中风与神经疾病杂志2019，Vol.36Issue(1)：37-42,6.
恶性肿瘤合并急性脑梗死的临床特点及预后分析
Clinical and prognosis features of acute ischemic stroke patient with cancer patient
郭琳佳 1刘文宏1
作者信息
- 1. 首都医科大学附属北京世纪坛医院神经内科, 北京 100038
- 折叠
摘要
Abstract
Objective To analyse the clinical features and functional outcomes of acute ischemic stroke patient with cancer patient. Methods A total of 41 patients with active cancer diagnosed with as acute ischemic stroke between January 2013 and July 2017 were retrospectively analyzed. Demographics, cerebrovascular risk factors, stroke characteristics including clinical and imaging manifestations、laboratory findings、acute treatment and prognosis were abstracted. The primary outcome measures included in-hospital mortality and 90-day functional outcome[as assessed by the modified Rankin scale (mRS) score, with mRS scores of 3 ～ 6 considered poor functional outcome]. SPSS statistics 20. 0 was employed for data analysis. Student's t test, Fisher's test or rank sum test was employed for comparison for different data between the two groups. Results (1) There were 33 cases (80. 5％) with traditional stroke risk factors. The most common stroke etiology was cryptogenic subtypes (43. 9％) , There there were 22 cases (53. 7％) whose lesions located in multiple blood vessels.Multiple small lesions were common (70. 7％) . Lesions were mainly located in cortex/subcortex (78. 5％) . Subtentorial lesions were mainly involved in cerebellum (31. 7％) . The D-dimer levels were 0. 96 (0. 22, 3. 76) mg/L. (2) The in-patient mortality was 9. 8％; the 90 day mortality was 39. 0％; half of survivors had poor functional outcome. We compared the patients with favourable prognosis (n = 12) and those with poor prognosis (n = 29) to elucidate possible differences, there were more cryptogenic stroke、multiple vascular lesions and advanced tumor in patients with poor prognosis. There were higher NIHSS scores、D-dimer levels and lower hemoglobin levels in patients with poor prognosis. There are were significant difference (P < 0. 05) . Conclusion Traditional stroke risk factors was common in ischemic stroke with cancer patients, which were characterized by predominately cryptogenic stroke、high D-dimer levels、more multiple vascular small lesions and poor functional outcome. It was supposed that the pathogenesis of ischemic stroke in cancer patients was differ from that in noncancer patients. Hypercoagulability along with traditional stroke risk factors affects the occurrence and progress of the disease.关键词
脑梗死/恶性肿瘤/临床特点/预后Key words
Ischemic stroke/Cancer/Clinical features/Prognosis分类
医药卫生引用本文复制引用
郭琳佳,刘文宏..恶性肿瘤合并急性脑梗死的临床特点及预后分析[J].中风与神经疾病杂志,2019,36(1):37-42,6.
