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原发性血小板增多症相关卒中的放射学特征和转归。

Radiological features and outcomes of essential thrombocythemia-related stroke.

机构信息

Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.

Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

出版信息

J Neurol Sci. 2019 Mar 15;398:135-137. doi: 10.1016/j.jns.2019.01.035. Epub 2019 Jan 22.

Abstract

BACKGROUND

Essential thrombocythemia (ET) is known to be associated with an increased vascular event, but the stroke patterns and prognosis have not been studied.

METHODS

Between January 2013 and December 2017, acute ischemic stroke patients with ET who were admitted to two tertiary hospital stroke centers in Seoul, Korea were included. We retrospectively reviewed their clinical, laboratory and imaging data. Stroke mechanism was determined as ET-only when no atherosclerotic, cardioembolic, or lacunar stroke etiology was demonstrated and as ET-plus group when any specific etiology was combined. Each group was analyzed to ascertain stroke patterns and outcomes.

RESULTS

A total of 26 patients were included, and their mean age was 66 ± 17 years, including 12 female patients. There were 12 ET-only cases and 14 ET-plus cases per stroke mechanism. The ET-plus group included 7 large artery atherosclerosis, 5 small vessel occlusion, and 2 cardioembolic cases. Multiple scattered lesions involving multiple vascular territories were more prevalent in the ET-only group. Poor outcome (modified Rankin scale >2 at discharge) was noted in 13 cases (50.0%), and old age, female sex, prior diagnosis of ET to stroke and low hemoglobin level were associated with poor outcome.

CONCLUSION

ET-related stroke displayed a characteristic infarction pattern, such as multiple embolisms.

摘要

背景

已知原发性血小板增多症(ET)与血管事件风险增加相关,但尚未研究其卒中类型和预后。

方法

2013 年 1 月至 2017 年 12 月期间,韩国首尔两家三级医院卒中中心收治的 ET 合并急性缺血性卒中患者被纳入研究。我们回顾性分析了他们的临床、实验室和影像学资料。如果没有动脉粥样硬化、心源性栓塞或腔隙性卒中病因,则将卒中机制确定为 ET 型;如果存在任何特定病因,则确定为 ET+型。分析每个组以确定卒中类型和结局。

结果

共纳入 26 例患者,平均年龄为 66±17 岁,包括 12 例女性患者。按照卒中机制,ET 型组有 12 例,ET+型组有 14 例。ET+型组包括 7 例大动脉粥样硬化性卒中、5 例小血管闭塞性卒中、2 例心源性栓塞性卒中。在 ET 型组中,更多见多发散在性病灶,累及多个血管区域。13 例(50.0%)出院时预后不良(改良 Rankin 量表评分>2),年龄较大、女性、ET 先于卒中诊断以及血红蛋白水平较低与预后不良相关。

结论

与 ET 相关的卒中表现为特征性的梗死模式,如多发栓塞。

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