Chronic effect

慢性效应
  • 文章类型: Journal Article
    苯海拉明(DPH)是一种抗组胺药。它经常在环境中被检测到,因为它在污水处理厂中没有完全降解。最近的研究表明,DPH暴露于各种水生生物的不利影响;然而,它对鱼类的长期影响尚不清楚。在这项研究中,将几对成熟的日本medaka(Oryziaslatipes)长时间暴露于DPH,以确定DPH暴露对后代的影响,产卵和受精卵的数量,性别相关基因的表达,喂养行为,胚胎发育,孵化率,孵化的幼虫畸形,和死亡率。产卵数量显著减少,当母鱼连续暴露于31.6μg/LDPH超过46天时。DPH暴露也改变了medaka个体的摄食行为,增加了幼虫的死亡率.DPH对鱼类的影响可能在一定程度上发生在实际的水生环境中,尽管该领域的风险评估有限。
    Diphenhydramine (DPH) is an antihistamine drug. It has been frequently detected in the environment, because it is not completely degraded in wastewater treatment plants. Recent studies have shown the adverse effects of DPH exposure to various aquatic organisms; however, its chronic effects on fish have been poorly elucidated. In this study, several pairs of mature Japanese medaka (Oryzias latipes) were exposed to DPH for a long period to determine the effects of DPH exposure on the subsequent generations, number of spawned and fertilized eggs, expression of sex-related genes, feeding behavior, embryo development, hatching rate, malformations among the hatched larvae, and mortality rate. The number of spawned eggs significantly decreased, when the parent fish were continuously exposed to 31.6 μg/L DPH for over 46 days. DPH exposure also altered the feeding behavior of medaka individuals, and increased the larval mortality rate. The effects of DPH exposure to fish may occur to some extent in the actual aquatic environment, although the risk evaluations in the field are limited.
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  • 文章类型: Journal Article
    抗生素在水生环境中的光降解产物(PDPs)日益受到关注,但它们对微藻的长期影响尚不清楚。这项研究最初集中于检查红霉素(ERY)的急性作用,然后探讨了ERYPDPs对蛋白核小球藻的慢性影响。4.0-32mg/L的ERY显著抑制细胞生长和叶绿素合成。确定的ERY对C。的96h中位有效浓度为11.78mg/L。较高浓度的ERY诱导更严重的氧化损伤,抗氧化酶减轻了氧化应激。在ERY的光降解进程中辨认了6个PDPs(PDP749、PDP747、PDP719、PDP715、PDP701和PDP557)。PDPs的预测联合毒性在前3小时增加,然后减少。慢性暴露对微藻生长和叶绿素含量的抑制作用逐渐降低。ERYPDPs的急性效应表现为生长刺激,但慢性效应表现为生长抑制。在7、14和21d时,随着ERY降解时间的延长,丙二醛含量降低。与对照组相比,ERYPDPs治疗21d后丙二醛含量升高。风险评估仍需考虑长期暴露下降解产物的潜在毒性。
    The photodegradation products (PDPs) of antibiotics in the aquatic environment received increasing concern, but their chronic effects on microalgae remain unclear. This study initially focused on examining the acute effects of erythromycin (ERY), then explored the chronic impacts of ERY PDPs on Chlorella pyrenoidosa. ERY of 4.0 - 32 mg/L ERY notably inhibited the cell growth and chlorophyll synthesis. The determined 96 h median effective concentration of ERY to C. pyrenoidosa was 11.78 mg/L. Higher concentrations of ERY induced more serious oxidative damage, antioxidant enzymes alleviated the oxidative stress. 6 PDPs (PDP749, PDP747, PDP719, PDP715, PDP701 and PDP557) were identified in the photodegradation process of ERY. The predicted combined toxicity of PDPs increased in the first 3 h, then decreased. Chronic exposure showed a gradual decreasing inhibition on microalgae growth and chlorophyll content. The acute effect of ERY PDPs manifested as growth stimulation, but the chronic effect manifested as growth inhibition. The malonaldehyde contents decreased with the degradation time of ERY at 7, 14 and 21 d. However, the malonaldehyde contents of ERY PDPs treatments were elevated compared to those in the control group after 21 d. Risk assessment still need to consider the potential toxicity of degradation products under long-term exposure.
