以反复脑梗死为首发症状的POEMS综合征1例报告并文献复习  

Recurrent cerebral infarction in POEMS syndrome: a case report and literature review

作　　者：王子高[1] 王冠群[1] 祖衡兵[1] 

机构地区：[1]复旦大学附属金山医院神经内科,上海201508

出　　处：《中风与神经疾病杂志》2016年第3期256-261,共6页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨POEMS综合征伴发脑梗死的临床特点。方法报道1例合并反复脑梗死的POEMS综合征病例,结合国内外文献对POEMS综合征合并脑梗死的临床表现、发病机制及治疗予以分析总结。结果 POEMS综合征伴发的脑梗死好发于中年人群,常在周围神经病变起病20 m后发生。以偏瘫为最常见的首发表现,梗死灶以大脑中动脉支配区为主,50%的患者存在颅内血管异常。骨髓浆细胞增殖与血小板增多可能参与脑梗死的发生,积极治疗原发病可降低脑梗死的复发率。结论 POEMS综合征是脑梗死的少见病因,原发病的治疗是预防脑梗死复发的重要手段。Objective To investigate the clinical features of cerebral infarction associated with POEMS syndrome.Methods A patient with recurrent ischemic stroke associated with POEMS syndrome was reported. The clinical characteristics,pathogenesis and treatments of ischemic stroke associated with POEMS syndrome were reviewed. Results Ischemic stroke occurred mainly 20 months later than the onset of peripheral neuropathy symptoms in POEMS syndrome,with hemiplegia as the most common symptom at onset. Areas supplied by middle cerebral artery were affected most frequently. Intracranial arteriopathy was found in nearly 50% of the patients. Plasma cell hyperplasia in bone marrow and thrombocytosis were involved in the pathogenesis of ischemic stroke in POEMS syndrome. Recurrence rate of cerebral infarction decreased after successful treatment of the underlying condition. Conclusion Cerebral infarction is a severe complication of POEMS syndrome. Treatment of the syndrome may be the best approach to lower the risk of ischemic stroke in these patients.

关 键 词：POEMS综合征 脑梗死 血管内皮生长因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学]