成人烟雾病起病方式与代偿循环特点关系分析-神经病学专业论文 word格式.docxVIP

Onsetsyndromeandcollateralcirculationcharactersresearchinadult-onsetMoyamoyadiseasePostgraduate：YihuaHeTutor：Prof. CongGaoInstituteof Neurosciences the 2ndAffiliatedHospital of Guangzhou Medical College,Guangzhou(510260),ChinaAbstractObjectiveThe purpose of this study is to analyse the characters of collateral circulationinadult-onsetMoyamoyadisease,toresearchthecorrelationbetween onsetclinicalmanifestationandthecharatersofcollateralcirculation.Theresultcan provide referenceto the furtherfunction study,clinical diagnosis andtherapy. Subjects and methods This study collected information of 86 patients with adult-onset Moyamoya disease, who had been diagnosed by angiography. These informationincludedtheclinicalmanifestationandtheneuroimaginginformation. Thenwe analysedthecollateralcirculationofcerebralarteriesinangiography,andthe correlationbetween thecollateral charactersandthe clinical features.ResultPatientsofadult-onsetMoyamoyadiseaseusuallymanifestedintracranial heamorrhage(62.8%).ventriculuscerebri,lobes,basalgangliawerethemostlikely partsofheamorrhage.HeamorrhagicMoyamoyapatientshadhigherrichnessofthe network-likeabnormalvascularthanischemicpatients.Dilatationofdeepbrain compensatorycollateralarteries(includinganteriorchoroidalarteries,posterior choroidalarteries,posteriorpericallosalarteries)wasmorelikelyshowedin heamorrhagicMoyamoyapatients.Theseresultsimpliedthataportionofintracranial heamorrhagein adult-onset Moyamoyadisease causedbyruptureof thedilatated deep brain compensatorycollateral arteries.Key words adult-onsetMoyamoyadisease,heamorrhage前言烟雾病（Moyamoyadisease）又称脑底异常血管网病。是以脑血管造影发现双侧颈内动脉远端、大脑中动脉和大脑前动脉近端进行性狭窄、闭塞，伴脑底烟雾样异常血管网形成为特征的一种慢性脑血管闭塞性疾病。临床表现复杂多样，可发生短暂性脑缺血发作、脑梗死、脑出血、癫痫等多种疾病，是儿童期卒中的主要病因，亦是青年卒中的常见病因之一。儿童烟雾病多以短暂性脑缺血发作及脑梗死为常见表现，成人烟雾病多以颅内出血为常见表现。根据国内外文献报道，烟雾病的好发年龄有2 个高峰，分别是10 岁以内的儿童以及40 岁左右的成人，因烟雾病为以慢性进展性颅内血管狭窄直至闭塞伴代偿循环形成，且起病方式的差异及各种可能与烟雾病起病相关因素的广泛报道，故有学者认为儿童起病的烟雾病与成人起病的烟雾病可能为以类似颅内血管改变为特点的异质性疾病。根据国外的文献报道，烟雾病病例报道以日本最多，韩国及中国等亚洲国家次之，白种人及黑种人发病率较低。国内暂时未有大规模的流