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  • 文章类型: Journal Article
    作为棉花脱叶器,既(S,S,三硫代磷酸S-三丁酯)在环境中广泛存在。它能对鸡造成神经毒性,大鼠生殖毒性,也会导致人类头痛和恶心。然而,人们对它对鸟类繁殖的影响知之甚少。这里,通过分析生殖指数和组织病理学特征的差异,我们调查了32mga.i./kg的慢性效应,160mga.i./kg和800mga.i./kg对日本鹌鹑(Coturnixjaponica)繁殖能力的影响。结果表明,32mga.i./kg和160mga.i./kg的丁香磷处理显著降低了鹌鹑的摄食量,显著提高了破蛋率,对性腺和肝组织有不良影响。160mga.i./kg的三磷处理也显著降低了平均产蛋量。此外,800mga.i./kg处理对采食量(FI)有显著的负面影响,体重(BW),蛋壳厚度,产蛋量(EP),受精率,孵化率和后代14天存活率,它也显著提高了破蛋率。此外,三叶草暴露导致鹌鹑性腺和肝组织病变。总的来说,我们的研究结果表明,秋千对日本鹌鹑的生殖能力有不利影响,特别是在高浓度。
    As a cotton defoliator, tribufos (S,S,S-tributyl phosphorotrithioate) is widespread in the environment. It can cause neurotoxicity in chickens, reproductive toxicity in rats, and can also cause headaches and nausea in humans. However, little is known about its impact on the reproduction of birds. Here, by analyzing the differences in reproductive indexs and histopathological characteristics, we investigated the chronic effects of 32 mg a.i./kg, 160 mg a.i./kg and 800 mg a.i./kg tribufos treatment on the reproductive ability of Japanese quail (Coturnix japonica). The results indicated that 32 mg a.i./kg and 160 mg a.i./kg tribufos treatment significantly reduced the food intake of quails, significantly increased the broken egg rate, and had adverse effects on gonads and liver tissue. The 160 mg a.i./kg tribufos treatment also significantly reduced the average egg production. Moreover, 800 mg a.i./kg treatment had significant negative effects on feed intake (FI), body weight (BW), eggshell thickness, egg production (EP), fertilization rate, hatchability and progeny 14-d survival rate, and it also significantly increased the broken egg rate. In addition, tribufos exposure caused lesions in quail gonads and liver tissue. Overall, our results revealed that tribufos had adverse effects on the reproductive ability of Japanese quail, especially at high concentrations.
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  • 文章类型: Journal Article
    本系统综述和同行评审文献的荟萃分析的目的是检查血流限制(RT-BFR)的阻力训练对血流动力学的慢性影响。并将这些适应与成人传统阻力训练(TRT)计划引起的适应进行比较(PROSPERO:注册:CRD42022339510)。在PubMed进行了文献检索,运动铁饼,Scielo,和WebofScience数据库。两名独立的评论者提取了研究特征和血压测量值。偏倚风险(用于随机对照试验的Cochrane偏倚风险工具[RoB-2]),和证据的确定性(建议分级,评估,发展,和评估[等级])。共有8项研究符合收缩压(SBP)的纳入标准,舒张压(DBP),和平均动脉压(MAP)。关于RT-BFR与非运动,没有观察到有利于运动组的显著差异(p>0.05)。然而,与TRT相比,RT-BFR引起了DBP的额外改善(-3.35;95CI-6.00至-0.71;I2​=14%;z​=-2.48,p=0.01),和MAP(-3.96;95CI-7.94至0.02;I2​=​43%;z​=​-1.95,p=0.05)。结果表明,与TRT相比,RT-BFR可能导致DBP降低,但是缺乏解决这个话题的数据使得任何结论都具有推测性。未来对这一主题的研究是有必要的。
    The purposes of this systematic review and meta-analysis of peer-reviewed literature were to examine the chronic effects of resistance training with blood flow restriction (RT-BFR) on hemodynamics, and to compare these adaptations to those induced by traditional resistance training (TRT) programs in adults (PROSPERO: Registry: CRD42022339510). A literature search was conducted across PubMed, Sports Discus, Scielo, and Web of Science databases. Two independent reviewers extracted study characteristics and blood pressure measures. Risk of bias (The Cochrane risk of bias tool for randomized controlled trials [RoB-2]), and the certainty of the evidence (Grading of Recommendations, Assessment, Development, and Evaluation [GRADE]) were used. A total of eight studies met the inclusion criteria for systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP). Regarding the comparison