骨髓增殖性肿瘤患者卒中的临床特点和危险因素分析  

Analysis of Clinical Feature and Risk Factors of Stroke in Classical Myeloproliferative Neoplasms

作　　者：余延芳[1] 王明迪[2] 黄燕华[1] 吴道香 崔海佳 马晓彩 YU Yan-fang;WANG Ming-di;HUANG Yan-hua;WU Dao-xiang;CUI Hai-jia;MA Xiao-cai(Department of Hematology,Shougang Hospital,Peking University,Beijing,100144,China;Department of laboratory Medicine,Shougang Hospital of Peking University,Beijing,100144,China)

机构地区：[1]北京大学首钢医院血液内科,北京100144 [2]北京大学首钢医院检验科,北京100144

出　　处：《血栓与止血学》2021年第5期721-724,共4页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的探讨骨髓增殖性肿瘤(cMPN)患者发生卒中的危险因素。方法收集从2015年1月到2020年8月我院诊治的179例cMPN患者的临床资料,包括91例真性红细胞增多症(PV)、67例原发性血小板增多症(ET)和21例原发性骨髓纤维化(PMF),分析cMPN患者发生卒中的影响因素。结果179例cMPN患者,卒中事件发生率为11.7%(21/179例),其中缺血性卒中为90.5%(19/21例),出血性卒中为9.5%(2/21例),差异有统计学意义(P<0.05)。年龄≥65、既往血栓病史、高血压病、高脂血症、JAK2基因突变、血红蛋白(Hb)≥170 g/L是MPN患者发生卒中事件的独立危险因素(P<0.05)。结论cMPN患者缺血性卒中发生率高于出血性卒中,年龄、既往血栓史、高血压病、高脂血症、JAK2基因突变、Hb对cMPN患者发生卒中有预测价值,应尽早预防。Objective To investigate the clinical characteristics and risk factors of stroke in patients with classical myeloproliferative neoplasms(cMPN).Methods In order to analyze risk factors of stroke,clinical data of 179 patients with cMPN from January 2015 to August 2020 were collected,including 91 cases of polycythemia vera(PV),67 cases of essential thrombocythemia(ET)and 21 cases of primary myelofibrosis,Results The incidence of stroke was 11.7%(21/179).Among 21 cases of patients with stroke,the percentages of ischemic and hemorrhagic stroke were 90.5%(19/21)and 9.5%(2/21),respectively.The difference achieved statistical significance(P<0.05).Multivariate logistic regression analysis demonstrated that 65≥years、history of thrombosis、history of hypertension、history of hyperlipidemia、JAK2 gene mutationand Hb≥170 g/Lwere independent risk factors for stroke in cMPN patients(P<0.05).Conclusion Ischemic stroke is more common than hemorrhagic stroke in patients with cMPN.And age、history of thrombosis、hypertension、hyperlipidemia、JAK2 gene mutation and Hb have important predictive values for stroke,which required early prevention in cMPN patients.

关 键 词：骨髓增殖性肿瘤 临床特点 卒中 

分 类 号：R558.3[医药卫生—血液循环系统疾病]