鄂东南基层地区成人烟雾病的发病特点及诊治分析  

Diagnosis, treatment and characteristics of adult Moyamoya disease in countryside in the southeast of Hubei province

作　　者：白亮[1] 李俊[2] 何峰[1] 毛秀琴[1] 石俊[1] 尤汉生 

机构地区：[1]湖北省黄梅县人民医院神经内科,435500 [2]广州军区武汉总医院神经外科,武汉430064

出　　处：《中华神经医学杂志》2017年第7期725-729,共5页Chinese Journal of Neuromedicine

摘　　要：目的分析鄂东南基层地区成人烟雾病发病的临床特征及诊治情况。方法选取自2010年5月至2015年5月黄梅县人民医院及辖区内一、二级医院收治的成人烟雾病患者资料共68例，收集其年龄、性别、住址（居住环境情况）、生活习惯（特殊嗜好）、家庭成员健康状况、既往病史、症状、确诊相关因素、治疗方法及治疗结果等资料，比较患者区域分布、年龄构成、发病类型及治疗效果等情况。结果该疾病存在高发区域与低发区域，男女性别比为1．09：1．年龄以35-44岁为发病高峰期；其中出血型患者42例，缺血型患者16例，非典型脑血管病变表现患者7例，无明显相关症状患者3例。68例患者中早期确诊（首发症状到确诊所需时间≤30d）38例（55．9％）晚期确诊（首发症状到确诊所需时间〉30d）30例（44．1％1，早期确诊组患者是否首诊于三级医院、首发症状是否为出血型脑卒中、文化程度及经济水平情况与晚期确诊组患者相比，差异均具有统计学意义（P〈0．05）。本组患者死亡10例，存活58例。其中首发症状出血型患者中，2例患者行颞浅动脉一大脑中动脉分支吻合术，2例硬脑膜颞浅动脉血管融通术：首发症状缺血型患者中，4例行硬脑膜颞浅动脉血管融通术：行脑血管重建手术的此8例患者仅占全部病例的11．8％。结论鄂东南层地区成人烟雾病的地域分布有区域聚集特点，发病人群以青壮年为主，首发症状主要为出血型脑卒中，首诊医院级别为三级的患者其确诊时间较短，患者接受脑血管重建术比例较低。Objective To analyze the clinical features, diagnosis and treatment of adult Moyamoya disease in countryside of the southeast of Hubei province. Methods Sixty-eight adult patients with Moyamoya disease, selected in countryside of the southeast of Hubei Province from May 2010 to May 2015, were enrolled. The clinical data, including age, gender, address （surrounding of residence）, living habit （special hobby）, health of family members, past medical history, symptom, confirmation related factors, treatment methods and prognoses, were retrospectively analyzed. Results These patients had high and low incidences in distribution. The ratio of male to female was 1.09：1. The peak age of onset was 35 to 44 years. There were 42 bleeding patients, 16 ischemia patients, and 7 patients with atypical symptom, and 3 patients were asymptomatic. Thirty-eight patients （55.9%） had early diagnosis and 30 （44.1%） had late conformed diagnosis; patients with early diagnosis had significantly higher percentages of first diagnosis in the tertiary hospitals, hemorrhagic apoplexy as first onset, high education level and economic level than patients with late conformed diagnosis （P〈0.05）. Ten patients died. Eight patients received vascular reconstruction, accounting for 11.8% （8/58）. Conclusions The distributions of adult moyamoya disease are regional cluster. The main age of onset is at the life prime. The initial symptom is hemorrhagic stroke. The time for diagnosis was short in the tertiary hospitals. The ratio of patients receiving vascular reconstruction is low.

关 键 词：脑底异常血管网病 临床特征 诊断 流行病学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]