儿童烟雾病脑梗死影响因素分析

doi:10.3969/j.issn.1673-5765.2017.09.011

摘要/Abstract

摘要：

目的分析儿童烟雾病（Moyamoya disease，MMD）的临床及影像学特征。方法回顾性分析176例儿童缺血型烟雾病患者临床资料，分为脑梗死组和非梗死组。组间的特征和影像学参数采用单因素分析和多因素分析，评估脑梗死的危险因素。结果儿童缺血型烟雾病中脑梗死好发于女童（P =0.006）。大脑前动脉（anterior cerebral artery， ACA）、大脑中动脉（middle cerebral artery，MCA）和颈内动脉（internal Carotid Artery，ICA）狭窄程度是脑梗死发生的危险因素（P＜0.001，0.014和＜0.001）。多因素分析显示颈内动脉狭窄[比值比（odds ratio，OR）6.945，95%置信区间（confidence interval，CI）1.406～34.302，P =0.017）、脉络膜后动脉代偿（OR 0.780，95%CI 0.078～0.324，P =0.000）、后交通动脉代偿（OR 3.288，95%CI 1.521～7.111， P =0.002）与脑梗死发生独立相关。结论儿童缺血型烟雾病中，脑血管狭窄程度以及侧支循环代偿情况与脑梗死发生有关。

文章导读： 通过回顾性分析缺血性儿童烟雾病患者的资料，进行单因素和多因素分析，结果显示脑血管狭窄程度和侧支循环与患者是否出现脑梗死有关。

关键词: 烟雾病; 儿童; 脑梗死; 影像学特征

Abstract:

Objective To investigate the clinical and angiographic characteristics of pediatric Moyamoya disease (MMD). Methods A restrospective analysis was conducted based on the clinical data of 176 pediatric MMD patients who were divided into cerebral infarction group and non-cerebral infarction group. Interblock characteristic and imaging parameters were used to evaluate risk factors for cerebral infarction by multivariates analysis. Results In our study, cerebral infarction was higher in girls than in boys (P =0.006). Between the infarction group and control group, the stenosis degree of anterior cerebral artery (ACA), middle cerebral artery (MCA) and internal carotid artery (ICA) were the risk factors of cerebral infarction (P <0.001, 0.014, <0.001). Multivariate analysis showed that ICA stenosis [odds ratio (OR) 6.945, 95% confidence interval (CI) 1.406-34.302, P =0.017], posterior choroidal artery compensatory (OR 0.780, 95%CI 0.780-0.324, P =0.000), compensatory posterior communicating artery (OR 3.288, 95%CI 1.521-7.111, P =0.002) were independently associated with the occurrence of cerebral infarction. Conclusion In pediatric Moyamoya disease, occlusion or stenosis of cerebral artery and some of well-formed collaterals did correlate with cerebral infarction occurrence.

Key words: Moyamoya disease; Pediatric; Ischemic stroke; Angiographic characteristics

王佳，张东，王嵘，赵继宗. 儿童烟雾病脑梗死影响因素分析[J]. 中国卒中杂志, 2017, 12(09): 817-821.

WANG Jia,ZHANG Dong, WANG Rong, ZHAO Ji-Zong. Analysis of Influential Factors for Ischemic Stroke of Pediatric Moyamoya Disease[J]. Chinese Journal of Stroke, 2017, 12(09): 817-821.

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