發(fā)布時間：2018-05-05 08:46

  本文選題：煙霧病 + 臨床表現(xiàn)　； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的： 分析煙霧病的臨床特點及影像學(xué)表現(xiàn)，探討各種輔助檢查對該病的診斷價值。 方法： 回顧性研究我院神經(jīng)內(nèi)科2012年8月至2013年12月收治的煙霧病患者，，共25例，對患者性別、發(fā)病的年齡、臨床表現(xiàn)、影像學(xué)分析、治療及預(yù)后等多方面進行分析。 結(jié)果： 1、本組患者共25例，年齡從21歲到59歲，平均年齡43歲，發(fā)病年齡高峰期在41-45歲，男性13例，女性12例。 2、本組病例中，25名患者發(fā)病前均無明顯誘因，臨床表現(xiàn)各異。其中缺血性腦血管病19例，出血性腦血管病6例，其中腦梗死12例，短暫性腦缺血發(fā)作7例，腦葉出血3例，腦室出血2例，蛛網(wǎng)膜下腔出血1例。 3、本組25名患者均行DSA檢查，雙側(cè)頸內(nèi)動脈末端狹窄2例，閉塞6例，雙側(cè)大腦中動脈閉塞4例，一側(cè)大腦前動脈、對側(cè)大腦中動脈狹窄或閉塞3例，單側(cè)大腦中狹窄4例，單側(cè)大腦中閉塞5例，同側(cè)大腦中動脈、大腦前動脈狹窄1例，3例合并動脈瘤。 4、25例患者均現(xiàn)行TCD檢查，發(fā)現(xiàn)血管狹窄或閉塞可能后行DSA檢查確診為煙霧病。 結(jié)論： 1、成人煙霧病的發(fā)病高峰為41-45歲左右。 2、成人煙霧病患者中缺血型患者比例較前明顯增高。 3、缺血型煙霧病DSA分期以第3期為主，而出血型煙霧病DSA分期以第4、5期為主。 4、出血型煙霧病患者血管增生明顯，常合并動脈瘤。 5、TCD對于煙霧病的診斷有一定特異性，其中對第3、4期患者的檢出率更高，對DSA結(jié)果有意義，因此TCD可以廣泛用于煙霧病的篩查。
[Abstract]:Objective: To analyze the clinical features and imaging manifestations of moyamoya disease and to explore the diagnostic value of various auxiliary examinations for moyamoya disease. Methods: A retrospective study of 25 patients with moyamoya disease from August 2012 to December 2013 was conducted. The sex, age of onset, clinical manifestation, imaging analysis, treatment and prognosis of moyamoya disease were analyzed. Results: 1. There were 25 patients, aged from 21 to 59 years, with an average age of 43 years. The peak age of onset was 41-45 years, 13 males and 12 females. 2. There were no obvious inducements and different clinical manifestations in 25 patients. There were 19 cases of ischemic cerebrovascular disease and 6 cases of hemorrhagic cerebrovascular disease, including 12 cases of cerebral infarction, 7 cases of transient ischemic attack, 3 cases of lobar hemorrhage, 2 cases of ventricular hemorrhage and 1 case of subarachnoid hemorrhage. 3. DSA examination was performed in all 25 patients, including bilateral internal carotid artery stenosis in 2 cases, occlusion in 6 cases, bilateral middle cerebral artery occlusion in 4 cases, unilateral anterior cerebral artery in 3 cases, contralateral middle cerebral artery stenosis or occlusion in 3 cases, unilateral middle cerebral artery stenosis in 4 cases. Unilateral middle cerebral occlusion in 5 cases, ipsilateral middle cerebral artery in 1 case, anterior cerebral artery stenosis in 1 case with aneurysm. 4 all 25 patients were diagnosed as moyamoya disease by DSA. Conclusion: 1. The peak of adult moyamoya disease is about 41-45 years old. 2. The proportion of ischemic patients in adult moyamoya disease was significantly higher than that before. 3. The DSA stage of ischemic moyamoya disease was mainly in the third stage, while the DSA stage of blood type moyamoya disease was stage 4 or 5. 4, the blood group moyamoya disease patient blood vessel proliferation is obvious, often complicates the aneurysm. 5TCD has a certain specificity for the diagnosis of moyamoya disease, among which the detection rate of stage 3 / 4 is higher, and it is significant to the result of DSA. Therefore, TCD can be widely used for screening of moyamoya disease.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3

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本文編號：1847023