乳腺癌手术围术期脑梗死患者的临床特点分析  

THE CLINICAL FEATURES OF BREAST CANCER PATIENTS WITH PERIOPERATIVE ACUTE CEREBRAL INFARCTION

作　　者：曾素丹 秦超[1] 梁志坚[1] 程道宾[1] 陈莉[1] 叶彬[1] 虞丽霞[2] 

机构地区：[1]广西医科大学第一附属医院神经内科,南宁530021 [2]广西医科大学第一附属医院病案科,南宁530021

出　　处：《广西医科大学学报》2015年第6期917-920,共4页Journal of Guangxi Medical University

基　　金：国家自然科学基金资助项目(No.30860088;81260186);广西自然科学基金资助项目(No.0832134;0991149;2015jjAA40737);广西壮族自治区教育厅科研资助项目(No.200710LX060);广西医科大学博士启动基金资助项目(No.304214)

摘　　要：目的：探讨乳腺癌手术围术期脑梗死患者的临床特点及其可能的发病机制。方法：回顾性分析2003年1月至2014年12月,住院接受乳腺癌手术治疗,在围术期发生脑梗死患者的临床资料。结果：共收集接受乳腺癌手术患者4 894例,其中符合乳腺癌手术围术期脑梗死患者13例,占所有住院接受乳腺癌手术患者的0.27%。4例患者存在1种以上传统脑卒中危险因素,余9例无传统脑卒中危险因素。其中,脑梗死发生在乳腺癌手术当天2例,术后第2天3例,术后第3天6例,术后第6天2例。头颅MRI的弥散成像（DWI）显示颅内出现单一病灶的患者2例（15.38%）,出现两个及以上病灶、而且病灶分布于不同动脉供血区的患者11例（84.62%）。血液生化检查显示11例患者血清D-二聚体水平升高874-6 855μg/L,平均（2 817.09±2 016.46）μg/L,9例患者CA153水平升高41.10-1 179.05U/mL,平均（264.47±364.89）U/mL,8例患者CEA水平升高10.18-31.25μg/L,平均（19.03±7.46）μg/L,8例患者CA125水平升高38.73-754.34 U/mL,平均（384.63±293.98）U/mL。结论：乳腺癌手术围术期脑梗死常发生在术后前3d,多数患者乳腺癌相关的血液生化指标异常、颅内出现分布于多个血管供血区的多发性梗死灶,其发病机制可能与血液的凝固性增高有关。Objective： To explore the clinical characteristics of breast cancer patients received surgery treatment and suffered from acute cerebral infarction within the perioperative period,and to investigate possible pathogenesis. Methods： The clinical data of patients received breast cancer surgery who developed acute ischemic stroke during perioperative period, from January 2003 to December 2014 were retrospectively reviewed. Results： Of 4894 breast cancer patients received surgery treatment, data of thirteen patients （0.27%） suffered from acute cerebral infarction within the perioperative period were collected. Among these 13 patients, 4 patients had at least one conventional cardiovascular risk factors, while the other 9 patients had none of such risk factors. In addition, 2 patients suffered from the cerebral infarction at the same day of operation, 3 patients at the following day, 6 patients at the third day, and 2 patients at the sixth day. Head MRI diffusion weighted imaging displayed that 2 patients（15.38%）had one lesion and 11 pa tients（84.62%） had two or more lesions in different arterial territories in their brain. Blood biochemical examination showed that 11 patients had elevated plasma D dimmer levels between 874 and 6 855 μg/mL,with an average of（2 817.09±2 016.46）μg/L Nine patients had elevated plasma cancer antigen （CA） 1S3 levels between 41.10 and 1 179.05 U/mL,with an average of（264.47±364. 89）U/mL. Eight patients had elevated plasma carcinoembryonic antigen （CEA） levels between 10.18 and 31.25μg/L,witb an average of （19.03±7.46）gg/L and 8 patients had elevated plasma CA125 levels between 38.73 and 754.34 U/mL,with an average of（384.63±293.98） U/mL. Conclusion： Patients received breast cancer surgery treatment who developed acute ischemic stroke had distinct clinical features, such as the acute cerebral infarction in breast cancer patients received surgery treatment usually occur within 3 days following the operation, abnormal blood test index and more

关 键 词：乳腺癌 围术期 脑梗死 临床特点 

分 类 号：R737.9[医药卫生—肿瘤]