP rise remarkably,with stat

摘要：目的 探讨肝切除治疗肝内胆管结石的效果及影响因素,研究既往胆道手术对肝内胆管结石治疗效果的影响及对策.方法 回顾性分析120例肝内胆管结石病例的临床资料,统计结石分布、术式选择、术后并发症和治疗效果.术中采用肝叶(段)切除、单纯胆总管探查取石T管引流、单纯胆肠吻合内引流、肝门成形胆肠吻合等术式,联合纤维胆道镜术中再诊断及辅助取石.术后结石残留,经T管窦道胆道镜取石.结果 近期结石总清除率86.7%,最终结石清除率100.0%.手术总并发症31例(25.8%).术后随访3个月～2.5年.总体治疗优良率86.7%.结论 肝叶(段)切除术安全、有效.既往多次胆道手术严重影响肝内胆管结石的治疗效果.首次针对肝内胆管结石手术的规范化有助于减少患者结石残留,提高结石清除率及治愈率. Abstract： Objective To study the treatment effects and affection of hepatolithiasis by resection of hepatic lobe and/or segments. And to investigate the affection of past biliary-tract surgery and how to avoid it. Methods The clinical data of 120 patients of hepatolithiasis were retrospectively analyzed.Stones distribution,operation modality,postoperative complications,and therapeutic effect were evaluated.During surgery we adopted hepatic lobe segment resection,common bile duct exploration simple T-tube drainage,simple drainage of biliary-enteric anastomosis,hepatic portal forming surgical biliary-enteric anastomosis,etc. Combined with choledochoscope rediagnosis and assisted in removing stones. Postoperative residual stones were removed via T-tube sinus tract by cholangioscopy. Results The total immediate stone clearance rate was 86.7%,and the final stone clearance rate was 100.0%. The total complication rate was 25.8%(31 cases out of 120 cases). Postoperative interview time was between three months to 2.5 years. The total effective curative rate was 86.7%. Conclusions Hepatic lobe(segment)resection is a safe and effective m

摘要：目的 观察评价喉全切除Amatsu改良法发音重建术防止误咽的效果.方法 2001年6月至2010年1月对96例喉全切除患者一期行Amatsu改良法发音重建术,评价术后吞咽功能.结果 83例(86.5%)术后均获得良好的言语功能,其中吞咽功能正常81例(97.6%),另2例仅在进食流食时可见气管内少量溢液(2.4%).结论 Amatsu改良法发音重建术能兼顾言语和吞咽功能,有效地防止误咽. Abstract： Objective To evaluate the deglutition function of modified Amatsu's tracheoesophageal shunt operation after total laryngectomy. Methods One stage voice rehabilitations were performed for 96 cases with modified Amatsu's tracheoesophgeal shunt operation. Results Eighty-three(86.5%)patients kept good voice function, and 81(97.6%)patients avoided deglutition disorders, but 2(2.4%)cases suffered water drip from his tracheoesophageal shunt when drinking. Conclusions Modified Amatsu's tracheoesophageal shunt operation is advantageous to prevent deglutition disorders as well as to restore the voice function for total laryngectomy.

摘要：目的 探讨慢性乙型肝炎患者血清转化生长因子-β1(TGF-β1)与血清肝纤维化指标的关系,评价其对早期肝纤维化诊断的临床价值.方法 分别检测38例慢性乙型肝炎患者和10名健康者(对照组)血清中TGF-β1水平和透明质酸(HA)、层粘蛋白(LN)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PC Ⅲ)水平.患者均行肝组织穿刺活检,标本进行常规HE染色和胶原纤维染色.结果 慢性乙型肝炎中、重度患者血清TGF-β1水平［(202±78)mg/L,(401±63)mg/L］显著高于对照组［(75±34)mg/L,P＜0.01］,HA、LN、IVC、PC Ⅲ水平随肝纤维化进展而呈逐渐升高.各组血清HA、LN、IVC、PC Ⅲ均与血浆TGF-β1呈明显正相关(P＜0.01).结论 慢性乙型肝炎患者血清TGF-β1水平与肝纤维化指标呈正相关,其对早期诊断出肝硬化具有重要意义. Abstract： Objective To study the relationship between serum level of TGF-β1 and hepatic fibrosis parameters in patients with chronic hepatitis B. Methods Serum TGF-β1 and hyalauronic acid(HA), laminin (LN), type Ⅳ collagen(Ⅳ-C) and type Ⅲ procollagen (PC Ⅲ) were detected by ELISA in 38 patients with chronic hepatitis B (CHB). Ten healthy persons served as controls. Liver puncture was performed in all patients with CHB. Results Serum TGF-β1 levels in moderate, severe CHB ［(202±78)mg/L,(401±63)mg/L］ were much higher than those of the control group ［(75±34)mg/L,P＜0.01］ and increased successively. TGF-β1 was correlated positively with serum levels of HA,LN,Ⅳ-C and PC Ⅲ (P＜0.01). Serum TGF-β1, PCⅢ, LN, Ⅳ-C and HA increased successively (P＜0.01) with aggravation of hepatic fibrosis. Conclusions Serum TGF-β1 levels of patients with CHB are consistent with serum indexes of hepatic fibrosis. It can help to judge the degree of hepatic tissue fibrosis.

