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目的:探讨恶性肿瘤患者并发脑梗死的临床特点及相关危险因素。方法:采用病例对照研究,将86例恶性肿瘤并发脑梗死患者作为病例组,按照年龄、性别以1:1比例匹配单纯脑梗死患者和单纯恶性肿瘤患者作为对照组,对相关临床资料进行比较,分析恶性肿瘤患者并发脑梗死的临床特点及相关危险因素。结果:恶性肿瘤合并脑梗死组中不明原因的缺血性卒中是最常见的病因分型(占37.2%),单纯脑梗死组则主要为大动脉粥样硬化性卒中(占48.8%)。43.0%的患者在确诊恶性肿瘤3月内发生脑梗死,23.3%的患者在3月~6月内发生脑梗死。与单纯脑梗死患者相比,恶性肿瘤合并脑梗死组患者的D-二聚体水平明显提高(486.3±201.4 vs.325.8±213.5,P<0.001),且MRI表现中病灶数>2个的比例明显高于单纯脑梗死患者(χ~2=43.914,P<0.001)。与单纯恶性肿瘤患者相比,恶性肿瘤合并脑梗死组患者的D-二聚体水平明显提高(486.3±201.4 vs.278.4±198.7,P<0.001),且发生远处转移的比例明显高于单纯恶性肿瘤患者(χ~2=9.313,P=0.002)。结论:恶性肿瘤患者在确诊半年内是发生脑梗死的高危时期,凝血-纤溶功能改变及发生远处转移可能与恶性肿瘤患者发生脑梗死有关。
Objective: To investigate the clinical features and related risk factors of patients with malignant tumor complicated by cerebral infarction. Methods: A case-control study was conducted in 86 patients with malignant tumor complicated with cerebral infarction. According to the age and sex, patients with simple cerebral infarction and simple malignant tumor matched with 1: 1 ratio were compared. The clinical data were compared. To analyze the clinical features and related risk factors of patients with malignant tumor complicated by cerebral infarction. Results: The most common cause of ischemic stroke was malignant tumor complicated with cerebral infarction (37.2%), while the simple cerebral infarction group was mainly atherosclerosis (48.8%). 43.0% of patients developed cerebral infarction within 3 months of confirmed malignancy and 23.3% of patients developed cerebral infarction within March to June. D-dimer levels in patients with malignant tumor complicated with cerebral infarction were significantly higher than those in patients with simple cerebral infarction (486.3 ± 201.4 vs.325.8 ± 213.5, P <0.001), and the number of lesions> 2 in MRI findings Significantly higher than those in patients with simple cerebral infarction (χ ~ 2 = 43.914, P <0.001). D-dimer levels were significantly higher in patients with malignant tumor complicated with cerebral infarction (486.3 ± 201.4 vs. 278.4 ± 198.7, P <0.001), and the proportion of distant metastases was significantly higher than that in patients with simple malignancy Malignant tumor patients (χ ~ 2 = 9.313, P = 0.002). Conclusions: Malignant tumor patients are at high risk of developing cerebral infarction within six months of diagnosis. Changes in coagulation - fibrinolysis and distant metastasis may be related to cerebral infarction in patients with malignant tumors.