CAJ | 학술논문

目的探讨鲁西南地区烟雾病临床特点和外科治疗经验.方法对自2011年3月至2013年12月济宁医学院附属医院神经外科收治的96例烟雾病患者临床资料进行回顾性分析,并将分析结果与日韩及国内相关报道分析比较.结果鲁西南地区烟雾病在发病年龄、性别比及临床表现方面具有特殊性,与日韩及国内相关报道不完全一致.具体表现为:女性多于男性(与日韩相似);有0～10岁及31～50岁2个发病高峰期(与日韩相似);但发病年龄更集中(与国内报道相似)且儿童发病率(12.5％)明显低于日韩;临床表现以缺血型为主(80.2％),但短暂脑缺血发作(TIA)的发生率高(高于日韩及国内报道),癫痫和脑梗死的发生率低(低于日韩及国内报道),脑出血的发生率(19.8％)与日本及国内报道相似,明显低于韩国.经颅内外血管重建术治疗后大部分患者的临床症状得到改善,与日韩及国内相关报道的治疗效果无明显差异.结论鲁西南地区的烟雾病临床特点具有特殊性,其发病机制可能与日韩存在差异;颅内外血管重建术治疗烟雾病临床效果显著,是治疗烟雾病的有效方法.
목적 탐토로서남지구연무병림상특점화외과치료경험.방법 대자2011년3월지2013년12월제저의학원부속의원신경외과수치적96례연무병환자림상자료진행회고성분석,병장분석결과여일한급국내상관보도분석비교.결과 로서남지구연무병재발병년령、성별비급림상표현방면구유특수성,여일한급국내상관보도불완전일치.구체표현위:녀성다우남성(여일한상사);유0～10세급31～50세2개발병고봉기(여일한상사);단발병년령경집중(여국내보도상사)차인동발병솔(12.5％)명현저우일한;림상표현이결혈형위주(80.2％),단단잠뇌결혈발작(TIA)적발생솔고(고우일한급국내보도),전간화뇌경사적발생솔저(저우일한급국내보도),뇌출혈적발생솔(19.8％)여일본급국내보도상사,명현저우한국.경로내외혈관중건술치료후대부분환자적림상증상득도개선,여일한급국내상관보도적치료효과무명현차이.결론 로서남지구적연무병림상특점구유특수성,기발병궤제가능여일한존재차이;로내외혈관중건술치료연무병림상효과현저,시치료연무병적유효방법.
Objective To explore the clinical characteristics of patients with Moyamoya disease in the southwest of Shandong province and evaluate the efficacy of cerebral revascularization treatment in it.Methods Clinical data of 96 patients with Moyamoya disease,admitted to our hospital form March 2011 to December 2013,were analyzed retrospectively and compared with those in Japan,South Korea and Inland.Results The clinical characteristics of patients with Moyamoya disease in the southwest of Shandong province were similar with that in Japan,South Korea and Inland,but enjoyed their own particularity:the age distribution showed two peaks (aged 0-10 and aged 31-50) and the sex ratio (female＞male) was similar to those among Japanese and Korean patients,but the age distribution was more concentrated;the incidence of children (12.5％) was significantly lower than that of Japan and South Korea;the main type of Moyamoya disease was the ischemic one (80.2％);the occurrence of transient ischemic attack was higher than that in Japan,South Korea and Inland;the incidences of epilepsy and cerebral infarction were lower than those in Japan,South Korea and Inland;the incidence of cerebral hemorrhage (19.8％) was similar to Japan and Inland,and significantly lower than that in Korea.The clinical symptoms of most Moyamoya disease patients were improved with the treatment of extracranial-intracranial revascularization;and the treatment outcomes showed no significant difference between Chinese,Japanese and Korean.Conclusions The clinical features and pathogenesis mechanism of Moyamoya disease in the southwest of Shandong province may be different form Japan and South Korea.Extracranial-intracranial revascularization is a effective treatment for Moyamoya disease.