治疗莫亚莫亚病的治疗方法 带有高同类素蛋白血症的莫亚莫亚病的治疗方法
Gan Gao1, Si-Meng Liu1, Fang-Bin Hao1
1Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China.
概括
在患有高homocysteinemia的Moyamoya疾病患者中进行脑膜硬化手术后控制血清同类蛋白水平显著改善了手术结果和长期预后. 有效的homocysteine控制是改善患者康复的关键.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 血管外科 血管外科
- 代谢医学是一种代谢医学.
背景情况:
- 莫亚莫亚病 (MMD) 是一种罕见的脑血管疾病,其特征是内动脉的渐进性狭窄.
- 超同胞蛋白血症 (HHcy) 是各种血管疾病的已知危险因素,包括MMD.
- 脑动脉同血管症 (EDAS) 是一种用于治疗MMD的手术复血管化手术.
研究的目的:
- 为了研究控制血清类固醇水平对HHcy.MMD患者手术结果的影响.
- 为了比较MMD患者的成像和长期临床预后,包括HHcy和没有HHcy的患者,以及手术后控制HHcy的患者.
主要方法:
- 一项前性观察队列研究,涉及477名MMD患者在EDAS手术后进行.
- 患者被分为三个组:控制后的HHcy-MMD (n=193),不受控制的HHcy-MMD (n=91) 和MMD (n=193).
- HHcy-MMD后对照组进一步细分为良好的 (0-10μmol/L) 和一般的 (10-15μmol/L) 控制子组.
主要成果:
- 在MMD和HHcy-MMD后对照组之间,在松岛等级后的EDAS中没有显著差异 (P>0.05).
- 在HHcy-MMD控制后组和HHcy-MMD不受控制的组之间,松岛等级的显著差异 (P<0.001).
- 在良好的和一般的HHcy对照组之间,在松岛等级 (P=0.025) 和长期结果 (P=0.035) 中存在显著差异.
- 预测不良结果的同类氨酸水平曲线下的面积为85.48% (95% CI:80.31-90.65%).
结论:
- 在HHcy的MMD患者中,在EDAS手术后有效控制血清类固醇水平与改善的预后有关.
- 血清homocysteine水平是接受EDAS的MMD患者不良临床结果的重要预测因素.
- 针对性地管理高homocysteinemia对于优化手术结果和长期的结果在moyamoya疾病至关重要.
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