of RT-BFR vs. non-exercise, no significant differences favoring the exercise group were observed (p ​> ​0.05). However, when compared to TRT, RT-BFR elicited additional improvements on DBP (-3.35; 95%CI -6.00 to -0.71; I2 ​= ​14%; z ​= ​-2.48, p ​= ​0.01), and on MAP (-3.96; 95%CI -7.94 to 0.02; I2 ​= ​43%; z ​= ​-1.95, p ​= ​0.05). Results indicate that RT-BFR may elicit a decrease in DBP in comparison with TRT, but the lack of data addressing this topic makes any conclusion speculative. Future research on this topic is warranted.
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  • 文章类型: Journal Article
    了解微生物群落对微污染物等外部干扰的响应对于生态风险评估至关重要。在这项研究中,通过两个批次实验研究了慢性抗生素暴露对社区组成和功能的影响。第一个实验调查了慢性磺胺甲恶唑(SMX)暴露的影响,第二个研究了溶解有机物(DOM)来源和多种抗生素暴露的综合影响。结果表明,社区对慢性抗生素暴露的反应取决于社区耐药性之间的动态平衡,适应,recovery,和选择,导致非线性成分多样性变化。慢性SMX暴露的干扰强度随浓度(0.5-50μg/L)的增加而增加。然而,共存有机物的复杂来源和结构可能通过提高代谢活性和产生功能冗余来延迟干扰。尤其是,当营养是一个限制因素时,DOM来源的干扰强度大于慢性抗生素暴露的干扰强度。丰富的分类群对外部分布的抗性导致对群落多样性的解释不足,而稀有分类单元在应对社区变异方面发挥了关键作用,从而影响了社区聚集。长期的SMX暴露减少了关键物种的数量,并有利于确定性组装过程21%。然而,提高社区适应性可能会削弱抗生素选择的影响。慢性SMX暴露使磺胺类抗性基因(sul1,sul2)的相对丰度提高了1.2-4.3倍,而固氮基因的相对丰度(nifH,nifK)和与甲苯相关的代谢途径,乙苯,二恶英降解减少。然而,DOM来源和多种抗生素暴露的综合影响几乎没有引起空白组和暴露组之间与元素代谢和微生物群落耐药性相关的基因差异。这项研究表明,应更加关注有机微污染物的慢性环境效应。
    Understanding the response of the microbial community to external disturbances such as micropollutants is vital for ecological risk evaluation. In this study, the effect of chronic antibiotic exposure on community compositions and functions was investigated by two batch experiments. The first experiment investigated the effect of chronic sulfamethoxazole (SMX) exposure, while the second investigated the combined effect of dissolved organic matter (DOM) sources and multi-antibiotic exposure. The results showed that the community responses to chronic antibiotic exposure depended on the dynamic balance among community resistance, adaptation, recovery, and selection, leading to nonlinear composition diversity variations. The disturbance strength of chronic SMX exposure increased with concentration (0.5-50 μg/L). However, complex sources and structures of coexisting organic matter might delay the disturbance by elevating metabolic activity and generating functional redundancy. Especially, when nutrient was a limiting factor, the disturbance strength by DOM source was greater than that by chronic antibiotic exposure. The resistance of abundant taxa to external distributions resulted in a low explanation of community diversity, while rare taxa played key roles in response to community variation and thereby affected community assembly. Long-term SMX exposure reduced the number of key species and favored the deterministic assembly process by 21%. However, elevated community adaptability might weaken the influence of antibiotic selection. Chronic SMX exposure elevated the relative abundance of sulfonamide resistance genes (sul1, sul2) by a factor of 1.2-4.3, while that of nitrogen-fixing genes (nifH, nifK) and the metabolic pathways related to the toluene, ethylbenzene, and dioxin degradation decreased. However, the combined influence of DOM sources and multi-antibiotic exposure barely caused the difference in the genes linking to element metabolism and drug resistance of microbial communities between blank and exposed groups. This study suggested that more concern should be given to the chronic environmental effect of organic micropollutants.
