摘要
目的探究隐源性卒中和肺静脉血栓形成(pulmonary venous thrombosis,PVT)的潜在关联。方法回顾性分析我院收治的隐源性卒中患者。采用64层多层螺旋CT血管成像对肺静脉进行评估。心脏结构和功能通过经胸超声心动图和Holter监测评估。结果在完善肺静脉CT血管成像的67例患者中,有13例患者发现存在肺静脉血栓。PVT组与non-PVT组的入院NIHSS评分无统计学差异,但PVT组的出院NIHSS评分(P=0.039)和出院mRS评分(P=0.026)较高,且住院期间脑梗死部位出血转化的风险也较高(P=0.047)。PVT组的临床症状无特异性,颅脑影像符合心源性栓塞表现,肺部影像多表现为双侧、多发的肺静脉血栓,其中12例患者合并肺部慢性炎症。使用新型口服抗凝药治疗后,随访无1例卒中复发。结论肺静脉血栓形成的发生率可能被低估,该病可能是隐源性卒中的潜在病因。
Objective To investigate the underlying relationship between pulmonary venous thrombosis(PVT)and cryptogenic stroke.Methods Retrospective analysis was conducted on inpatients with cryptic stroke in our hospital.Pulmonary vein was evaluated by 64-slice multidetector computed tomography angiography.Cardiac structure and function were assessed using transthoracic echocardiography and Holter monitoring.Results Of the 67 patients with enhanced CT angiography of pulmonary vein,pulmonary thrombus was found in 13 patients.There was no statistical difference in NIHSS score at admission between the PVT group and the non-PVT group,whereas the NIHSS score at discharge(P=0.039),mRS score at discharge(P=0.026)and the risk of hemorrhagic transformation of the cerebral infarction site during hospitalization(P=0.047)were higher in the PVT group.The clinical symptoms of PVT group were unspecific,and the brain images were similar to cardiogenic embolism.The pulmonary imaging was characterized by bilateral,multiple pulmonary vein thrombosis.In addition,12 patients had chronic pulmonary inflammation.There was no recurrence of ischemic stroke in the follow-up and the new oral anticoagulants were possibly effective.Conclusion The incidence of pulmonary vein thrombosis may be underestimated,which may be the underlying cause of cryptogenic stroke.
作者
曾秀丽
朱佳佳
尹恝
吴齐恒
ZENG Xiuli;ZHU Jiajia;YIN Jia;WU Qiheng(Department of Neurology,Nanfang Hospital,Southern Medical University,NO.1838,North Guangzhou Avenue,Guangzhou,510515,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2020年第12期710-715,共6页
Chinese Journal of Nervous and Mental Diseases
基金
国家自然科学基金项目(编号:81671171)
2018年广东省信息产业发展互联网+应用项目[粤经信信息函2018(145)号]。
关键词
肺静脉血栓形成
隐源性卒中
病因
抗凝
出血转化
Pulmonary vein thrombosis
Cryptogenic stroke
Cause
Anticoagulation
Hemorrhagic transformation
