真性红细胞增多症并发脑卒中27例临床分析

目的 探讨真性红细胞增多症(PV)并发脑卒中的临床特点及治疗方法.方法 对27例PV并发脑卒中患者的临床资料进行回顾性分析.结果 (1)本组PV并发脑梗死22例(81.5%),其中多发性脑梗死18例(66.7%);短暂性脑缺血发作2例(7.4%);脑出血2例(7.4%);蛛网膜下腔出血(SAH)1例(3.7%).均符合PV的临床表现和体征及血象、骨髓象的改变.(2)影像学检查显示脑梗死以多发小梗死灶多见(66.7%),常见于脑叶、基底节、内囊;脑出血的出血灶内密度不均匀,周边水肿明显.(3)本组采用静脉放血加小剂量化疗治疗,脑卒中痊愈8例,显著进步18例,无效1例.结论 PV并发脑卒中以脑梗死多见,其中又以多发性梗死为主,并发脑出血和SAH较少,采用静脉放血加小剂量化疗治疗的效果较好.

The clinical analysis of 27 cases of polycythemia vera complicating stroke

Objective To explore the clinical features and treatment of polycythemia vera(PV)complicating stroke.Methods Clinical data of 27 cases of PV complicating stroke were analysed retrospectively.Results(1)Among all the cases,PV complicating cerebral infarction were 22 cases(81.5%),among the 22 cases,18 cases(66.7%)of multiple cerebral infarction,2 cases(7.4%)of transient ischemic attack,2 cases(7.4%)of cerebral hemorrhage,1 case(3.7%)of subarachnoid hemorrhage(SAH).The patients's clinical manifestation,physical sign,hemogram,marrow characteristic were consistent with that of PV diagnosis criteria.(2)Imageology check show that small infarction focus were common(66.7%).Lobe of brain,basal ganglia,capsula interna were common place of cerebral infarction.The density of hemorrhagic focus was asymmetrical,there was obvious edema around the hemorrhagic focus.(3)Applied vein blood-letting and small dose chemotherapy,8 cases were recovery,18 cases were obviously improved,1 case of stroke was invalid.Conclusion The cerebral infarction are common in PV complicating stroke.Among all the PV complicating stroke cases,multiple cerebral infarction are the most common,cerebral hemorrhage and subarachnoid hemorrhage are few,vein blood-letting and small dose chemotherapy has a good curative effect for the patients.