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  • 文章类型: Journal Article
    微塑料(0.1μm-5mm塑料碎片)的污染目前是全球水生和陆地生态系统保护的主要威胁之一。人们对这一问题的认识日益提高,导致了对微塑料对淡水生物影响的研究增加,尽管关于这种污染物可能沿水营养链从生产者转移到主要消费者的研究仍然很少。在这项研究中,蛾Cataclystalemnata的水生食草幼虫以无微塑料(对照)和受污染(MPs处理)的Lemnaminuta叶为食。对于治疗,浮萍植物生长在富含聚(苯乙烯-co-甲基丙烯酸甲酯)荧光微粒的矿泉水中(MPs,100mg/L),然后饲喂幼虫作为食物来源。在暴露0、7、14和21天测试了微塑料对幼虫的影响,对应于昆虫生命周期的敏感阶段。污染物影响是根据生存能力等参数进行评估的,幼虫的体型/体重,昆虫生命周期的摄食变化和规律性。使用扫描电子和荧光显微镜,证实了幼虫中存在微塑料。在肠腔和排泄物样品中发现荧光微塑料表明,幼虫摄入了受污染的浮萍叶。此外,随着时间的推移,饲喂受污染叶片的幼虫受到微塑料污染物存在的强烈影响,显示高死亡率(90%),并且由于未能达到成翼阶段而在21天后完全无法完成生命周期。在控制测试中,生存率高于治疗,50%的幼虫成功化蛹并以飞蛾的形式出现,到了成人阶段。结果表明,微塑料沿着淡水食物链从生产者到初级消费者的营养转移,对这种水生草食动物的生命周期产生负面影响。
    Contamination by microplastics (0.1 μm-5 mm plastic fragments) is currently one of the major threats to the conservation of aquatic and terrestrial ecosystems worldwide. Growing awareness on this issue has led to an increase in studies on the effects of microplastics on freshwater organisms, although there are still few investigations on possible transfer of this contaminant along water trophic chains from producers to primary consumers. In this study, aquatic herbivorous larvae of the moth Cataclysta lemnata were fed on microplastic-free (control) and contaminated (MPs treatment) Lemna minuta fronds. For treatments, Lemna fronds were grown in mineral water enriched with fluorescent microparticles of poly(styrene-co-methyl methacrylate) (MPs, 100 mg/L) and then fed to the larvae as a food source. Microplastics effects on larvae were tested at 0, 7, 14 and 21 days of exposure, corresponding to sensitive phases of the insect life cycle. Contaminant impact was assessed based on some parameters such as viability, larva body size/weight, feeding alterations and regularity of the insect life cycle. Using scanning electron and fluorescence microscopy, the presence of microplastics in the larvae was verified. The finding of fluorescent microplastics in both the intestinal lumen and excrement samples showed that larvae ingested contaminated Lemna fronds. In addition, larvae fed contaminated fronds were strongly affected by the presence of microplastic contaminant over time, showing high mortality (90 %) and total inability to complete the life cycle after 21 days by failing to reach the winged adult phase. In control tests, survival rates were higher than in treatments, and 50 % of the larvae managed to pupate and emerge as moths, reaching the adult phase. The results show that there was a trophic transfer of microplastics from producer to primary consumer along a freshwater food chain, generating negative effects on the life cycle of this aquatic herbivore.
