基于胚胎发育的烟雾病新分型

发布时间：2018-04-24 03:20

本文选题：烟雾病 + 后循环　；参考：《首都医科大学》2017年硕士论文

【摘要】：目的:烟雾病是一种原因不清的慢性脑血管病,以颅内主要血管进行性狭窄或闭塞为特点。本文旨在从胚胎发育的新角度对烟雾病提出新分型。资料与方法:回顾性分析烟雾病患者的脑血管造影资料,在每一个患者的造影中分析其异常的血管及从哪一段开始病变的。结果:共回顾性分析了262例烟雾病患者。32例儿童患者有大脑后动脉病变,其中17例男性15例女性;68例成人患者有大脑后动脉病变,其中33例男性35例女性。我们又分别对比了男女患者之间和成人儿童患者之间大脑后动脉开始病变的节段,结果显示无统计学差异(男女组之间p=0.233,成人儿童之间p=0.855)。然而,在100例有大脑后动脉受累的患者中,只有4例病变节段起自P1段,而且这4例患者都有基底动脉病变。其余所有96例大脑后动脉病变的患者病变节段都是起自P2或以后的节段(P3/P4)。从胚胎发育的角度看,大脑后动脉P1段由基底动脉发出其余各段都由颈内动脉发出。结论:烟雾病应该分为原始颈内动脉系统烟雾病和原始椎基底动脉系统烟雾病两大类。原始椎基底动脉系统烟雾病发病率特别低的原因可能是原始椎基底动脉在胚胎发育后期才长入颅内,也就是原始椎基底动脉系统在发育时与颅内环境接触比原始颈内动脉系统更少。
[Abstract]:Objective: moyamoya disease is a chronic cerebrovascular disease, characterized by progressive stenosis or occlusion of the main intracranial vessels. This article is aimed at presenting a new classification of moyamoya disease from a new angle of embryonic development. Data and methods: a retrospective analysis of cerebral angiography materials in moyamoya patients and the analysis of their abnormalities in each patient's angiography. Results: a total of 262 cases of.32 children with moyamoya disease had posterior cerebral artery disease, including 17 males and 15 women, 68 adult patients with posterior cerebral artery disease, of which 33 were male and 35 women. We also compared between male and female patients and adult children. There was no statistical difference in the segment of the intercerebral posterior artery (p=0.233 between men and women, p=0.855 between adult children). However, only 4 of the 100 patients with posterior cerebral artery involvement were from the P1 segment, and all of the 4 patients had basilar artery lesions. All the remaining 96 cases of the posterior cerebral artery disease The segment of the lesion is from P2 or later (P3/P4). From the point of view of embryonic development, the P1 segment of the posterior cerebral artery is emitted by the internal carotid artery from the rest of the basilar artery. Conclusion: moyamoya disease should be divided into two major categories: moyamoya disease of the original internal carotid artery system and the primitive vertebrobasilar system moyamoya disease. The original vertebral basilar artery system smoke The cause of the very low incidence of foggy disease may be that the original vertebral basilar artery grows into the skull in the late embryonic development, that is, the primitive vertebral basilar artery system has less contact with the intracranial environment than the original internal carotid artery system when it develops.

【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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