摘要：目的 探讨高龄孕产妇妊娠与分娩加强监护与处理的重要性.以减少因处理不当对母婴产生的不良影响.方法 选取单胎妊娠分娩的孕妇分高龄组和非高龄组,观察两组妊娠期分娩期并发症和围生期结局.结果 两组在妊娠分娩期并发症、围生儿并发症方面差异均有统计学意义.结论 高龄孕妇妊娠分娩并发症高,增加了妊娠期及分娩期的高危状况,应加强妊娠期围生期监护,及早发现其潜在不利因素,及时处理,以保证孕产妇安全渡过围生期,达到母婴健康的目的. Abstract： Objective To investigate the importance of enhancing the monitoring and management of pregnancy and delivery in elderly pregnant women,and to reduce the harmful influence to mothers and infants due to the unsuitable treatments. Methods The pregnant women who had singleton pregnancy were divided into elderly group and non-elderly group.We observed the complications of gestation and delivery and the results of peripartum in the two groups. Results The complications of pregnancy,delivery and perinatal infants in elderly group were significantly higher than in non-elderly group. Conclusions The elderly in maternal pregnancy,the incidence of the complications of gestation and delivery was higher,which added the risk during pregnancy and delivery.For ensuring the safety of the pregnant women during perinatal period,and for the sake of the health of mothers and infants,it is significant to pay more attention to gestational and perinatal monitoring,to discover the latent adverse factors early,and to treat in time.

摘要：目的 了解河南省妇女视力残疾流行病学情况,为制定防治和康复计划提供科学依据.方法 本次调查采取分层、多阶段、整群抽样方法,利用SAS 9.1.3统计学软件对第二次全国残疾人抽样调查河南省数据库资料进行分析.结果 我省妇女视力残疾患病率为1.95%,其中1级占21.30%,2级占18.82%,3级占14.11%,4级占51.77%;城乡之间的差异有统计学意义(χ 2 =178.96,P＜0.01).引起视力残疾的主要原因依次为:白内障占46.7%,角膜病占10.3%,视网膜色素变性占9.8%.结论 残疾人中视力残疾者占极高的比例,其中又以乡村发病率为高,值得注意.视力残疾者白内障引起的视力障碍占大多数,防治某些老年性疾病如高血压、动脉粥样硬化、糖尿病等将有助于延缓、改善老年性视力障碍,并能降低残疾的发生率. Abstract： Objective To investigate the population-based epidemiological conditions of visual impairment in Henan Province and provide scientific data for drawing up the prevention and treatment strategies. Methods The methods of sampling survey that Stratified and multistage random cluster sampling were performed. The second national sampling data of disabled population in Henan province with SAS 9.1.3 software was analyzed. Results The morbidity of visual impairment was 1.95%. Grades of visual impairment were first(21.3%), second(18.22%), third(14.11%)and forth(51.77%). Significant difference of the morbidity between urban and rural areas was observed(χ 2 =178.96,P＜0.01).The causes of visual impairment were senile cataract (46.7%), corneal diseases (10.3%), and retinitis pigmentosa (9.8%). Conclusions Those with visual impairment account for a pretty high rate in the total disability population and we should know that the rate of incidence is higher in rural area. And the visual impairment is mostly caused by senile cataract. The prevention and cure of senile diseases such as hypertension, arteriosclerosis and diabetes mellitus can help delay the

