87例烟雾病临床特点及影像学回顾性研究

发布时间：2018-05-16 20:27

本文选题：烟雾病 + 临床特点　；参考：《浙江大学》2014年硕士论文

【摘要】：目的研究近年来江浙地区神内科首诊烟雾病患者的临床表现及影像学特点以指导临床工作。方法回顾性分析了浙二医院(2005年4月-2013年4月)8例患儿(≤17岁)及79例成人(17岁)烟雾病的首发症状、临床特点及影像学表现。结果(1)8例烟雾病未成年患者的男：女为1：1,平均年龄为14.50±2.73岁,79例成人烟雾病男：女为1.08：1,平均年龄为41.20±11.13岁；(2)87例患者中18例存在可疑家族史,10例合并有甲亢或亚临床甲亢；(3)62.5%烟雾病患儿以缺血症状首发,54.43%成人烟雾病以脑梗死首发,31.65%以脑出血首发；(4)75例烟雾病患者在头颅CT或MRI可发现异常,其中脑出血27例,脑梗死44例,脑卒中的高发部位是基底节、颞顶叶等；(5)20例患者行CTA检查,57例行MRA检查,CTA和MRA发现双侧均有病变58例,烟雾血管已形成的有59例,合并动脉瘤2例,均为前交通单发动脉瘤；(6)46例行DSA确诊,根据铃木分期分为6期,不同分期烟雾病在DSA上的表现不同,45例烟雾病患者中42例烟雾血管形成,11例单侧血管累及,34例双侧血管均累及,5例患者同时累及大脑后动脉,双侧颈内动脉系统均受累的病例显著高于仅单侧受累病例。结论成人型烟雾病发病高峰仍在40岁,在神内科就诊烟雾病患者以缺血性脑卒中多见；MRA能发现更多烟雾病,可作为本病的初筛；DSA仍为烟雾病诊断的金标准,烟雾病血管造影以双侧颈内动脉系统病变多见,且可同时累及大脑后动脉；另,甲亢或许与烟雾病相关,临床遇到癫痫发作病人无法找到明确癫痫原因需考虑烟雾病可能。
[Abstract]:Objective to study the clinical and imaging features of moyamoya disease in Jiangsu Province and Zhejiang Province in recent years in order to guide clinical work.
Methods the first symptoms, clinical features and imaging features of 8 children (less than 17 years of age) and 79 adult (17 years old) moyamoya disease in Zhejiang two hospital (April April 2005 -2013) were retrospectively analyzed.
Results (1) 8 cases of moyamoya disease were 1:1, the average age was 14.50 + 2.73 years, 79 cases of adult moyamoya disease male: 1.08:1, the average age was 41.20 + 11.13 years; (2) 18 cases of suspected family history in 87 patients, 10 cases of hyperthyroidism or subclinical hyperthyroidism; (3) 62.5% moyamoya disease children started with ischemic symptoms, 54.43% The onset of adult moyamoya disease was cerebral infarction, 31.65% with cerebral hemorrhage, and (4) 75 cases of moyamoya patients were found abnormal in the head CT or MRI, including 27 cases of cerebral hemorrhage, 44 cases of cerebral infarction, the high incidence of cerebral apoplexy was basal ganglia, temporal parietal lobe and so on; (5) 20 patients underwent CTA examination, 57 routine MRA examination, CTA and MRA found that both had 58 cases of bilateral lesions, smog blood. There were 59 cases and 2 cases of aneurysm combined with anterior communicating single artery aneurysm; (6) 46 cases were diagnosed by DSA, divided into 6 stages according to SUZUKI staging, different stages of moyamoya disease in different stages were different on DSA, 42 cases of smoke vessels formed in 45 cases of moyamoya disease, 11 cases of unilateral vascular involvement, 34 cases of bilateral vessels involved, 5 patients involved the brain simultaneously. The posterior artery and bilateral internal carotid artery system were significantly higher than those with only unilateral involvement.
Conclusion the peak of adult moyamoya disease is still at the age of 40, and the patients with moyamoya disease in the medical department are more common with ischemic stroke; MRA can find more moyamoya disease and can be used as the initial screening of this disease. DSA is still the gold standard for the diagnosis of moyamoya disease. In addition, hyperthyroidism may be related to moyamoya disease. The patients with epilepsy can not find the cause of epilepsy, so we should consider the possibility of moyamoya disease.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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