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  • 文章类型: Meta-Analysis
    拉伸训练增加关节的运动范围。然而,到目前为止,这种拉伸效应背后的机制还没有得到很好的理解。对几项研究的早期荟萃分析报告说,肌肉的被动特性没有变化(即,肌肉僵硬)长期拉伸训练后进行各种类型的拉伸(静态,动态,和本体感觉神经肌肉拉伸)。然而,近年来,越来越多的论文报道了长期静态拉伸对肌肉僵硬的影响。本研究的目的是研究静态拉伸训练对肌肉僵硬度的长期(≥2周)影响。PubMed,WebofScience,和EBSCO在2022年12月28日之前发表的论文进行了检索,10篇论文符合荟萃分析的纳入标准。通过应用混合效应模型,亚组分析,其中包括性别比较(男性与混合性)和肌肉硬度评估类型(从肌肉-肌腱连接处与剪切模量),被执行了。此外,我们进行了一项荟萃回归,以检验总拉伸持续时间对肌肉僵硬度的影响.荟萃分析的结果表明,与对照条件相比,静态拉伸训练3-12周后肌肉僵硬度有所降低(效果大小=-0.749,p<0.001,I2=56.245)。亚组分析显示性别(p=0.131)和肌肉僵硬评估类型(p=0.813)之间没有显着差异。此外,总拉伸时间与肌肉僵硬度之间没有显着关系(p=0.881)。
    Stretch training increases the range of motion of a joint. However, to date, the mechanisms behind such a stretching effect are not well understood. An earlier meta-analysis on several studies reported no changes in the passive properties of a muscle (i.e., muscle stiffness) following long-term stretch training with various types of stretching (static, dynamic, and proprioceptive neuromuscular stretching). However, in recent years, an increasing number of papers have reported the effects of long-term static stretching on muscle stiffness. The purpose of the present study was to examine the long-term (≥2 weeks) effect of static stretching training on muscle stiffness. PubMed, Web of Science, and EBSCO published before December 28, 2022, were searched and 10 papers met the inclusion criteria for meta-analysis. By applying a mixed-effect model, subgroup analyses, which included comparisons of sex (male vs. mixed sex) and type of muscle stiffness assessment (calculated from the muscle-tendon junction vs. shear modulus), were performed. Furthermore, a meta-regression was conducted to examine the effect of total stretching duration on muscle stiffness. The result of the meta-analysis showed a moderate decrease in muscle stiffness after 3-12 weeks of static stretch training compared to a control condition (effect size = -0.749, p < 0.001, I2  = 56.245). Subgroup analyses revealed no significant differences between sex (p = 0.131) and type of muscle stiffness assessment (p = 0.813). Moreover, there was no significant relationship between total stretching duration and muscle stiffness (p = 0.881).
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  • 文章类型: Randomized Controlled Trial
    灵活性训练是一个基本的生物学过程,它通过改善关节的活动范围来提高老年人的生活质量,姿势平衡和运动,从而降低跌倒的风险。通过静坐测试和12周后对两种不同的训练计划进行了严格评估。31名健康的老年人被随机分为三组:实验I组(Exp)进行力量和静态伸展运动;实验II组进行动态和静态伸展运动;在整个研究期间,被分配到对照组的参与者保持久坐的生活方式。在第一次测试(ΔT0=7.63±1.26%;ES=0.36;p=0.002)和第二次测试(ΔT1=3.74±0.91%;ES=0.20;p=0.002)时,ExpI的柔韧性急剧增加。同样,在第一次测试(ΔT0=14.21±3.42%;ES=0.20;p=0.011)和第二次测试(ΔT1=9.63±4.29%;ES=0.13;p=0.005)时,ExpII显着增加。在12周的训练中,ExpI(ΔT0-T1=9.03±3.14%;ES=0.41;p=0.020)和ExpII(ΔT0-T1=22.96±9.87%;ES=0.35;p=0.005)的柔韧性显着增加。两组之间的急性和慢性差异均无统计学意义(p>0.05)。这些结果表明,不同运动类型在改善老年人后部肌肉链的灵活性方面的有效性。因此,可以根据参与者的身体特征来选择优化训练干预措施的计划。
