前列腺癌相关脑梗死的发病特点

目的 探讨前列腺癌相关脑梗死的发病特点。方法 收集2003年1月-2015年12月在广西医科大学第一附属院住院治疗的前列腺癌合并脑梗死患者的临床表现、实验室及器械检查等资料。结果 本研究共筛查前列腺癌患者2 584例,其中符合前列腺癌合并脑梗死的患者共有34例(1.31%),平均年龄(61.60±6.28)岁。入选的患者中无脑卒中危险因素21例(61.76%)。血液学检查发现D-二聚体水平升高22例(64.71%),总前列腺特异性抗原(Total prostate specific antigen,T-PSA)水平异常升高(>100 ng/mL )19例(55.88%),头颅MRI显示脑内单一梗死灶8例(23.52%),出现累及多个动脉供血区的2个或2个以上梗死灶26例(76.47%),脑梗死发生30 d多数患者预后不良,其中4例(11.77%)死亡。结论 前列腺癌相关脑梗死的患者以缺少常见的脑卒中危险因素、血清D-二聚体水平升高以及T-PSA异常升高、一次发病出现累及多血管分布区的多发性梗死灶以及预后不良等为特点,其发生机制可能与患者血液的凝固性升高有关。

Clinical features of ischemic stroke in patients with prostate cancer

ObjectiveTo investigate the clinical features of ischemic stroke in patients with prostate cancer.Methods The clinical data of prostate cancer patients with acute ischemic stroke in first affiliated hospital of Guangxi medical university from January,2003 and December 2015 were retrospectively analyzed.Results Out of 2 584 cases of prostate cancer patients,34 patients were suffered from acute ischemic sroke(1.31%),with an average age of(61.60±6.28)years.Among the 34 patients,21 patients(61.76%)lacked of the conventional risk factors for ischemic stroke.Blood biochemistry tests showed that there was an elevated plasma D-dimer levels in 22 patients(64.71%)and there was a significantly elevated levels of the total prostate specific antigen in 19 patients(55.88%)(>100 ng/mL).And the magnetic resonance imaging examination showed that there was the single lesions in 8 patients(23.52%)and there were two or more lesions distributed to multiple cerebral arterial regions in the other 26 patients(76.47%).At the 30^th day,most of the prostate cancer patients with acute ischemic stroke were found with poor prognosis,and 4 patients died.Conclusion It was suggested that the ischemic stroke associate to prostate cancer had distinct clincal feathers such as without the conventional risk factors,with an elevated plasma D-dimer levels and a significantly elevated levels of T-PSA,and with multiple lesions distributed to multiple cerebral arterial regions.And its pathogenesis might be related to blood hypercoagulability.