特鲁索综合征相关性脑梗死患者的临床与影像特征分析  

Analysis of Clinical and Imaging Features of Patients with Trousseau Syndrome Associated Cerebral Infarction

作　　者：张蝴蝶 苏楹文 林晶 洪道俊[1] ZHANG Hudie;SU Yingwen;LIN Jing;HONG Daojun(Department of Neurology,The First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院神经内科,南昌330006

出　　处：《中国卒中杂志》2025年第2期144-150,共7页Chinese Journal of Stroke

摘　　要：目的探讨特鲁索综合征相关性脑梗死(Trousseau syndrome associated cerebral infarction,TSCI)的临床及影像特征,并对比不同系统肿瘤患者的临床资料、影像学特征及实验室检查结果差异,以提高临床医师对TSCI的诊治水平。方法本研究根据纳入标准与排除标准选择南昌大学第一附属医院2020年4月—2024年9月收治的诊断为TSCI的患者为研究对象,收集患者的临床资料、影像学特征、实验室检查结果并进行回顾性分析。结果研究最终纳入103例TSCI患者,平均年龄为(66.0±10.6)岁,其中男性62例(60.2%),女性41例(39.8%)。首发症状以运动障碍为主(62例,60.2%)。“三流域征”是TSCI患者最常见的影像学特征(73例,70.9%)。最常见的肿瘤是消化系统肿瘤(38例,36.9%)和呼吸系统肿瘤(36例,35.0%),消化系统肿瘤相关的TS CI患者的炎症指标及D-二聚体水平高于呼吸系统肿瘤相关的TS CI患者(P<0.05),且更容易出现进展性脑梗死(P=0.020),预后更差(P=0.003)。结论对于原因不明脑梗死,尤其是梗死病灶涉及三流域非单根血管供血分布、D-二聚体和炎症因子水平升高的患者,应考虑TSCI的可能性。消化系统肿瘤相关的TSCI患者相较于呼吸系统肿瘤相关的TSCI患者病情更容易进展,预后更差。Objective To explore the clinical and imaging features of Trousseau syndrome associated cerebral infarction(TSCI),and to compare the differences in clinical data,imaging features,and laboratory test results among patients with tumors in different systems,so as to improve the diagnosis and treatment of TSCI by clinicians.Methods This study selected patients diagnosed with TSCI admitted to the First Affiliated Hospital of Nanchang University from April 2020 to September 2024 as research subjects,based on inclusion and exclusion criteria.Clinical data,imaging features,and laboratory test results of patients were collected and subjected to retrospective analysis.Results A total of 103 TSCI patients were ultimately included,with an average age of(66.0±10.6)years,including 62 males(60.2%)and 41 females(39.8%).The initial symptom was mainly dyskinesia(62 cases,60.2%).The“three-territory sign”was the most common imaging feature in TSCI patients(73 cases,70.9%).The most common tumors were digestive system tumors(38 cases,36.9%)and respiratory system tumors(36 cases,35.0%).Patients with TSCI related to digestive system tumors had significantly higher inflammatory factors and D-dimer levels than patients with TSCI related to respiratory system tumors(P<0.05),and were more likely to experience progressive cerebral infarction(P=0.020)and had a worse prognosis(P=0.003).Conclusions For patients with undetermined cerebral infarction,especially those with infarction lesions involving the distribution of multiple vessels,elevated levels of D-dimer and inflammatory factors,the possibility of TSCI should be considered.Patients with TSCI related to digestive system tumors tend to progress more easily and have a worse prognosis compared to those with TSCI related to respiratory system tumors.

关 键 词：特鲁索综合征 脑梗死 肿瘤 消化系统 呼吸系统 

分 类 号：R74[医药卫生—神经病学与精神病学] R73[医药卫生—临床医学]