以脑梗死为首发症状的急性早幼粒细胞白血病1例及文献回顾  

Cerebral infarction as the first symptom in acute promyelocytic leukemia:A case report and literature review

作　　者：赵成琛 谢小慧 盖东征 吴登蜀[3] 谢启应[1] 信红亚[3] 杨天伦[1] ZHAO Chengchen;XIE Xiaohui;GE Dongzheng;WU Dengshu;XIE Qiying;XIN Hongya;YANG Tianlun(Department of Cardiovascular,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Nephology,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Hematology,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院心内科,长沙410008 [2]中南大学湘雅医院肾内科,长沙410008 [3]中南大学湘雅医院血液科,长沙410008

出　　处：《中南大学学报（医学版）》2020年第4期476-480,共5页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(81570334)。

摘　　要：急性早幼粒细胞白血病常见出血等并发症,而栓塞并发症较少报道。本例患者以脑梗死表现起病,治疗过程中出现分化综合征、肺动脉栓塞合并肺出血和心肌缺血的表现,即同时存在出血和栓塞并发症,诊断为弥散性血管内凝血。经过成分输血等治疗,患者顺利完成诱导缓解治疗。该患者的治疗经验可为出血合并栓塞并发症的患者提供帮助。In the clinical settings,disseminated intravascular coagulation(DIC)and complications such as hemorrhage are commonly seen in acute promyelocytic leukemia patients,whereas thrombosis is rarely reported.We reported a case here that the patient presented with cerebral infarction as the first manifestation.During the admission,the patient encountered differentiation syndrome,pulmonary embolism,pulmonary hemorrhage,and myocardial ischemia,as well as bleeding and thrombosis complications.Hence the patient was diagnosed as DIC.After the treatment of blood transfusion instead of anticoagulation,his condition was stable and the remission was completely achieved.The treatment experience provides guides for other patients with similar complications of simultaneous bleeding and thrombosis.

关 键 词：急性早幼粒细胞白血病 肺栓塞 脑梗死 分化综合征 弥散性血管内凝血 

分 类 号：R733.71[医药卫生—肿瘤]