烟雾病行血运重建术后缺血性脑卒中发作的危险因素分析

Risk Factor Analysis of Ischemic Stroke in Moyamoya Disease Revascularization

目的:探讨烟雾病患者颅内外血运重建术后继发缺血性脑卒中发作的相关危险因素。方法:选取2016年6月-2019年11月郑州人民医院收治的64例行颅内外血运重建术的烟雾病患者。根据是否存在术后继发缺血性脑缺血发作将患者分为卒中组和未卒中组。采用回顾性分析的方法,收集患者一般资料、既往病史、术前检查结果、手术方式等临床资料。分析患者的临床资料与术后缺血性脑卒中发作的关系。结果:术后卒中组与未卒中组患者年龄、吸烟、糖尿病、术前有颅内代偿血管形成、Suzuki分期、术中完整保存脑膜中动脉、血运重建方式之间比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,吸烟、糖尿病、手术重建方式、Suzuki分期是影响烟雾病血运重建术后继发缺血性脑卒中发作的的独立危险因素。结论:戒烟、控制血糖、早期手术(低龄、SuzukⅢ期前),术中采用联合重建方式、充分保存代偿血管可降低烟雾病患者血运重建术后缺血性脑卒中发作。

Objective: To explore the risk factors of ischemic stroke in moyamoya disease revascularization. Methods: Totally64 patients with Moyamoya disease accepting extracranial-intracranial revascularization in the hospital from June 2016 to November 2019 were included. The patients were divided into ischemic stroke group and not ischemic stroke group according to the presence of postoperative magnetic resonance imaging. The general data, anamnesis, preoperative examination results and modus operandi were collected. Results: There were statistically significant differences in history of smoking, smoking, diabetes, preoperative intracranial compensatory revascularization, Suzuki stage, middle meningeal artery preserved in operation, and revascularization methods between the ischemic stroke and not ischemic stroke group(P<0.05). Multivariate logistic regression analysis showed that smoking, diabetes and Suzuki stage were independent risk factors for ischemic stroke in Moyamoya disease revascularization. Conclusion: The application of unite revascularization and conservative compensatory vessel can reduce the ischemic stroke in moyamoya disease.