Trousseau综合征和心房纤颤相关急性多发性脑梗死的临床与影像特点比较  

Comparison of clinical and imaging features between Trousseau syndrome and atrial fibrillation-related acute multiple cerebral infarction

作　　者：刘方辉 王金涛[2] 凌一童 王晶[1] 郑加平[2] LIU Fanghui;WANG Jintao;LING Yitong(Department of Neurology,People’s Hospital of Rizhao,Rizhao 276800,China)

机构地区：[1]潍坊医学院神经病学专业,山东潍坊261000 [2]日照市人民医院神经内科,山东日照276800

出　　处：《中风与神经疾病杂志》2021年第6期505-508,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨Trousseau综合征相关急性多发性脑梗死(Trousseau syndrome-acute multiple cerebral infarction,TS-AMCI)和心房纤颤相关急性多发性脑梗死(atrial fibrillation-acute multiple cerebral infarction,AF-AMCI)在临床表现、实验室检查及影像学检查等方面有无区别,为临床鉴别及治疗两类疾病提供帮助。方法回顾性收集2017年6月-2020年6月期间在日照市人民医院住院的30例TS-AMCI(TS-AMCI组)及39例AF-AMCI(AF-AMCI组)患者的临床、影像等相关资料,并进行对比分析。结果TS-AMCI组高血压、糖尿病、既往卒中史所占比例低于AF-AMCI组(P<0.05)。血浆纤维蛋白原、D-二聚体值显著高于AF-AMCI组(P<0.001)。TS-AMCI组在DWI脑梗死病灶数目<10个所占比例显著低于AF-AMCI组(P<0.001);脑梗死灶分布区域为双侧前循环加后循环显著高于AF-AMCI组(P<0.001),而AF-AMCI组的脑梗死灶分布区域则以单侧前循环为主(P<0.001)。随访30 d mRS评分及30 d死亡例数均显著高于AF-AMCI组(P<0.05)。结论TS-AMCI组较AF-AMCI组卒中传统危险因素如高血压、糖尿病等更少见,纤维蛋白原、D-二聚体值升高更明显,病灶分布以多支动脉供血区的多发小病灶更常见,两组患者在起病时临床表现无显著差异,但TS-AMCI组30 d预后较差。Objective To study the clinical characteristics and differentiation between TS-AMCI and AF-AMCI.It aims to help clinicians better distinguish and treat patients with two diseases.Methods The clinical symptoms,imaging tests,prognostic data of 30 TS-AMCI(TS-AMCI group)and 39 AF-AMCI(AF-AMCI group)who received hospital treatment from June 2017 to June 2020 in Rizhao people’s Hospital were retrospectively analyzed.Results The proportion of hypertension,diabetes and stroke history in TS-AMCI group was lower than that in AF-AMCI group(P<0.05);But the plasma fibrinogen and D-dimer in TS-AMCI group were significantly higher than those in AF-AMCI group(P<0.001).The proportion of the number of cerebral infarction lesions less than 10 in DWI of TS-AMCI group was significantly lower than that in AF-AMCI group(P<0.001).The number of cerebral infarction lesions in bilateral anterior and posterior circulation in TS-AMCI group was significantly higher than that in AF-AMCI group(P<0.001),while,AF-AMCI group was characterized by unilateral anterior circulation,which was significantly higher than that in TS-AMCI group(P<0.001).The mRS score and the Death cases at 30 days of follow-up in TS-AMCI group were significantly higher than those in AF-AMCI group(P<0.05).Conclusion Compared with the AF-AMCI group.The traditional risk factors of stroke such as hypertension and diabetes in TS-AMCI group were more rare than those in AF-AMCI group.The plasma fibrinogen and D-dimer value increased more obviously and multiple small lesions in the blood supply area of multiple arteries were more common in TS-AMCI group.There was no significant difference in clinical manifestations at the onset of the disease between the two groups,but the prognosis of TS-AMCI group was poor at 30 days.

关 键 词：TROUSSEAU综合征 急性多发性脑梗死 心房纤颤 D-二聚体 DWI 

分 类 号：R743.3[医药卫生—神经病学与精神病学]