国际神经病学神经外科学杂志2024，Vol.51Issue(2)：23-28,6.DOI:10.16636/j.cnki.jinn.1673-2642.2024.02.005
缺血型烟雾病手术疗效的多中心研究
Efficacy of surgical revascularization for stroke prevention and prognosis in ischemic-type moyamoya disease:A multicenter study
摘要
Abstract
Objective To investigate the efficacy of cerebral revascularization(different surgical procedures)for stroke prevention and prognosis in ischemic-type moyamoya disease(MMD)through a multicenter retrospective study.Methods Clinical,neuroradiologic,and follow-up data of 462 patients with ischemic-type MMD from Xiangya Hospital of Central South University,Changde People's Hospital,and Hunan Children's Hospital were analyzed in this study.Propensity score matching was performed,and then the Kaplan-Meier curve was used to compare the recurrence rate of stroke between the patients receiving surgical treatment and those receiving conservative treatment.A multivariable Cox regression analysis was performed to identify the risk factors for stroke recurrence after surgical treatment.Results The mean follow-up time was 33.6 months in the 462 patients.Stroke occurred in 31(12.8%)of the 242 surgically treated patients and 63(28.6%)of the 220 conservatively treated patients.A total of 185 pairs were selected through propensity score matching.The Kaplan-Meier curve showed a significant difference in the incidence of recurrent stroke between the two groups(P=0.018).The multivariable Cox regression analysis revealed that posterior cerebral artery involvement(95%confidence interval[CI]:2.343-11.375,P<0.001)and cerebral white matter hyperintensities(95%CI:1.083-4.828,P=0.030)were risk factors for stroke recurrence after surgery.There was no significant difference between the two surgical procedures(combined and indirect revascularization)in the prevention of recurrent stroke(P=0.777).Conclusions Compared with conservative treatment,surgical revascularization can reduce the incidence of recurrent stroke and achieve favorable outcome in ischemic-type MMD,and different surgical procedures are similar in preventing recurrent stroke.关键词
烟雾病/脑血运重建术/脑卒中/预后Key words
moyamoya disease/cerebral revascularization/stroke/prognosis分类
医药卫生引用本文复制引用
汤东,黄正,丁威,吴水华,陈华,王君宇,陈风华..缺血型烟雾病手术疗效的多中心研究[J].国际神经病学神经外科学杂志,2024,51(2):23-28,6.基金项目
湖南省科技重大专项(2020SK1012). （2020SK1012）
