Kocaman Canan, Yilmaz Yuksel
Marmara University School of Medicine, Department of Pediatrics, Division of Child Neurology, Istanbul, Turkey.
Brain Dev. 2012 Feb;34(2):133-9. doi: 10.1016/j.braindev.2011.04.003. Epub 2011 May 11.
This study aimed to investigate the maternal, pre- and perinatal, and prothrombotic factors with congenital hemiparesis due to presumed perinatal stroke (PPS). Prothrombotic risk factors including protein C and S, antithrombin III, lipoprotein (a), homocystein, factor VIII levels; anticardiolipin antibodies and lupus anticoagulant; methylenetetrahydrofolate reductase mutations, factor V Leiden, prothrombin G20210A mutations were investigated. Arterial ischemic stroke was detected in 60% and periventricular venous infarction in 40%. At least one prothrombotic risk factor was present in 69%, two in 17%, and three or more in 8.5% of cases. The most common combination was methylenetetrahydrofolate reductase C677T and factor V Leiden heterozygosity. The etiology and pathogenesis of PPS is still unclear. According to this study, most of the patients with PPS might have one or more prothrombotic risk factors and certain prenatal risk factors including intrauterine growth retardation, twin gestation and preeclampsia might be related to PPS.
本研究旨在调查因假定的围产期卒中（PPS）导致先天性偏瘫的母体、产前和围产期及血栓形成前因素。对血栓形成前危险因素进行了调查，包括蛋白C和S、抗凝血酶III、脂蛋白(a)、同型半胱氨酸、因子VIII水平；抗心磷脂抗体和狼疮抗凝物；亚甲基四氢叶酸还原酶突变、因子V莱顿突变、凝血酶原G20210A突变。检测到60%为动脉缺血性卒中，40%为脑室周围静脉梗死。69%的病例存在至少一种血栓形成前危险因素，17%存在两种，8.5%存在三种或更多种。最常见的组合是亚甲基四氢叶酸还原酶C677T和因子V莱顿杂合性。PPS的病因和发病机制仍不清楚。根据本研究，大多数PPS患者可能有一个或多个血栓形成前危险因素，某些产前危险因素包括宫内生长迟缓、双胎妊娠和先兆子痫可能与PPS有关。
