以急性脑梗死起病伴发恶性肿瘤患者的临床特征及相关危险因素分析  

Analysis of clinical features and related risk factors in patients with cerebral infarction as the first symptom accompanied by malignant tumor

作　　者：潘成玉 刘草原 梁涛 张霞 郝仁方 徐祖才 Pan Chengyu;Liu Caoyuan;Liang Tao;Zhang Xia;Hao Renfang;Xu Zucai(Department of Neurology,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563000,China)

机构地区：[1]遵义医科大学附属医院神经内科,贵州遵义563000

出　　处：《遵义医科大学学报》2025年第3期270-273,共4页Journal of Zunyi Medical University

基　　金：国家自然科学基金资助项目(NO:82360268)。

摘　　要：目的 探讨以急性脑梗死起病伴发恶性肿瘤患者的临床特点、影像学表现、实验室检查结果及危险因素。方法 回顾性收集2019年8月至2023年12月遵义医科大学附属医院急性脑梗死患者39例,根据是否伴发恶性肿瘤分为肿瘤组(19例)和对照组(20例),分析两组患者的临床特点及相关危险因素。结果 19例伴发恶性肿瘤的脑梗死表现患者中,最常见肿瘤为肺癌13例(68.4%),肿瘤组在发病年龄、男女比例、NIHSS评分方面跟对照组相比有显著差异(P<0.05)。对照组病变血管多分布在前循环,跟肿瘤组相比有显著差异(P<0.05),肿瘤组患者前、后循环多支血管检出率高于对照组,差异有统计学意义(P<0.05)。肿瘤组和对照组外周血纤维蛋白原、NLR、PLR比较差异有统计学意义(P<0.05)。结论 伴发恶性肿瘤的急性脑梗死表现患者最常见肿瘤类型为肺癌。较多恶性肿瘤患者合并传统脑卒中危险因素,对于不符合单支动脉供血区的急性多发性脑梗死患者应进行系统性的肿瘤筛查。Objective To explore the clinical features,imaging manifestations,laboratory findings and risk factors of patients with acute cerebral infarction starting with concomitant malignant tumor.Methods Thirty-nine patients with acute cerebral infarction in the Affiliated Hospital of Zunyi Medical University were retrospectively collected from August 2019 to December 2023,and divided into the tumor group(19 cases)and the control group(20 cases)according to whether they were accompanied by malignant tumors or not,and analyzed the clinical characteristics and related risk factors of the patients in the two groups.Results Among the 19 patients with cerebral infarction manifested with malignant tumors,the most common tumor was lung cancer in 13 cases(68.4%),and there were significant differences between the tumor group and the control group in terms of age of onset,male to female ratio,and NIHSS score(P<0.05).In the control group,most of the diseased vessels were distributed in the anterior circulation,which was significantly different from the tumor group(P<0.05),and the detection rate of multiple vessels in the anterior and posterior circulation of the patients in the tumor group was higher than that of the control group,which was statistically significant(P<0.05).The difference in peripheral blood fibrinogen,Neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ration(PLR)between the tumor group and the control group was statistically significant(P<0.05).Conclusion The most common tumor type in patients with acute cerebral infarction manifestations associated with malignant tumors was lung cancer.More patients with malignant tumors combined with traditional stroke risk factors and systematic tumor screening should be performed in patients with acute multiple cerebral infarctions that do not fit into a single arterial supply zone.

关 键 词：脑梗死 肿瘤 恶性 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]