摘要
目的研究并总结以急性脑梗死为首发表现的隐匿性恶性肿瘤患者的临床及影像学特点。方法搜集安徽医科大学第一附属医院2012年1月~2016年5月以急性脑梗死为首发表现,之后查出恶性肿瘤患者的病史、生化检查及影像学检查结果。结果共纳入13例患者,消化系统或肺部肿瘤11例(84.6%),转移11例(84.6%),肿瘤指标阳性率66.7%。D-二聚体值增高11例(91.7%),FDP值增高10例(100%)。11例(84.6%)为多发性脑梗死,脑梗死病灶累及循环个数≥2占76.9%,前后循环同时累及占61.5%,小病灶占74.7%。结论该组患者肿瘤多来源于消化系统或肺部,转移比例高。D-二聚体和FDP值明显增高,阳性率高于肿瘤指标。梗死病灶容易出现在多个循环尤其是前后循环且以小病灶为主。
Objective To investigate the clinical and imaging features of occult malignant tumors with acute cerebral infarction as the initial manifestation. Methods The patients who had acute cerebral infarction as the initial manifestation and were later diagnosed with malignant tumors in The First Affiliated Hospital of Anhui Medical University from January 2012 to May 2016 were enrolled. Their medical history,biochemical examination results,and imaging findings were analyzed. Results A total of 13 patients were enrolled,and there were 11 cases（84. 6%） of digestive system or lung neoplasms and 11 cases（84. 6%） of metastasis. The positive rate of tumor markers was 66. 7%. Elevated D-dimer and fibrinogen degradation product（ FDP） values were observed in 11 patients（91. 7%） and 10 patients（100%）,respectively. Of all patients,11（84. 6%） had multiple brain infarctions,76. 9% had two or more circulations involved in cerebral infarction lesions,61. 5% had involvement of both anterior and posterior circulations,and74. 7% had small lesions. Conclusions In these patients,the primary tumor is mainly located in the digestive system or the lung with a high metastasis rate. There are significant increases in D-dimer and FDP values,which have a higher positive rate than tumor markers. Infarction lesions are more likely to occur in several circulations,especially the anterior and posterior circulations,and are mainly small lesions.
出处
《国际神经病学神经外科学杂志》
北大核心
2017年第1期58-62,共5页
Journal of International Neurology and Neurosurgery
基金
国家自然科学基金(81100877)
关键词
脑梗死
隐匿性恶性肿瘤
急性多发性脑梗死
高凝状态
cerebral infarction
occult malignant tumor
acute multiple cerebral infarctions
hypercoagulability
