CAJ | 학술논문

　　目的研究成人型烟雾病的临床特点及经颅多普勒超声（TCD）检测对诊断烟雾病的临床价值。方法归纳64例经磁共振血管成像（MRA）或数字减影血管造影（DSA）确诊的年龄≥14岁的成人型烟雾病患者的临床特征及经颅多普勒（TCD）的血流动力学改变。结果36~45岁为发病高峰年龄。最常见的首发症状包括TIA和脑梗死在内的缺血性表现共33例（51.5%）；最常见的确诊症状包括TIA和脑梗死在内的缺血性表现共32例（50.0%）。有21例（32.8%）患者在首次发作时，先行TCD筛查而后经MRA或DSA全部确诊。以非脑出血症状确诊的46例患者中29例（63%）先经TCD筛查而后行DSA或MRA确诊烟雾病。结论成人型烟雾病首发及确诊症状均以缺血性血管病表现为主，TCD是筛选烟雾病的有效方法。
　　목적연구성인형연무병적림상특점급경로다보륵초성（TCD）검측대진단연무병적림상개치。방법귀납64례경자공진혈관성상（MRA）혹수자감영혈관조영（DSA）학진적년령≥14세적성인형연무병환자적림상특정급경로다보륵（TCD）적혈류동역학개변。결과36~45세위발병고봉년령。최상견적수발증상포괄TIA화뇌경사재내적결혈성표현공33례（51.5%）；최상견적학진증상포괄TIA화뇌경사재내적결혈성표현공32례（50.0%）。유21례（32.8%）환자재수차발작시，선행TCD사사이후경MRA혹DSA전부학진。이비뇌출혈증상학진적46례환자중29례（63%）선경TCD사사이후행DSA혹MRA학진연무병。결론성인형연무병수발급학진증상균이결혈성혈관병표현위주，TCD시사선연무병적유효방법。
Objective To investigate the clinical characteristics of moyamoya disease(MMD) in adult and the clinical value with transcranial Doppler(TCD). Methods Totally 64 MMD in adult(≥14 years) diagnosed by using DSA and MRA were enrolled in this study. We studied the clinical characteristics of MMD in adult and analyze hemodynamic changes of TCD. Results 36~45 years old was an age peak. Among 64 MMD patients, cerebral ischemia occurred in 33(51.5%) and was shown as the commonest initial clinical manifestation. Cerebral ischemia occurred in 32(50.0%) and was shown as the commonest confirmed clinical manifestation. Among 21 patients (32.8%) were screened by using TCD first and then diagnosed by using DSA or MRA in the first episode.All 29 patients (63%) with non-hemorrhagic symptom were screened by using TCD first and then diagnosed by using DSA or MRA. Conclusion Ischemic stroke is the major clinical manifestation in adult MMD .TCD is an effective method of screening out moyamoya disease.