| Objective:To explore the effect of edaravone in perioperative vascular reconstruction of moyamoya disease,and analyze its correlation with postoperative hyperperfusion syndrome,in order to play a role in the prevention and treatment of postoperative hyperperfusion syndrome in such patients.Methods:A total of 133 patients with moyamoya disease who underwent vascular revascularization in the Neurosurgery Department of The Second Affiliated Hospital of Nanchang University from September 2019 to September 2021 were selected as subjects.According to whether edaravone was used during perioperative period,they were divided into observation group(n=90)and control group(n=43).The levels of nerve injury markers[Brain Derived Neurotrophic Factor(BDNF)、 Nerve Growth Factor(NGF)、 Neurotrophin-α(NTF-α)、 Insulin-like Growth Factor-1(IGF-1)],cognitive function[Montreal Cognitive Assessment(Mo CA)] and expression levels of matrix metalloproteinase-9(MMP-9)and vascular endothelial growth factor(VEGF)were compared between the two groups.According to whether high perfusion postoperative syndrome,the observation group patients were divided into high perfusion group(n = 19)and the high perfusion group(n = 71),collected in general and in patients with clinical data,using the single factor and multiple factors Logistic regression analysis to evaluate moyamoya disease blood vessel revascularization perioperative application in accordance with the high perfusion syndrome risk factors in the aftermath of the adr.Results:(1)After treatment,the levels of BDNF,NGF,NTF-α and IGF-1 in both groups were significantly increased(P<0.05),and the levels of BDNF,NGF,NTF-α and IGF-1 in the observation group were significantly higher than those in the control group(P<0.05).(2)After treatment,scores of all dimensions and total scores of Mo CA scale in both groups were significantly increased(P<0.05),and scores of all dimensions and total scores of Mo CA scale in the observation group were significantly higher than those in the control group(P<0.05).(3)After treatment,the expression levels of MMP-9 and VEGF in both groups were significantly decreased(P<0.05),and the expression levels of MMP-9 and VEGF in the observation group were significantly lower than those in the control group(P<0.05).(4)The incidence of hyperperfusion syndrome in the observation group was21.11%,significantly lower than that in the control group(37.2%),χ2=3.889 P=0.049,the difference was statistically significant(5)Univariate analysis showed that there were no significant differences in gender,initial incidence type,aneurysm,diabetes and abnormal cerebral glucose metabolism between the hyperperfusion syndrome group and the non-hyperperfusion syndrome group(P>0.05).Age,m RS score on admission,Suzuki stage,operative side,cerebral infarction and hypertension were significantly different(P<0.05),which were the risk factors of postoperative hyperperfusion syndrome of moyamoya disease.(6)Multivariate Logistic regression analysis showed that m RS score on admission [OR=2.859,95%CI(1.612-5.105)],surgical side [OR=2.967,95%CI(1.039-8.477)],complicated cerebral infarction [OR=3.838,95%CI(1.159-12.712)]and hypertension [OR=1.874,95%CI(1.068-3.289)](P<0.05)were independent risk factors for hyperperfusion syndrome after moyamoya disease revascularization.Conclusion:(1)Perioperative application of edaravone during moyamoya disease revascu-larization can improve neurotrophic markers,facilitate the secretion of neurotrophic factors,facilitate the reconstruction and recovery of postoperative neurological function and improve cognitive function,and also reduce the expression levels of MMP-9 and VEGF and the incidence of cerebral hyperperfusion syndrome.(2)Age,m RS admission score,operation side,suzuki in installment,merging,cerebral infarction,vascular hypertension is moyamoya disease revascularization risk factors for postoperative high perfusion syndrome,multi-factor analysis m RS admission score,don’t by the side of surgery,cerebral infarction,the combining high blood pressure,are independent risk factors for postoperative high perfusion syndrome... |
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