本文選題：煙霧病 + 臨床特點(diǎn)��； 參考：《浙江大學(xué)》2014年碩士論文

【摘要】：目的研究近年來(lái)江浙地區(qū)神內(nèi)科首診煙霧病患者的臨床表現(xiàn)及影像學(xué)特點(diǎn)以指導(dǎo)臨床工作。 方法回顧性分析了浙二醫(yī)院(2005年4月-2013年4月)8例患兒(≤17歲)及79例成人(17歲)煙霧病的首發(fā)癥狀、臨床特點(diǎn)及影像學(xué)表現(xiàn)。 結(jié)果(1)8例煙霧病未成年患者的男：女為1：1,平均年齡為14.50±2.73歲,79例成人煙霧病男：女為1.08：1,平均年齡為41.20±11.13歲；(2)87例患者中18例存在可疑家族史,10例合并有甲亢或亞臨床甲亢；(3)62.5%煙霧病患兒以缺血癥狀首發(fā),54.43%成人煙霧病以腦梗死首發(fā),31.65%以腦出血首發(fā)；(4)75例煙霧病患者在頭顱CT或MRI可發(fā)現(xiàn)異常,其中腦出血27例,腦梗死44例,腦卒中的高發(fā)部位是基底節(jié)、顳頂葉等；(5)20例患者行CTA檢查,57例行MRA檢查,CTA和MRA發(fā)現(xiàn)雙側(cè)均有病變58例,煙霧血管已形成的有59例,合并動(dòng)脈瘤2例,均為前交通單發(fā)動(dòng)脈瘤；(6)46例行DSA確診,根據(jù)鈴木分期分為6期,不同分期煙霧病在DSA上的表現(xiàn)不同,45例煙霧病患者中42例煙霧血管形成,11例單側(cè)血管累及,34例雙側(cè)血管均累及,5例患者同時(shí)累及大腦后動(dòng)脈,雙側(cè)頸內(nèi)動(dòng)脈系統(tǒng)均受累的病例顯著高于僅單側(cè)受累病例。 結(jié)論成人型煙霧病發(fā)病高峰仍在40歲,在神內(nèi)科就診煙霧病患者以缺血性腦卒中多見(jiàn)；MRA能發(fā)現(xiàn)更多煙霧病,可作為本病的初篩；DSA仍為煙霧病診斷的金標(biāo)準(zhǔn),煙霧病血管造影以雙側(cè)頸內(nèi)動(dòng)脈系統(tǒng)病變多見(jiàn),且可同時(shí)累及大腦后動(dòng)脈；另,甲亢或許與煙霧病相關(guān),臨床遇到癲癇發(fā)作病人無(wú)法找到明確癲癇原因需考慮煙霧病可能。
[Abstract]:Objective to study the clinical and imaging features of moyamoya disease in Jiangsu Province and Zhejiang Province in recent years in order to guide clinical work.
Methods the first symptoms, clinical features and imaging features of 8 children (less than 17 years of age) and 79 adult (17 years old) moyamoya disease in Zhejiang two hospital (April April 2005 -2013) were retrospectively analyzed.
Results (1) 8 cases of moyamoya disease were 1:1, the average age was 14.50 + 2.73 years, 79 cases of adult moyamoya disease male: 1.08:1, the average age was 41.20 + 11.13 years; (2) 18 cases of suspected family history in 87 patients, 10 cases of hyperthyroidism or subclinical hyperthyroidism; (3) 62.5% moyamoya disease children started with ischemic symptoms, 54.43% The onset of adult moyamoya disease was cerebral infarction, 31.65% with cerebral hemorrhage, and (4) 75 cases of moyamoya patients were found abnormal in the head CT or MRI, including 27 cases of cerebral hemorrhage, 44 cases of cerebral infarction, the high incidence of cerebral apoplexy was basal ganglia, temporal parietal lobe and so on; (5) 20 patients underwent CTA examination, 57 routine MRA examination, CTA and MRA found that both had 58 cases of bilateral lesions, smog blood. There were 59 cases and 2 cases of aneurysm combined with anterior communicating single artery aneurysm; (6) 46 cases were diagnosed by DSA, divided into 6 stages according to SUZUKI staging, different stages of moyamoya disease in different stages were different on DSA, 42 cases of smoke vessels formed in 45 cases of moyamoya disease, 11 cases of unilateral vascular involvement, 34 cases of bilateral vessels involved, 5 patients involved the brain simultaneously. The posterior artery and bilateral internal carotid artery system were significantly higher than those with only unilateral involvement.
Conclusion the peak of adult moyamoya disease is still at the age of 40, and the patients with moyamoya disease in the medical department are more common with ischemic stroke; MRA can find more moyamoya disease and can be used as the initial screening of this disease. DSA is still the gold standard for the diagnosis of moyamoya disease. In addition, hyperthyroidism may be related to moyamoya disease. The patients with epilepsy can not find the cause of epilepsy, so we should consider the possibility of moyamoya disease.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R743.3

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本文編號(hào)：1898281