Moyamoya病相关眼部症状临床分析36例  

Clinical feature of ocular presentations of Moyamoya disease in 36 cases

作　　者：王爱平[1] 

机构地区：[1]南阳市中心医院神经内科,河南省南阳市473009

出　　处：《眼科新进展》2012年第8期769-771,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨与Moyamoya病相关的眼部的临床表现和发生机制。方法回顾性分析36例Moyamoya病患者的临床资料和眼部表现。结果 36例Moyamoya病患者中眼部症状与其他症状同时出现者13例(36.1%),仅以眼部症状为首发症状就诊者6例(16.7%)。数字减影血管造影(DSA)/核磁共振血管造影(MRA)检查显示:单侧或双侧颈内动脉狭窄或闭塞者10例(27.8%),其中2例患者双侧颈内动脉完全闭塞,而无任何眼部症状;单侧或双侧大脑中动脉起始部狭窄或闭塞者20例(55.6%),大脑前动脉起始部狭窄或闭塞者2例(5.6%)。19例患者眼部表现主要为一过性黑矇3例、视力下降甚至丧失9例、视野缺损4例、瞳孔大小异常3例、瞳孔直接/间接对光反射消失2例、眼球运动障碍2例、上睑下垂1例、眼部疼痛1例。结论神经内科及眼科临床医师均应掌握Moyamoya病的发病特点及临床表现,特别是对于有眼部症状的Moyamoya病患者应该做到早期诊断及治疗,避免误诊漏诊,防止发生严重的视觉障碍或神经系统其他相关功能障碍。Objective To discuss the clinical features and occurring mechanism of eye signs related to Moyamoya disease.Methods The clinical materials and eye signs for 36 cases of Moyamoya patients were retrospectively analyzed.Results There were 13 patients（36.1%） whose eye signs and other signs were occurred together and 6 patients（16.7%） only had eye signs.DSA and MRI check indicated 10 patients（27.8%） with one side or double side’s cervical artery stenosis or obstruction.Among them,there were two patients with double side’s complete cervical artery obstruction but without eye signs,20 patients（55.6%） with one side or double side’s middle cerebral artery stenosis or obstruction at the initial part of the artery,and 2 patients（5.6%） with anterior cerebral artery stenosis or obstruction.Among 19 cases with eye symptoms（one or several signs and symptoms）,3 cases demonstrated with transient amaurosis,9 cases with visual acuity decreasing or loss,4 cases with defect vision field,3 cases with abnormal pupil size,2 cases with pupil direct or indirect light reaction loss,1 case with ptosis,2 cases with eyeball movement obstacle and 1 case with eye pain.Conclusion The neurological physician and eye doctor in the clinical department should master the occurring features and clinical demonstration of Moyamoya disease,especially the patients with eye signs and symptoms.The patients should be diagnosed and treated in the early stage to avoid the wrong diagnosis or leaked diagnosis,so as to prevent the serious vision defect or other neurological system function disorder.

关 键 词：MOYAMOYA病 颈内动脉 大脑中动脉 动脉狭窄 动脉闭塞 眼部表现 

分 类 号：R743[医药卫生—神经病学与精神病学]