Tanashyan M M, Melikyan A L, Kuznetsova P I, Raskurazhev A A, Shabalina A A, Konovalov R N
Research center of Neurology.
National Research Center for Hematology.
Ter Arkh. 2019 Jul 15;91(7):29-34. doi: 10.26442/00403660.2019.07.000329.
Myeloproliferative disorders (MPD) are accompanied by a high proportion of thrombotic complications, which may lead to cerebrovascular disease (CVD).
To describe MRI-findings in patients with Ph - negative MPD and evaluate any cerebrovascular disease.
We included 104 patients with Ph - negative MPD (age varied between 20 and 58) with clinical correlates of cerebrovascular pathology.
Brain MRI showed post - stroke lesions in 20% of patients (7 hemispheric infarcts due to thrombotic occlusion of one of the large cerebral arteries, 14 - cortical infarcts). 37 patients (36%) had vascular cerebral lesions. Cerebral venous sinus thrombosis occurred in 5 patients - in 7% (n=3) of patients with polycythemia vera and 5% (n=2) - in patients with essential thrombocythemia. The incidence of vascular cerebral lesions was associated with higher levels of the following: erythrocyte, platelet count, fibrinogen, and with the decrease in fibrinolytic activity, as well.
The pioneering results of the study include the description and analysis of brain MRI-findings in patients with Ph - negative MPD. The underlying mechanisms of cerebrovascular pathology in these patients are associated with certain blood alterations (particularly, hemorheology) which present a major risk factor.
骨髓增殖性疾病（MPD）伴有高比例的血栓并发症，这可能导致脑血管疾病（CVD）。
描述Ph阴性MPD患者的MRI表现并评估任何脑血管疾病。
我们纳入了104例Ph阴性MPD患者（年龄在20至58岁之间），这些患者具有脑血管病变的临床相关性。
脑部MRI显示20%的患者有中风后病变（7例因大脑大动脉之一的血栓闭塞导致半球梗死，14例皮质梗死）。37例患者（36%）有脑血管病变。5例患者发生脑静脉窦血栓形成——真性红细胞增多症患者中7%（n = 3），原发性血小板增多症患者中5%（n = 2）。脑血管病变的发生率与以下因素水平升高有关：红细胞、血小板计数、纤维蛋白原，以及纤溶活性降低。
该研究的开创性结果包括对Ph阴性MPD患者脑部MRI表现的描述和分析。这些患者脑血管病变的潜在机制与某些血液改变（特别是血液流变学）有关，这些改变是主要危险因素。
