39例成人烟雾病TCD诊断及临床特点分析  

TCD Diagnosis and Clinical Characteristics of 39 Cases of Adult Moyamoya Disease

作　　者：李芳 张晨 董亮艳 陈景云 LI Fang;ZHANG Chen;DONG Liangyan;CHEN Jingyun(Department of Neuroelectrophysiology,Cardio-cerebrovascular Disease Hospital,the General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院心脑血管病医院神经电生理科,银川750004

出　　处：《宁夏医科大学学报》2020年第9期941-943,共3页Journal of Ningxia Medical University

摘　　要：目的探讨成人烟雾病患者的临床特点及经颅多普勒超声(TCD)在烟雾病诊断及筛查中的作用。方法TCD筛出的可疑烟雾病患者45例,经数字减影血管造影(DSA)最终确诊为烟雾病者39例,应用CT血管成像(CTA)和TCD检查方法对双侧颈内动脉末端(TICA)、大脑中动脉(MCA)及大脑前动脉(ACA)病变的检出进行对比分析,同时分析39例患者的临床表现。结果TCD诊断成人烟雾病阳性率占86.66%(39/45);39例患者首次TCD检查结果:90条血管狭窄或闭塞,其中MCA29条,TICA31条,ACA20条,大脑后动脉(PCA)10条;CTA、TCD对成人烟雾病患者双侧TICA、ACA、MCA病变的检出差异均无统计学意义(P均>0.05);10例烟雾病患者1年后门诊复查TCD,部分患者血管狭窄程度加重;39例成人烟雾病中男性占41.03%,女性占58.97%,男女比例为0.69∶1,平均发病年龄(46.91±9.45)岁;39例成人烟雾病患者起病以缺血型多见。结论TCD可作为成人烟雾病快捷有效的常规筛查和复查的重要检查方法。Objective To investigate the clinical features of adult patients with moyamoya disease(MMD)and the role of transcranial doppler ultrasound(TCD)in the diagnosis and screening of adult moyamoya disease.Methods TCD screened 45 patients with suspected moyamoya disease,and digital subtraction angiography(DSA)finally confirmed 39 patients with moyamoya disease:CT angiography(CTA)and TCD were used to compare the detection of bilateral terminal carotid artery(TICA),middle cerebral artery(MCA)and anterior cerebral artery(ACA)lesions.The clinical manifestations of 39 patients were also analyzed.Results 86.66%of adults diagnosed with moyamoya disease by TCD(39/45).The first TCD examination results of 39 patients showed that 90 vessels were narrow or occluded,including 29 MCA,31 TICA,20 ACA and 10 PCA.There was no significant difference between CTA and TCD in the detection of bilateral TICA,ACA and MCA lesions in adult MMD patients(P all>0.05).One year later,the TCD examination was reexamined in the outpatient department of the above 10 patients,and the severity of vascular stenosis was aggravated in some of them.Among the 39 adult MMD patients,males accounted for 41.03%and females for 58.97%,and the ratio of males to females was 0.69∶1.The average age of onset was(46.91±9.45)years old.39 cases of adult moyamoya disease with the onset of ischemic blood types are more common.Conclusion The peak age of 39 cases of adult moyamoya disease is between 40 and 50 years old,and females are higher than males.Ischemic stroke is more common in clinic.TCD can be used as an effective and efficient method for routine screening and reexamination of Adult moyamoya disease.

关 键 词：烟雾病 经颅多普勒超声 数字减影血管造影 CT血管成像 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]