中国卒中杂志2017，Vol.12Issue(11)：995-999,5.DOI:10.3969/j.issn.1673-5765.2017.11.005
成人出血型烟雾病自然病史研究
Study on Natural History of Adult Patients with Hemorrhagic Moyamoya Disease
摘要
Abstract
Objective To explore the risk factors related with the long term natural history and outcome of adult patients with hemorrhagic moyamoya disease (MMD). Methods A retrospective analysis was made upon the clinical data of 115 cases of adult patients (age>17) with hemorrhagic MMD. Long-term follow-up study was conducted on 40 patients who received conventional therapy. The main observation indexes were newly onset cerebral hemorrhage and death event. Results Among 40 patients, who received conventional therapy, 6 cases were losted and 34 cases were followed up cumulatively for 398.7 person-years. The median follow-up time was (11.7±4.6) years. During 398.7 person-years, 15 patients experienced (44.1%) twenty-one episodes of rebleeding, rendering an average annual incidence of 5.3%. Among them, 5 patients (33.3%) died from rebleeding and 4 patients had serious disability (modified Ranking Scale ≥3; 26.6%). The annual risk of rebleeding increased gradually from 2.6% in the first five years to 7.9% after 10 years after the first bleeding. Patients older than 35 years sustained a higher risk of rebleeding than ones under the age of 35 [hazard ratio (HR) 2.8, 95% confidence interval (CI) 1.1-7.7, P=0.04]. Gender, bleeding location, DSA stage, hypertension, family history of MMD and whether there were complication with aneurysm were not associated with the risk of rebleeding. Conclusion The risk of rebleeding of adult patients with hemorrhagic MMD obviously increased as time went on; and patients older than 35 years had a higher risk of rebleeding.关键词
烟雾病/自然病史/脑出血/再出血Key words
Adult moyamoya disease/Natural History of disease/Cerebral hemorrhage/Rebleeding引用本文复制引用
刘兴炬,康帅,张东,王嵘,张岩,张谦,赵继宗..成人出血型烟雾病自然病史研究[J].中国卒中杂志,2017,12(11):995-999,5.基金项目
国家"十三五"科技支撑计划:缺血性脑血管病和脑肿瘤关键技术研究(2015BAI12B04)北京市优秀人才青年项目(D161100003816005)国家自然科学基金青年项目(81701137) （2015BAI12B04）
