| Part Ⅰ Effects of extracranial revascularization on cognitive function in adult patients with moyamoya diseaseObjective : To investigate the effect of extracranial vascular revascularization on cognitive function in adult patients with moyamoya disease.Methods : Selected 55 adult patients with moyamoya disease diagnosed in neurosurgery department of our hospital from October 2017 to August 2018,and 30 healthy adults.The above subjects were divided into three groups.Preoperative(A) group: 35 adult patients with moyamoya disease who had not received surgical treatment;Postoperative(B) group: 20 cases of adult patients with moyamoya disease 6 months after intracranial and extracranial vascular revascularization in our hospital;Control(C) group: 30 healthy adults.Results:There were no statistically significant differences in gender,age and years of education among subjects in groups A,B and C(P>0.05),which was comparable.MoCA,MMSE and TMT-A results were significantly different between group A and group C(P < 0.05),but there was no significant difference in the results of digital span test(reverse memorization)(P=0.323).MoCA,MMSE,TMT-A and digital span test(reverse memorization) results of group A and group B showed no significant difference(P > 0.05).Conclusion: The cognitive function score of adult patients with moyamoya disease was lower than that of healthy subjects,suggesting that the cognitive function of adult patients with moyamoya disease was impaired.The cognitive function score of adult patients with moyamoya disease at 6 months after surgery was not significantly changed compared with that before surgery,suggesting that the role of intracranial and extracranial vascular revascularization in preventing cognitive impairment in patients with moyamoya disease remains to be further investigated.Part Ⅱ Effects of extracranial revascularization on the expression of related vasogenic factors in serum of adult patients with moyamoya diseaseObjective:To investigate the effect of intracranial and extracranial vascular revascularization on the expression of related vasogenic factors in serum of adult patients with moyamoya disease.Methods : Selected 37 adult patients with moyamoya disease diagnosed in neurosurgery department of our hospital from January 2018 to October 2018,and 30 healthy adults.The above subjects were divided into three groups.Preoperative(A) group: peripheral blood samples of 22 adult patients with moyamoya disease who had not received surgical treatment;Postoperative(B) group: peripheral blood samples of 15 adult patients with moyamoya disease 6 months after intracranial and extracranial vascular revascularization in our hospital;Control(C) group:peripheral blood samples from 20 healthy adults were selected.The collected peripheral blood samples were separated and refrigerated.The concentrations of VEGF,bFGF,TGF-1 and mmp-9 in serum of the three groups were determined by Elisa.Results:Group A compared with group C,the expression levels of VEGF,bFGF,TGF-1 and mmp-9 in serum of group A were increased,and the differences were statistically significant(P< 0.01).Group B compared with group A,the expression levels of bFGF and TGF-1 in serum of group B were decreased,and the difference was statistically significant(P< 0.01),while the difference in the concentrations of VEGF and mmp-9 was not statistically significant(P> 0.05).Conclusion:The expressions of VEGF,bFGF,TGF-1 and mmp-9in the serum of adult patients with moyamoya disease were higher than those of healthy adults,suggesting that the above four factors may be related to the occurrence and development of moyamoya disease.The expression of bFGF and TGF-1 in adult patients with moyamoya disease decreased 6 months after intracranial vascular revascularization compared with that before surgery,suggesting that bFGF and TGF-1 May beinvolved in the process of self-repair in adult patients with moyamoya disease. |
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