Ischemic Stroke in Cancer Patients With and Without Conventional Mechanisms A Multicenter Study in Korea
Ischemic Stroke in Cancer Patients With and Without Conventional Mechanisms A Multicenter Study in Korea
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DOI：
10.1161/strokeaha.109.571356
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发表时间：
2010-04-01
期刊：
影响因子：
8.3
通讯作者：
Bang, Oh Young
中科院分区：
文献类型：
--
作者：
Kim, Seon Gyeong;Hong, Ji Man;Bang, Oh Young
背景和方法：为了评估癌症患者中风的确切机制，我们分析了韩国6个中心登记的癌症患者急性缺血性中风的数据。比较常规卒中机制（csm）和隐源性卒中患者的临床特征、危险因素、弥散加权成像病变模式和实验室检查结果，包括d -二聚体水平。结果：本研究共纳入161例患者，其中CSM组97例（60.2%），隐基因组64例（39.8%）。CSM组患者年龄较大，血管危险因素比隐基因组更普遍。与CSM组相比，隐源性组更常观察到累及多动脉区域的多发病变的弥散加权成像模式。此外，隐基因组的d -二聚体水平高于CSM组（11.5 +/- 14.6 vs 3.6 +/- 10.3 μ g/dL）。在多因素分析中，多血管区域的弥散加权成像病变模式（优势比，11.2;95% CI, 3.74 ~ 33.3）和d -二聚体水平>1.11 μ g/dL（优势比，10.6;95% CI, 3.29 ~ 33.8）与隐源性组独立相关。结论：肿瘤患者大量发生CSM外脑卒中。在伴有癌症的脑卒中患者中，d -二聚体水平和弥散加权成像病变模式可能有助于早期识别非csm（特别是与癌症相关的凝血功能障碍），并可能指导脑卒中的预防策略。（中国医学杂志。2010;41:798-801）
Background and Methods-To assess the precise mechanisms of stroke in cancer patients, we analyzed the data for cancer patients with acute ischemic stroke registered from 6 centers in South Korea. Clinical features, risk factors, diffusion-weighted imaging lesion patterns, and laboratory findings including D-dimer levels were compared between patients with conventional stroke mechanisms (CSMs) and cryptogenic group.Results-A total of 161 patients were included in this study: 97 (60.2%) patients in the CSM group and 64 (39.8%) in the cryptogenic group. Patients in the CSM group were older and vascular risk factors were more prevalent than in the cryptogenic group. Diffusion-weighted imaging patterns of multiple lesions involving multiple arterial territories were observed more frequently in the cryptogenic group than in the CSM group. In addition, levels of the D-dimer were higher in the cryptogenic group than in the CSM group (11.5 +/- 14.6 versus 3.6 +/- 10.3 mu g/dL). In multivariate analysis, the diffusion-weighted imaging lesion pattern of multiple vascular territories (odds ratio, 11.2; 95% CI, 3.74 to 33.3), and D-dimer levels of >1.11 mu g/dL (odds ratio, 10.6; 95% CI, 3.29 to 33.8) were associated independently with the cryptogenic group.Conclusions-Stroke outside of CSM occurred in a large number in cancer patients. In stroke patients with cancer, D-dimer levels and diffusion-weighted imaging lesion patterns may be helpful in early identification of non-CSMs (especially coagulopathy associated with cancer) and possibly in guiding preventive strategies for stroke. (Stroke. 2010; 41: 798-801.)