成人烟雾病合并后循环病变的相关因素分析  

Analysis of the Risk Factors of Adult Patients with Moyamoya Disease Involved with Posterior Circulation Lesions

作　　者：王莉[1,2] 韩聪[2] 段炼[2] 杨伟中[2] 张正善[2] 暴向阳[2] 赵峰[2] 

机构地区：[1]解放军总医院军医进修学院,北京100085 [2]军事医学科学院附属医院解放军第307医院神经外科,北京100071

出　　处：《现代生物医学进展》2013年第17期3263-3266,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金面上项目(81171083);解放军第307医院创新科研基金重点项目(ZD-2012-04)

摘　　要：目的:探讨成人型烟雾病合并后循环病变发生的相关危险因素,以期指导临床诊治。方法:回顾性分析2009年3月～2010年1月于解放军307医院神经外科就诊并住院的成人烟雾病患者418例,根据是否合并后循环病变(大脑后动脉病变为主)分为合并后循环病变组130例,未合并后循环病变组为288例。分别记录患者的的性别、年龄、籍贯、临床表现类型、铃木分期、既往病史(高血压、高脂血症、高血糖)、不良生活习惯(吸烟、饮酒),是否有烟雾病家族史。对其进行组间对比及logistic回归法进行变量分析。结果:阳性家族史是成人烟雾病患者合并后循环病变的独立危险因素(OR=3.898,95%CI:1.103～13.776,P=0.035),而其余观察指标均无明显相关性(P>0.05);相对于只存在前循环病变的患者,成人烟雾病合并后循环病变的患者较易出现卒中及头痛,脑出血相对较少;此类患者于31-40岁组出现小高峰。结论:阳性家族史是成人烟雾病患者合并后循环病变的独立危险因素,患者的临床表现较重,治疗后仍可出现反复卒中。Objective： To investigate the relevant risk factors of the adult patients with moyamoya disease involved with posterior circulation lesions and guid the clinical diagnosis and treatment.Methods： According to whether they had posterior circulation lesions（most of the posterior cerebral artery lesions） in moyamoya disease,418 adult patients were divided into two groups： group with posterior circulation lesions including 130 patients and the other group including 288 patients.The clinical data including gender,age,native place,the types of clinical manifestations,Suzuki＇s staging,medical history（hypertension,hyperlipoidemia,hyperglycemia）,bad habits（smoke,drink） and positive family history were collected and the relationship of clinical data between two groups was analyzed.Results： By the comparison between groups and the multiple logistic regression analysis： positive family history was the independent risk factors for adult moyamoya disease patients with posterior circulation lesions.The rest of the observed indicators had no significant correlation（P0.05）;the incidence of stroke and headache is higher,but the incidence of cerebral hemorrhage is lower than that of patients suffering from anterior circulation lesion;there was a disease peak in the age distribution from 31 to 40 years.Conclusion： Positive family history was the independent risk factors for adult moyamoya disease patients with posterior circulation lesions,who could have poorer conditions and stroke repeatedly after treatment.

关 键 词：成人烟雾病 后循环 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]