摘要
目的探讨恶性肿瘤患者脑梗死的临床特点及可能的病因、发病机制。方法回顾性总结2018-06—2019-02河南省人民医院神经内科收治的9例确诊恶性肿瘤后发生急性脑梗死的患者,并收集其临床资料。结果9例恶性肿瘤伴发脑梗死患者中男7例,女2例,起病年龄37~75岁,确诊恶性肿瘤到发生脑梗死时间1~72个月,其中7例患者在确诊恶性肿瘤后的6个月内出现急性脑梗死,且6例有肿瘤转移;9例患者中5例有传统危险因素,按照TOAST分型,6例均属于原因不明型,9例患者红细胞沉降率、CRP、纤维蛋白原、D-二聚体均有升高,所有患者影像学梗死病灶均≥2个,9例患者肿瘤治疗中7例采用化疗方案,1例采用放疗方案。结论恶性肿瘤相关脑梗死患者生物学标志物变化明显,颅内出现多发病灶,发病机制可能与高凝状态及肿瘤治疗方式相关。
Objevtive To investigate the clinical characteristics of cerebral infarction in patient with malignant tumor patients as well as possible etiology and pathogenesis.Methods Patients with newly diagnosed acute cerebral infarction after malignant tumor diagnosis admitted to the neurology department of Henan Provincial People's Hospital from June 2018 to February 2019 were retrospectively summarized,and their clinical date were collected.Results Among the 9 patients with malignant tumor associated with cerebral infarction,there were 7 males and 2 females,the onset age was 37-75 years old.The time from malignant tumor diagnosis to cerebral infarction was 1-72 months.Among them,7 patients developed acute cerebral infarction within 6 months after the diagnosis of malignant tumor,and 6 patients had tumor metastasis.Five of the nine patients had traditional risk factors,and according to TOAST classification,all the six patients were of unknown causes.Among them,7 patients developed acute cerebral infarction within 6 months after the diagnosis of malignant tumor,and 6 patients had tumor metastasis.Five of the nine patients had traditional risk factors,and according to TOAST classification,all the six patients belong to stroke of undetermined etiology.ESR,CRP,fibrinogen and d-dimer elevated in the all patients,and all patients have more than 2 imaging infarction lesions.Among the 9 patients,7 received chemotherapy and 1 received radiotherapy.Conclusion Cerebral infarction patients with malignant tumor tend to have significant changes in biological markers,multiple intracranial lesions,and the pathogenesis may be associated with hypercoagulability and tumor treatment.
作者
谭蕾蕾
贾燕
李鹏辉
秦亚辉
黄月
TAN Leilei;JIA Yan;LI Penghui;QIN Yahui;HUANG Yue(People’s Hospital of Zhengzhou University,Zhengzhou 450003,China;Henan Provincial People's Hospital,Zhengzhou 450003,China)
出处
《中国实用神经疾病杂志》
2020年第8期645-649,共5页
Chinese Journal of Practical Nervous Diseases
基金
河南省科技厅科技攻关项目(编号:172102310017)。
关键词
恶性肿瘤
脑梗死
生物学标志物
高凝状态
肿瘤治疗
Malignant tumor
Cerebral infarction
Biological marker
Hypercoagulability
Tumor therapy
