Huang Gelun, Qin Chao, Liang Zhijian, Cheng Daobin, Chen Li, Lu Qiuhong, Yu Lixia
Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
Zhonghua Yi Xue Za Zhi. 2016 May 10;96(17):1336-40. doi: 10.3760/cma.j.issn.0376-2491.2016.17.007.
To investigate the clinical features of systemic malignancy patients with acute cerebral hemorrhage as well as its underlying mechanism.
The clinical data, including presentation, lab tests and neurological images, of systemic malignancy patients with acute cerebral hemorrhage at the First Affiliated Hospital of Guangxi Medical University between January 2003 and December 2014 were collected and analyzed.
Among 61 326 systemic malignancy patients, 25 patients(0.04%)were found with acute cerebral hemorrhage and were enrolled. Out of these 25 patients, age ranged from 31 to 77 years old, with an average age of 61 years, 18 patients were males. The clinical features of the systemic malignancy patients with acute cerebral hemorrhage were found that most patients (14/25, 54.0%) lacked traditional risk factors, with sudden symptom onset and some degree of neurologic deficiency in all patients, and most hemorrhagic lesions (19/25, 76.0%) involved the hemicerebrum, for most patients (16/25, 60.0%) cerebral hemorrhage occurred after 3 days to 3 years of the malignancy diagnosis, and some malignancy patients (8/25, 32.0%) presented with cerebral hemorrhage as the first presentation. The common subtypes of malignancy found were lung cancer (8/25, 32.0%), liver cancer (7/25, 28.0%), and then gastric carcinoma (6/25, 24.0%). Most patients (22/25, 88.0%) had elevated plasma level of cancer biochemical marks (including one or more than one of cancer antigen 125, 153 and 199, carcino-embryonic antigen, and alpha fetal protein), most patients (16/25, 64.0%) were found to have coagulation disorder.
The unique clinical features of the systemic malignancy patients with acute cerebral hemorrhage are most patients lacking traditional risk factors, with coagulation disorder and with hemorrhagic lesions in hemicerebrum. And coagulation disorder might be responsible for the cerebral hemorrhage.
探讨合并急性脑出血的全身恶性肿瘤患者的临床特征及其潜在机制。
收集广西医科大学第一附属医院2003年1月至2014年12月期间合并急性脑出血的全身恶性肿瘤患者的临床资料，包括临床表现、实验室检查及神经影像学资料，并进行分析。
在61326例全身恶性肿瘤患者中，发现25例（0.04%）合并急性脑出血并纳入研究。这25例患者年龄在31至77岁之间，平均年龄61岁，男性18例。合并急性脑出血的全身恶性肿瘤患者的临床特征为：大多数患者（14/25，54.0%）缺乏传统危险因素，所有患者症状突发且有一定程度的神经功能缺损，大多数出血性病变（19/25，76.0%）累及大脑半球，大多数患者（16/25，60.0%）脑出血发生在恶性肿瘤诊断后3天至3年，部分恶性肿瘤患者（8/25，32.0%）以脑出血为首发表现。常见的恶性肿瘤亚型为肺癌（8/25，32.0%）、肝癌（7/25，28.0%），其次为胃癌（6/25，24.0%）。大多数患者（22/25，88.0%）血浆肿瘤生化标志物水平升高（包括癌抗原125、153和199、癌胚抗原、甲胎蛋白中的一种或多种），大多数患者（16/25，64.0%）存在凝血功能障碍。
合并急性脑出血的全身恶性肿瘤患者的独特临床特征为大多数患者缺乏传统危险因素、存在凝血功能障碍且出血性病变累及大脑半球。凝血功能障碍可能是导致脑出血的原因。
