血小板异常并发脑卒中临床分析

目的:总结血小板异常患者并发脑卒中的临床特点.方法:回顾性分析1999年1月至2009年1月中山大学孙逸仙纪念医院收治的血小板异常(原发性血小板增多症、特发性血小板减少性紫癜)并发脑卒中患者的临床资料.结果:原发性血小板增多症(ET)患者60例中,10%(6/60)出现脑梗死,年龄为69±11岁.血小板计数为(1112±366)×109/L;1.7e(1/60)出现脑出血,54岁,血小板计数为597×109/L.特发性血小板减少性紫癜(ITP)患者696例中,0.6%(4/696)患者出现脑出血,年龄为56±30岁,血小板计数为(29±12)×109/L:ITP患者中0.3%(2/696)出现脑梗死,分别为64岁、73岁,血小板计数分别为49×109/L、166×109/L.结论:ET患者脑梗死发生率高,建议二级预防治疗中强化抗血小板治疗以预防再次脑梗塞;ITP患者并发卒中少见,二级治疗中建议谨慎选择抗血小板方案.

The Clinical Analysis of Patients with Platelet Dysfunction Accompanying Stroke

Objective： To investigate clinical manifestation of patients with platelet dysfunction accompanying stroke. Methods： The clinical data of patients with platelet dysfunction accompanying stroke, which including essential thrombocythemia （ET） and idiopathic thrombocytopenic purpura （ITP） in Sun Yat-sen Memorial hospital of Sun Yat-sen University from Jan 1999 to Jan 2009 were analyzed retrospectively. Results： 60 patients with ET were studied, 10%（6/60）of them accompanied with cerebral infarction ,the average age and initial platelet count were 69±11 years and （1112±366） ×l0^9/L, 1.7%（1/60）of ET accompanied with encephalorrhagia,which 54 years old and initial platelet count of 597×10^9/L. 696 patients with ITP were studied, 0.6% （4/696）of ITP accompanied with encephalorrhagia, the average age and initial platelet count were 56±30 years and （29±12）×10^9/L. 0.3%（2/696）of ITP accompanied with cerebral infarction, one was 64 years old, and the other was 73 years old, their initial platelet count were 49x109/L and 166x109/L. Conclusion： Morbidity of cerebral infarction with ET was high. In these patients, antiplatelet therapy in secondary prevention should be strengthened. Morbidity of stroke with ITP was rare. In these patients,antiplatelet therapy in secondary prevention should act with caution.