Analysis Of Clinical Characteristics Of Single Central Moyamoya Disease In Anhui Province

Objective Moyamoya disease(MMD),also called the bottom abnormal vascular net brain disease,is a set of Chronic occlusive cerebrovascular disease that bilateral internal carotid artery(ICA)terminus or anterior cerebral artery(ACA)and middle cerebral artery(MCA)start,are progressive stenosis or occlusion,and the formation of abnormal neovascularization network in the pia mater at the base of the skull and perforating artery is characteristic.Because the abnormal vascular network on the cerebral angiography is not clear,like smoke,so called moyamoya disease.At present,the etiology is still unknown,the main clinical manifestations are cerebral hemorrhage and cerebral ischemia.However,its distribution has obvious regional and ethnic differences.Global case reports show that the main population of the disease is the yellow race,among which Japan has the highest incidence,followed by China,South Korea and other east Asian countries.There is still a lack of large-scale and systematic epidemiological investigation in China,and there are some single-center reports on the clinical characteristics of moyamoya disease,but there are also differences among the reported results in different regions.Systematic reports on the clinical characteristics of moyamoya disease in Anhui area still rare.Through the analysis of the clinical characteristics of moyamoya disease in Anhui province,this project enables clinical workers to further understand MMD,preventing missed diagnosis and misdiagnosis and enhancing the awareness of vascular protection.Methods Clinical data of 600 MMD patients admitted to Anhui Provincial Hospital affiliated to Anhui Medical University from May 2015 to July 2019 were retrospectively analyzed,including the age of onset,gender,geographical distribution,education level,occupation,clinical symptoms and family history,etc.The obtained data were analyzed bySPSS 19.0 statistical software.The quantitative data with normal distribution were expressed by mean standard deviation and the qualitative data were showed by rate(%),so as to analyze the clinical characteristics of MMD in Anhui provincial.Results The sex ratio of male to female in 600 patients with MMD was 1:1.2.The onset age ranged from 5 to 85 years old,with 97.2% of adult patients,and the average age was(47.1 ±12.6)years old.The age distribution was generally bimodal,mainly occurring in the ages of 11-13 years old and 42-53 years old.High-incidence area was noted in Hefei,Fuyang,Lu 'an,and patients are mostly found in the junction areas of Changfeng county,Funan county,Yingshang county,Huoqiu county,and Shouxian county in particular.89% of the patients came from rural areas.Among the occupations,51.7% of them were engaged in agriculture,the proportion of migrant workers was 24.7 percent,freelancer accounted for 13%,students accounted for 3%,and other occupations(including civil servants,medical workers,teachers,retired staff,etc.)accounted for 7.6%.88.2% of them had a junior high school level or below,5.3% of them had a senior high school level,3.3% of them had a senior high school level,and 3.2% of them had a bachelor's degree.In clinical symptoms,hemorrhagic type accounted for 55.7%,ischemic type accounted for 41.2%(TIA attacks accounted for 16.2%,cerebral infarction attacks accounted for 25%).The most common hemorrhagic sites in hemorrhagic type were lateral ventricle(31.7%)and brain parenchyma(32.3%).Family history was found in only 3 patients.Conclusion The clinical characteristics of MMD in Anhui province are different from those in other regions.The incidence of MMD in women is slightly higher than that in men in Anhui province.Though two definite peaks in age distribution are found,the number of adult patients is larger than that of children.Clinical symptoms are more common with hemorrhagic type.The clinical manifestations of adults are mainly hemorrhagic symptoms and the clinical manifestations of children are mainly ischemic symptoms.The regionaldistribution shows the characteristics of regional concentration and they almost all come from the countryside,suggesting that the inducing factors of moyamoya disease are related to rural living environment,rural traditional daily life and dietary habits.