摘要：目的 探讨焦虑症与躯体形式障碍患者心理障碍特点及甲状腺激素的异同.方法 采用放射免疫分析法检测62例焦虑症和46例躯体形式障碍患者的血清三碘甲状腺素原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)的水平,同时进行90项症状清单(SCL-90)的评定.结果 ①焦虑症组躯体化因子分较躯体形式障碍组低(t=2.759,P= 0.008);②焦虑症组T4水平较躯体形式障碍组高(t=-2.556,P= 0.013).结论 焦虑症患者心理障碍特点和甲状腺激素水平存在一定特征,有助于与躯体形式障碍鉴别. Abstract： Objective To explore the characteristics of psychological problems and thyroid function in patients with anxiety neurosis and somatoform disorders. Methods Sixty-two patients with anxiety neurosis and 46 patients with somatoform disorders were evaluated by Symptom Checklist 90(SCL-90),thyroid function(T3,T4,FT3,FT4,TSH)were tested by radio immunoassay method. Results ①The score of anxiety neurosis somatization factor in the group with anxiety neurosis was lower than that of the group with somatoform disorders(t=2.759,P=0.008).②The level of T4 in the group with anxiety neurosis was higher than that of the group with somatoform disorders(t=-2.556,P=0.013). Conclusions There are certain characteristics of psychological problems and thyroid function of the patients with anxiety neurosis,which is useful to differentiated from somatoform disorders.

摘要：目的 探讨CT导引下经皮穿刺 125I放射性粒子植入治疗中晚期肺癌的近期疗效及安全性.方法 对36例中晚期肺癌患者,应用治疗计划系统(TPS)计算剂量,CT定位下行肿瘤内 125I放射性粒子植入术.于术后1、3、6个月定期复查胸部CT.结果 术后1、3、6个月随访,有效率分别为88.89%、91.66%、88.89%;术后有6例发生少量气胸,未给予特殊处理3～5d后自行消失;5例术后咳少量血痰,给予止血药物后3～5d消失;无一例出现感染和癌灶种植等并发症.结论 CT引导下经皮穿刺 125I粒子植入治疗肺癌定位准确、操作简单安全、近期疗效确切. Abstract： Objective To explore the short-term curative effect and safety of CT-guided percutaneous implantation of 125I seeds in treating lung cancer. Methods Thirty-six patients with metaphase or terminal lung cancer had been analyzed.All patients were evaluated with TPS(treatment plan system)preoperatively and the post-operative quality was verified.Thirty-six cases were treated with CT-guided interstitial implantation of 125I radioactive seeds.After the implantation,CT scan was performed again after operation for 1,3 and 6 months respectively. Results The effective power was 88.89%,91.66%,88.89% respectively after 1,3 and 6 months.Pneumothorax had happened in 6 patients and it had disappeared automatically within 3-5 days.Manipulus hemoptysis had happened in 5 patients and it had been cured after using hemostatic medicine 3-5 days later.The complications of infection and cancer planting had not occured. Conclusions CT-guided interstitial implantation of 125I seeds is a safe and simple method for lung cancer with few complications and good short-term outcomes.

