摘要
目的探讨老年新发恶性肿瘤患者合并急性脑梗死的临床和影像学特点。方法回顾性分析2014年1月~2019年6月北京大学第三医院神经内科诊治年龄≥60岁的老年急性脑梗死合并恶性肿瘤患者71例,其中3个月内新发恶性肿瘤患者18例为新发肿瘤组,恶性肿瘤病史>3个月患者53例为对照组,收集受试者临床和影像学资料,采用多因素logistic回归分析。结果新发肿瘤组年龄明显低于对照组,D-二聚体水平明显高于对照组,差异有统计学意义(P<0.05,P<0.01)。2组幕下病灶及颅内外血管狭窄程度比较,差异无统计学意义(P>0.05)。新发肿瘤组多发病灶、皮质/皮质下病灶比例明显高于对照组,深部病灶比例明显低于对照组,差异有统计学意义(P<0.01)。多因素logistic回归分析显示,年龄、D-二聚体、多发病灶及缺少深部病灶与新发恶性肿瘤合并急性脑梗死相关(95%CI:0.695~0.931,P=0.004;95%CI:1.576~34.789,P=0.011;95%CI:1.131~55.581,P=0.037;95%CI:0.009~0.828,P=0.034)。结论老年脑梗死患者D-二聚体升高,影像学呈多发病灶,尤其是双侧且前后循环均受累,应警惕合并恶性肿瘤的风险。
Objective To investigate the clinical and radiological characteristics of elderly patients with malignant tumors complicated with acute cerebral infarction.Methods A retrospective ana-lysis was performed on 71 elderly patients(aged≥60 years)with acute cerebral infarction complicated with malignant tumor admitted to our department from January 2014 to June 2019.Among them,those with malignant tumor diagnosed within 3 months were assigned as the new tumor group(n=18),and patients with malignant tumor history>3 months as the control group(n=53).Clinical and imaging data were collected,and multivariate logistic regression analysis was performed.Results The new tumor group was significantly younger and had higher D-dimer level than the control group(P<0.05,P<0.01).There were no significant differences in subatentorial lesions and intracranial and extracranial vascular stenosis between the two groups(P>0.05).The proportions of multiple lesions and cortical/subcortical lesions were obviously larger,but that of deep lesions was notably lower in the new tumor group than the control group(P<0.01).Multivariate logistic regression analysis showed that age,D-dimer,presence of multiple lesions and lack of deep lesions were associated with new malignant tumors with acute cerebral infarction(95%CI:0.695-0.931,P=0.004;95%CI:1.576-34.789,P=0.011;95%CI:1.131-55.581,P=0.037;95%CI:0.009-0.828,P=0.034).Conclusion For the elderly patients with cerebral infarction,increased D-dimer and multiple lesions in images,especially bilateral and anterior and posterior circulation involved,may indicate an alert to the risk of malignant tumor.
作者
孙庆利
傅瑜
李小刚
Sun Qingli;Fu Yu;Li Xiaogang(Department of Neurology,Perking University Third Hospital,Beijing 100191,China)
出处
《中华老年心脑血管病杂志》
北大核心
2022年第7期738-741,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
脑梗死
肿瘤
静脉血栓栓塞
磁共振成像
brain infarction
neoplasms
venous thromboembolism
magnetic resonance imaging
