| Background:Moyamoya disease(MMD)is a chronic occlusive cerebrovascular disease characterized by progressive stenosis at the terminal portion of the internal carotid artery and an abnormal vascular network at the base of the brain.Very recently,studies from several groups showed that numbers of hypotheses of MMD,such as genetic hypothesis,cytokine hypothesis,inflammation hypothesis,etc.But the etiology of the disease is not yet understood.With people's requirements for living standards and the continuous improvement of medical imaging equipment,people's awareness of moyamoya disease continues to deepen.However,its incidence has also increased year by year.The diagnosis of moyamoya disease does not have a strict diagnostic standard.It has almost the same imaging manifestations,clinical symptoms,and treatment methods as moyamoya syndrome.The identification of them often requires the exclusion of a large number of other related diseases.It will cause a lot of unnecessary financial burden on patients,so the two types of patients have not been strictly distinguished in Shandong University Qilu Hospital,and this study will discuss the two together.So far,the treatment of moyamoya disease is mainly divided into medical treatment and surgical treatment.Internationally recognized that once moyamoya disease or moyamoya syndrome is diagnosed,earlier surgical treatment can improve the symptoms of patients and reduce the occurrence of related complications.However,there are still some complications during surgery.Among them,postoperative acute cerebral infarction and hyperperfusion syndrome(HPS)are the most common postoperative complications.Severe cases will affect the quality of life of patients or even endanger their lives.Therefore,how to delay the progress of the disease and how to predict and reduce the probability of postoperative complications in patients is a more serious problem.More and more people are currently focusing on hematology-related indicators,such as blood routine,blood biochemical,or lipid-related indicators.Hematology-related indicators have several characteristics such as easy availability,low cost,and low trauma.And it has a relatively stable reference interval in the normal population."Blood" as an important medium for the transportation of material throughout the body when certain diseases occur,at the same time,its composition will be sensitive to make some corresponding changes,which may not be obvious in each individual.However,in terms of a certain type of disease,systematic observation of these changes can predict the progress of some diseases or the high-risk factors of some complications in advance,such as the hotter in recent years,Platelet to lymphocyte ratio(PLR),Neutrophil to lymphocyte ratio(NLR),and triglyceride/high density lipoprotein cholesterol ratio(TG/HDL-c).There is an inseparable relationship between cardiovascular disease or malignant tumors of various organs.Moreover,there are few studies on the correlation between several hematological indicators and moyamoya disease.What is more important,this study intends to retrospectively analyze the patients with moyamoya disease treated in Qilu Hospital of Shandong University,to study the correlation between hematological indicators and the progress of moyamoya disease and postoperative complications.Objective:To collect the medical records and imaging datas of patients with,moyamoya disease undergoing surgical treatment and cerebral angiography in our hospital,to retrospectively analyze the gender,age,blood routine and blood biochemical lipid indexes of patients,and to observe whether there are significant differences in hematological indicators between patients with moyamoya disease at each stages,and to study the correlation between the changes of various indicators and the stages of moyamoya disease.Also explore whether the various hematological indicators and complication occur after moyamoya disease.Is there a significant relationship between infarcts.The purpose of this project is to further deepen the understanding and understanding of the clinical characteristics of the pathogenesis of moyamoya disease and its related complications,to improve the clinical treatment effect of patients and to screen out high-risk groups of postoperative complications,in order to slow down the disease process and improve patient quality of life.Methods:A retrospective analysis was performed on 275 patients(247 patients,29 of whom underwent two surgeries twice at intervals greater than 3 months)from Qilu Hospital of Shandong University between January 2015 and May 2019.Patients were diagnosed with angiography as moyamoya disease or moyamoya syndrome and which undergone surgical treatment in our hospital.Firstly,the patients were divided into four groups(A1-A4 group)based on the improved Suzuki's grading method of Mugikura et al.By comparing the general clinical data and various hematological indicators among the four groups,the preliminary understanding of the changes in the hematological indicators among the four groups and their relationship with moyamoya disease;and then based on whether the patient had neurological deficit after surgery,which were divided into two groups:(1)asymptomatic group(243 cases),and(2)symptomatic group(32 cases).The general clinical data and hematological indicators of the two groups of patients were further compared.Statistical software was used to analyze the results to investigate whether there was a correlation between the indicators of postoperative infarction.Results:(1)The results of univariate analysis showed that the triglyceride/low-density lipoprotein ratio in patients with stage 1 moyamoya disease was significantly higher than that in patients with stage 4 moyamoya disease,and Al(0.787 ±0.448)<A2(0.649 ± 0.271))<A3(0.630±0.404)<A4(0.553±0.364),and TG/LDL-c has a significant correlation with the stage of moyamoya disease(P=0.016),which is statistically significant.The gender,age,and platelet count of patients in each group,Lymphocyte count,eosinophil count,monocyte count,neutrophil count,homocysteine,free fatty acid,triglyceride,low density lipoprotein,high density lipoprotein,TG/HDL-c,PLR,NLR was not statistically significant.(2)The results of binary logistic regression analysis showed that age,triglyceride,low density lipoprotein,triglyceride/low density lipoprotein ratio and triglyceride/high density lipoprotein ratio were the occurrence of neurological deficit in patients with moyamoya disease is correlated(P<0.05)and has statistical significance.Based on the ROC curve,the optimal cutoff value for TG/LDL-c to predict infarction in patients with moyamoya disease is 0.491,and the sensitivity is 78.1%,Specificity is 42.4%,(95%CI,0.532-0.729,area under the curve is 0.63;P=0.016).There were no significant differences in gender,platelet count,lymphocyte count,eosinophil count,monocyte count,neutrophil count,homocysteine,free fatty acid,high density lipoprotein,PLR,NLR between the two groups.Conclusion:(1).TG/LDL-c is significantly correlated with the disease progression status of moyamoya disease patients,platelet count,lymphocyte count,eosinophil count,monocyte count,centroblast count,homocysteine,free Fatty acids,triglycerides,low-density lipoproteins,high-density lipoproteins,TG/LDL-c,PLR,NLR were not related to the progress of moyamoya disease.(2).TG/LDL-c may be a.good predictor in assessing the risk of surgery and the occurrence of postoperative neurological deficit in patients with moyamoya disease.There were no significant differences in blood indexs,such as platelet count,lymphocyte count,eosinophil count,monocyte count,centroblast count,homocysteine,free fatty acids,high-density lipoprotein,PLR,NLR between infarction after moyamoya disease. |
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