摘要：目的 观察血液回收技术应用在二尖瓣加主动脉瓣的心脏双瓣膜置换术中对红细胞、血小板和血液流变学的影响.方法 选择40例2008年6月至2010年1月间在我院完成初次心脏手术的双瓣置换术的病人,随机分为实验组(血液回收组)和对照组(不使用血液回收机组),每组20例.观察两组用悬浮红细胞和血浆的数量、术后24 h的引流量,比较两组术前和术后24 h的红细胞计数、血红蛋白浓度、红细胞压积、血小板计数、低切全血黏度和高切全血黏度.结果 实验组用悬浮红细胞和血浆的量明显少于对照组,两组术后24 h引流量、术前和术后24 h的红细胞计数、血红蛋白、红细胞压积、血小板计数、低切全血黏度和高切全血黏度之间比较差异无统计学意义(P＞0.05).结论 血液回收技术在双瓣置换中应用能减少输血,对红细胞、血小板和血液黏度无不利影响,安全有效. Abstract： Objective To observe the influence of autologous blood receiving on erythrocyte,platelet and blood viscidity in double valve replacement(mitral valve and aortic valve replacement).Methods From June 2008 to Jan 2010,40 patients who underwent double valve replacement were enrolled in autologous blood receiving group and control group randomly,20 persons each group.Volume of transfused erythrocytes,blood plasma and postoperative blood loss(within 24 hours after operation)were compared. Samples were taken for the determination of erythrocyte count,hemoglobin,hemotocrite,platelet count and Blood viscosity after operation 24 hours. Results Volume of transfused erythrocytes and blood plasma in autologous blood receiving group were fewer than control group.No significant differences between the two groups were discovered on postoperative blood loss,erythrocyte count,hemoglobin,hemotocrite,platelet count and blood viscosity(P＞0.05). Conclusions Autologous blood receiving can reduce quantity of transfusion in double valve replacement.It has no adve

摘要：目的 探讨培本通幽法对习惯性便秘的治疗作用.方法 将60例患者随机分成治疗组30例(培本通幽汤)与对照组30例(麻仁润肠丸).结果 治疗组治愈9例,显效11例,有效8例,无效2例,总有效率为93.3%,而对照组相应分别为2、8、12、8例,总有效率为73.3%,经统计学分析,两组疗效比较差异有统计学意义(P＜0.05).结论 培本通幽法对于习惯性便秘具有较好的治疗作用. Abstract： Objective To explore the therapy effect of fostering root and passing barrier method on habitual constipation. Methods All the 60 patients were divided into two groups randomly: 30 patients in fostering root and passing barrier group and 30 patients in control group. Results In fostering root and passing barrier group, 9 patients were cured, 11 patients were better, 8 patients were good and 2 patients were ineffective. The total effective rate was 93.3%. In control group, 2 patients were cured, 8 patients wre better, 12 patients were good and 8 patients were ineffective. The total effective rate was 73.3%. There was significant difference between two groups by statistics analysis(P＜0.05). Conclusions Fostering root and passing barrier method has good therapy effect on habitual constipation.

摘要：目的 探讨脑桥中央和脑桥外髓鞘溶解症的临床及神经影像学特点.方法 分析5例脑桥中央髓鞘溶解症和2例脑桥外髓鞘溶解症患者的临床特点,包括基础疾病、起病前诱因、临床表现、头颅MRI特点、治疗及预后情况.结果 7例患者均有慢性形成低钠血症后被快速纠正的病史,以意识改变、构音和吞咽困难、四肢瘫痪等为临床表现.5例脑桥中央髓鞘溶解症的MRI表现为脑桥部位对称性的T1加权低信号灶、T2加权高信号灶,均呈典型"蝙蝠翅"样的改变;2例脑桥外髓鞘溶解症者分别在丘脑、基底节区域有对称性的T1加权低信号、T2加权高信号病灶.5例患者基本痊愈.结论 髓鞘溶解症的发病与低钠血症及过快补钠有关,缓慢纠正慢性形成的低钠血症是预防的关键. Abstract： Objective To investigate the clinical features and neuroimaging features of myelinolysis in central pontine and extrapontine. Methods The clinical features of 5 patients with central pontine myelinolysis and 2 cases with extrapontine myelinolysis were analyzed,including the inducing factors,clinicalmanifestations,cranial MRI,treatrnent and prognosis. Results All the seven patients had the history of rapidity of correcting chronic hyponatraemia, The common clinicalrranifestations included change of consciousness, dysphasia,dysphagia tetraplegia etc. The MRI of 5 cases of central pontine myelinolysis showed pontine parts of the symmetry T1-weighed low signal lesions,T2-weighed high signal lesions,all showed typical change like "Bat Wing". Two cases of extrapontine myelinolysis respectively in the hypothalamus、basical ganglia region of summetry T1-weighed low signal,T2-weighed high signal lesions.Five examples were basically cured. Conclusions The incidence of myelinolysis is related to hyponatremia and rapidity of correcting chronic hyponatraemia,and avoiding the rapidity of correcting chronic hyponatraemia is the key point for preventing its happening.