    Flexibility training is a fundamental biological process that improves the quality of life of the elderly by improving the ranges of motion of joints, postural balance and locomotion, and thus reducing the risk of falling. Two different training programs were assessed acutely and after 12 weeks by means of the sit-and-reach test. Thirty-one healthy older adults were randomly divided into three groups: the Experiment I group (Exp) performed strength and static stretching exercises; the Experiment II group performed dynamic and static stretching exercises; and participants assigned to the control group maintained a sedentary lifestyle for the entire period of the study. Flexibility acutely increased in Exp I by the first (ΔT0 = 7.63 ± 1.26%; ES = 0.36; p = 0.002) and second testing sessions (ΔT1 = 3.74 ± 0.91%; ES = 0.20; p = 0.002). Similarly, it increased in Exp II significantly by the first (ΔT0 = 14.21 ± 3.42%; ES = 0.20; p = 0.011) and second testing sessions (ΔT1 = 9.63 ± 4.29%; ES = 0.13; p = 0.005). Flexibility significantly increased over the 12 weeks of training in Exp I (ΔT0 - T1 = 9.03 ± 3.14%; ES = 0.41; p = 0.020) and Exp II (ΔT0 - T1 = 22.96 ± 9.87%; ES = 0.35; p = 0.005). The acute and chronic differences between the two groups were not significant (p > 0.05). These results suggest the effectiveness of different exercise typologies in improving the flexibility of the posterior muscular chains in older adults. Therefore, the selection of a program to optimize training interventions could be based on the physical characteristics of the participants.
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  • 文章类型: Journal Article
    目的:我们进行了吸入和气管内滴注研究,以检查三氧化钨(WO3)纳米颗粒对肺的影响,并评估纳米颗粒是否会引起持续的肺部炎症。
    方法:在吸入研究中,将雄性10周龄Fischer334大鼠分为3组。控制,低剂量,高剂量组吸入清洁空气,2,和10mg/m3的WO3纳米颗粒,分别,每天6小时,共4周。大鼠在3天解剖,1个月,吸入后3个月,并检查支气管肺泡灌洗液(BALF)和肺组织。在气管内滴注研究中,将雄性12周龄Fischer334大鼠分为3个亚组。控制,低剂量,高剂量组气管内滴注0.4ml蒸馏水,0.2和1.0mgWO3纳米颗粒,分别,溶于0.4毫升蒸馏水。3天处死大鼠,1周,气管内滴注后1个月,BALF和肺组织如吸入研究一样进行分析。
    结果:吸入和滴注WO3纳米颗粒导致中性粒细胞数量和速率的短暂增加,BALF中细胞因子诱导的中性粒细胞趋化因子(CINC)-1和CINC-2,但肺组织未见组织病理学改变或血红素加氧酶(HO)-1上调。
    结论:我们的结果表明WO3纳米颗粒对肺具有低毒性。根据吸入研究的结果,我们还提出WO3纳米颗粒的未观察到的不良反应水平(NOAEL)为2mg/m3。
    OBJECTIVE: We conducted inhalation and intratracheal instillation studies in order to examine the effects of tungsten trioxide (WO3 ) nanoparticles on the lung, and evaluated whether or not the nanoparticles would cause persistent lung inflammation.
    METHODS: In the inhalation study, male 10-week-old Fischer 334 rats were classified into 3 groups. The control, low-dose, and high-dose groups inhaled clean air, 2, and 10 mg/m3 WO3 nanoparticles, respectively, for 6 h each day for 4 weeks. The rats were dissected at 3 days, 1 month, and 3 months after the inhalation, and the bronchoalveolar lavage fluid (BALF) and lung tissue were examined. In the intratracheal instillation study, male 12-week-old Fischer 334 rats were divided into 3 subgroups. The control, low-dose, and high-dose groups were intratracheally instilled 0.4 ml distilled water, 0.2, and 1.0 mg WO3 nanoparticles, respectively, dissolved in 0.4 ml distilled water. The rats were sacrificed at 3 days, 1 week, and 1 month after the intratracheal instillation, and the BALF and lung tissue were analyzed as in the inhalation study.
