摘要
目的探讨以脑梗死为首发表现的胃癌患者的临床特点和可能的发病机制。方法收集以脑梗死为首发表现的胃癌患者16例为癌症组,同时按照14的比例随机收录同期年龄、性别相匹配的单纯脑梗死患者64例为对照组,回顾性分析2组临床资料。结果符合条件的癌症组患者TOAST分型原因不明型脑梗死12例(75.0%),头颅MRI出现累及不同动脉供血区的≥2个脑梗死病灶10例。与对照组比较,癌症组患者血红蛋白低、凝血酶原时间延长和癌胚抗原、甲胎蛋白及血浆D-二聚体水平明显升高,差异有统计学意义(P<0.05)。logistic回归分析显示,凝血酶原时间延长(OR=1.640,95%CI:1.031~2.608,P=0.037)和D-二聚体升高(OR=1.210,95%CI:1.180~1.260,P=0.000)是以脑梗死为首发表现的胃癌患者的独立危险因素。结论以脑梗死为首发表现的胃癌患者常以脑内出现多发性脑梗死灶为特点,其发生机制可能与胃癌导致的高凝状态有关。
Objective To study the clinical features of gastric cancer patients with ischemic stroke as their initial manifestation and its underlying pathogenesis.Methods Sixteen gastric cancer patients with ischemic stroke as their initial manifestation served as a gastric cancer group and 64age-and sex-matched ischemic stroke patients served as a control group in this study.Their clinical data were retrospectively analyzed.Results The pathogenesis was unknown in 12（75.0%）and≥2ischemic stroke foci involving different artery blood supply areas were detected in 10 out of the 16 gastric cancer patients.The hemoglobulin level was significantly lower,the prothrombin time was significantly longer,and the serum levels of CEA,AFP and D-dimer were significantly higher in gastric cancer group than in control group（P〈0.05）.Logistic regression analysis showed that prolonged prothrombin time and elevated serum D-dimer level were the independent risk factors for gastric cancer patients with ischemic stroke as their initial manifestation（OR=1.640,95%CI：1.031-2.608,P=0.037;OR=1.210,95%CI：1.180-1.260,P=0.000）.Conclusion Gastric cancer patients with ischemic stroke as their initial manifestation are characterized by multiple ischemic stroke foci which are possibly related with gastric cancer-induced hypercoagulability.
作者
黄戈伦
秦超
梁志坚
程道宾
陈莉
卢秋红
邓添新
HUANG Ge-lun QIN Chao LIANG Zhi-jian et al(Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China)
出处
《中华老年心脑血管病杂志》
CAS
2017年第3期269-272,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家自然科学基金(30860088
81260186)
广西自然科学基金(0832134
0991149
2015GXNSFAA139228)
关键词
脑梗死
胃肿瘤
凝血酶原时间
癌胚抗原
brain infarction
stomach neoplasms
prothrombin time
carcinoembryonic antigen
