脑卒中合并真性红细胞增多症19例临床分析  

The clinical analysis of 19 cases of stroke complicating polycythemis vera

作　　者：张子斌[1] 宋彦峰[1] 陶伟[1] 张文英[1] 

机构地区：[1]泰山医学院附属聊城市二院神经内科,252601

出　　处：《中国临床实用医学》2010年第4期224-226,共3页China Clinical Practical Medicine

摘　　要：目的探讨脑卒中合并真性红细胞增多症（PV）的临床特点及治疗方法。方法对19例脑卒中合并PV患者的临床资料进行回顾性分析。结果①本组PV并发脑梗死14例（14／19，73．4％），其中多发性脑梗死12例（12／14，85．7％）；短暂性脑缺血发作2例（2／15，13．3％）；脑出血2例（2／19，10．5％）；蛛网膜下腔出血（SAH）1例（1／19，5．3％）。均符合PV的临床表现和体征及血象、骨髓象的改变；②影像学检查显示脑梗死以多发小梗死灶多见（13／19，68．4％），常见于脑叶、基底节、内囊；脑出血的出血灶内密度不均匀，周边水肿明显；③本组采用静脉放血加小剂量化疗治疗，脑卒中痊愈7例，显著进步11例，无效1例。结论脑卒中合并PV以脑梗死多见，其中又以多发性梗死为主，并发脑出血和SAH较少，采用静脉放血加小剂量化疗治疗的效果较好。Objective To explore the clinical features and treatment of stroke complicating polycythemia vera（PV）. Methods Clinical data of 19 cases of stroke complicating PV were analysed retrospectively. Results （1）Among all the cases, cerebral infarction complicating PV were 14 cases （ 14/19,73.4% ） , among the 14 cases, 12 cases（ 12/14,85.7% ） of multiple cerebral infarction, 2 cases（2/15,13.3% ）of transientischemis attack ;2 cases （ 2/19,10. 5 % ） of cerebral hemorrhage, 1 case （ 1/19,5.3 % ） of subarachnoid hemorrhage （SAH）. The patients＇ s clinical manifestation, physical sign, hemogram, marrow characteristic were consistentwith that of PV diagnosis criteria. （2） Imageology check show that small infarction focus were common （ 13/19, 68.4% ）. Lobe of brain, basal ganglia, capsula intema were common place of cerebral infarction. The density of hemorrhagic focus was asymmetrical, there was obvious edema around the hem orrhagic focus. （3）Applied vein blood-letting and small dose chemotherapy, 7 cases were covery, 11 cases were obviously inproved, 1 case of stroke was invalid. Conclusion The cerebral infarction is common in stroke complicating PV. Among all the stroke complicating PV cases, multiple cerebral infarction are the most common, cerebral hemorrhage and subarachnoid hemorrhage are few, vein blood-letting and small dose chemotherapy has a good curative effect for the patients.

关 键 词：真性红细胞增多症 脑卒中 治疗 

分 类 号：R74[医药卫生—神经病学与精神病学] R5[医药卫生—临床医学]