问题 问答题 简答题

脑梗死实验室检测

答案

参考答案:

1.影像学检查脑的影像学检查可以直观地显示脑梗死的范围、部位、血管分布、有无出血、陈旧和新鲜梗死灶等,帮助临床判断组织缺血后是否可逆、血管状况,以及血流动力学改变。帮助选择溶栓患者、评估继发出血的危险程度。

2.头颅计算机断层扫描(CT)是最常用的检查。但是对超早期缺血性病变和皮质或皮质下小的梗死灶不敏感,特别是后颅窝的脑干和小脑梗死更难检出。在超早期阶段(发病6小时内),CT可以发现一些轻微的改变,如大脑中动脉高密度征;皮质边缘(尤其是岛叶)以及豆状核区灰白质分界不清楚、脑沟消失等。通常平扫在临床上已经足够使用。若进行CT血管成像,灌注成像或要排除肿瘤、炎症等则须注射造影剂增强显像。

3.头颅磁共振成像(MRI)标准的MRI序列(T1、T2和质子相)对发病几个小时内的脑梗死不敏感。弥散加权成像(DWI)可以早期显示缺血组织的大小、部位,甚至可显示皮质下、脑干和小脑的小梗死灶。早期梗死的诊断敏感性达到88%~100%,特异性达到95%~100%。

4.灌注加权成像(PWI)是静脉注射顺磁性造影剂后显示脑组织相对血流动力学改变的成像。灌注加权改变的区域较弥散加权改变范围大,目前认为弥散一灌注不匹配区域为半暗带。

5.经颅多普勒超声(TCD)对判断颅内外血管狭窄或闭塞、血管痉挛、侧支循环建立程度有帮助。最近,应用于溶栓治疗的监测,对预后判断有参考意义。

6.血管影像虽然现代的血管造影已经达到了微创、低风险水平,但是对于脑梗死的诊断没有必要常规进行血管造影数字减影(DSA)检查。在开展血管内介入治疗、动脉内溶栓、判断治疗效果等方面DSA很有帮助,但仍有一定的风险。

7.磁共振血管成像(MRA)、CT血管成像(CTA)等是无创的检查,对判断受累血管、治疗效果有一定的帮助。

8.其他检查正电子发射断层扫描(PET)、氙加强CT、单光子发射计算机断层扫描(SPECT)等,多在有条件的单位用于研究。

完形填空
完型填空。
     Mr. Glen is a millionaire. Five years ago, after returning from abroad to his motherland, he    1    up his small company. Speaking of success, Glen often tells us a story about his    2   expensive "school" fees. He always owes his success to it.
     At that time, Glen, who already got a Ph. Degree, decided to return to the homeland, starting a
company. Before    3  , he bought a Rolex watch with the    4   made through years of work after school
and the scholarships. At the airport he had to accept the routine customs check. The watch on his wrist
was also demanded to be    5   down for inspection. Glen knew that carrying the    6   goods out had to
pay the tax. And he worried about paying    7   for his watch. So when he was checked, he told a lie that
his watch was a worthless    8  . When he was    9   of his "smarts", immediately,   10   the presence of
Glen, the officers hit the watch, which    11   nearly ¥100,000, into pieces at hearing Glen's words. Glen was amazed.    12   he understood why, he was taken to the office to be    13   strictly. For many times of entryexit    14   he knew that only those people in the "blacklist" would "enjoy" this special treatment. The
officers looked out every thing carefully in the box, and warned him    15   time of entry and exit he must
accept the check and if    16   reusing and carrying fake and shoddy (劣质的) goods, he would be
charged according to law! Suddenly, his face turned red, and he had nothing in mind after   17   the plane
for long.
     After returning to the homeland, he often told the story to his family, and his employees, too. He said
that this made a deep    18   on him, because an additional high "school" fee that he had ever paid made
him realize the value of    19 , which he would    20   as the secret of his success forever.
( )1. A. set        
( )2. A. good      
( )3. A. staying    
( )4. A. books      
( )5. A. put        
( )6. A. ordinary    
( )7. A. one        
( )8. A. present    
( )9. A. afraid      
( )10. A. in          
( )11. A. paid      
( )12. A. Before    
( )13. A. appreciated  
( )14. A. conditions  
( )15. A. no matter what
( )16. A. came out  
( )17. A. landing    
( )18. A. expression  
( )19. A. honesty      
( )20. A. remember      
B. came          
B. bad          
B. leaving      
B. things        
B. looked        
B. common        
B. it            
B. trade        
B. proud        
B. on            
B. spent        
B. After        
B. beaten        
B. experiences  
B. no matter how
B. found out    
B. flying        
B. idea          
B. lies          
B. learn        
C. went        
C. extra        
C. living      
C. saving      
C. taken      
C. specific      
C. them        
C. toy          
C. well        
C. before      
C. took        
C. If          
C. spoken        
C. experiments  
C. no matter when
C. sent out    
C. catching    
C. thought      
C. goods      
C. revise      
D. called        
D. few          
D. coming        
D. pounds        
D. lied          
D. many          
D. these        
D. fake          
D. hard          
D. after        
D. cost          
D. Though        
D. examined      
D. chances      
D. no matter why
D. set out      
D. boarding      
D. impression    
D. things        
D. read          
名词解释