胃腺癌合并蛛网膜下腔出血及脑梗死:特鲁索综合征的罕见病例并文献复习  

Gastric adenocarcinoma complicated by subarachnoid hemorrhage and cerebral infarction:a rare case of Trousseau syndrome and literature review

作　　者：赵珺 邱峰 冯锦丽[1] Zhao Jun;Qiu Feng;Feng Jinli(Department of Neurology,the Eighth Medical Center of Chinese PLA General Hospital,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心神经内科,北京100091

出　　处：《中华内科杂志》2025年第2期148-151,共4页Chinese Journal of Internal Medicine

摘　　要：特鲁索综合征是与恶性肿瘤相关的血栓栓塞事件,脑梗死和脑出血是肿瘤患者常见的中枢神经系统并发症。本文回顾了解放军总医院第八医学中心1例胃腺癌患者同时发生脑梗死及蛛网膜下腔出血的诊治过程,并检索了万方和PubMed数据库中关于特鲁索综合征、脑栓塞及蛛网膜下腔出血的相关文献,共纳入42例临床资料完整的病例(包括本院病例1例)。分析结果显示,患者中男性23例,女性19例,涉及10种不同肿瘤类型,其中肺癌、胃癌和卵巢癌为前3位。38例患者D-二聚体水平升高,38例出现3个以上血管分布区的梗死,40例接受抗凝治疗,22例在短期内发生脑梗死复发,28例在1年内死亡。特鲁索综合征伴蛛网膜下腔出血的临床病例较为罕见,目前尚未有相关报道。特鲁索综合征引起的卒中患者预后较差,但针对病因的抗肿瘤治疗和抗凝治疗可有效降低卒中复发风险并改善患者预后。Trousseau′s syndrome is a thromboembolic disorder associated with malignancies,with cerebral infarction and hemorrhage representing common central nervous system complications in patients with cancer.This report details the diagnosis and treatment of a patient with gastric adenocarcinoma at our institution who concurrently developed cerebral infarction and subarachnoid hemorrhage.We performed a comprehensive literature review in the Wanfang and PubMed databases,searching for relevant studies on Trousseau′s syndrome,cerebral embolism,and subarachnoid hemorrhage.A total of 42 patients(23 male and 19 female)with complete clinical data were included,including the present case.Our analysis showed that these patients had 10 different types of tumors,with lung cancer,gastric cancer,and ovarian cancer being the most prevalent.D-dimer levels were elevated in 38 cases,and 38 patients exhibited cerebral infarction affecting three or more vascular territories.Anticoagulant therapy was administered to 40 patients,22 experienced a recurrence of cerebral infarction within a short timeframe,and 28 died within one year.Cases of Trousseau′s syndrome associated with subarachnoid hemorrhage are rare and,to our knowledge,have not been previously reported in the literature.Patients experiencing strokes due to Trousseau′s syndrome tend to have poor prognoses.However,targeted antitumor therapy in conjunction with anticoagulation may effectively reduce the risk of stroke recurrence and enhance patient outcomes.

关 键 词：特鲁索综合征 脑梗死 蛛网膜下腔出血 血栓形成 

分 类 号：R73[医药卫生—肿瘤]