    RESULTS: The inhalation and instillation of WO3 nanoparticles caused transient increases in the number and rate of neutrophils, cytokine-induced neutrophil chemoattractant (CINC)-1, and CINC-2 in BALF, but no histopathological changes or upregulation of heme oxygenase (HO)-1 in the lung tissue.
    CONCLUSIONS: Our results suggest that WO3 nanoparticles have low toxicity to the lung. According to the results of the inhalation study, we also propose that the no observed adverse effect level (NOAEL) of WO3 nanoparticles is 2 mg/m3 .
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  • 文章类型: Journal Article
    在临床过程中有许多记录在案的性别差异,症状表现概况,和帕金森病的治疗反应,为患者管理带来额外的挑战。虽然丘脑底核深部脑刺激是帕金森病的一种既定疗法,性别对治疗结果的影响尚不清楚.这项回顾性观察研究的目的是,是检查运动症状的性别差异,非运动症状,丘脑底核深部脑刺激后的生活质量。对90例接受丘脑下核深部脑刺激治疗的帕金森病患者(年龄63.00±8.01岁,男55例,女35例),术后1个月和12个月评估预后指标。临床评估结果通过学生t检验在性别之间进行比较,并通过配对样本t检验在性别内进行比较。并建立广义线性模型,以确定与各性别治疗效果和强度相关的因素.我们发现,在术后1个月和12个月的药物治疗条件下,丘脑底核深部脑刺激可以改善男性的运动症状,但不能改善女性的运动症状。男性不宁腿综合征的缓解程度大于女性。在丘脑下核深部脑刺激后,女性在基线时的生活质量较差,生活质量的改善程度低于男性。此外,Hoehn-Yahr分期与男性的治疗反应呈正相关,而术后12个月的左旋多巴等效剂量与女性运动改善呈负相关。总之,在运动症状方面,女性从丘脑底核深部脑刺激中获得的益处比男性少,非运动症状,和生活质量。我们发现了性别特异性因素,即,Hoehn-Yahr阶段和左旋多巴等效剂量,与电机改进有关。这些发现可能有助于指导丘脑底核深部脑刺激患者的选择,预后,和刺激编程,以实现帕金森病的最佳治疗效果。
    There are many documented sex differences in the clinical course, symptom expression profile, and treatment response of Parkinson\'s disease, creating additional challenges for patient management. Although subthalamic nucleus deep brain stimulation is an established therapy for Parkinson\'s disease, the effects of sex on treatment outcome are still unclear. The aim of this retrospective observational study, was to examine sex differences in motor symptoms, non-motor symptoms, and quality of life after subthalamic nucleus deep brain stimulation. Outcome measures were evaluated at 1 and 12 months post-operation in 90 patients with Parkinson\'s disease undergoing subthalamic nucleus deep brain stimulation aged 63.00 ± 8.01 years (55 men and 35 women). Outcomes of clinical evaluations were compared between sexes via a Student\'s t-test and within sex via a paired-sample t-test, and generalized linear models were established to identify factors associated with treatment efficacy and intensity for each sex. We found that subthalamic nucleus deep brain stimulation could improve motor symptoms in men but not women in the on-medication condition at 1 and 12 months post-operation. Restless legs syndrome was alleviated to a greater extent in men than in women. Women demonstrated poorer quality of life at baseline and achieved less improvement of quality of life than men after subthalamic nucleus deep brain stimulation. Furthermore, Hoehn-Yahr stage was positively correlated with the treatment response in men, while levodopa equivalent dose at 12 months post-operation was negatively correlated with motor improvement in women. In conclusion, women received less benefit from subthalamic nucleus deep brain stimulation than men in terms of motor symptoms, non-motor symptoms, and quality of life. We found sex-specific factors, i.e., Hoehn-Yahr stage and levodopa equivalent dose, that were related to motor improvements. These findings may help to guide subthalamic nucleus deep brain stimulation patient selection, prognosis, and stimulation programming for optimal therapeutic efficacy in Parkinson\'s disease.
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