Woimant F, Moulinier L, Lecoz P, Soria C, Mikol J, Cochan Priollet B, Haguenau M, Pépin B
Unité d'Accidents Vasculaires Cérébraux, Hôpital Lariboisière, UER Lariboisière-Saint Louis, Paris.
Rev Neurol (Paris). 1988;144(2):120-4.
Cerebral infarcts in 3 patients revealed the presence of disseminated intravascular coagulation (DIVC) of cancerous origin before any clinical manifestations of the neoplasm. Neurologic manifestations of these consumption coagulopathies almost constantly produce a picture of diffuse encephalopathy, expression of disseminated microinfarcts; however, transient or constituted focalized ischemic accidents by occlusion of a medium sized artery are also possible, and this in the absence of non-bacterial thrombotic endocarditis. Biologic diagnosis of DIVC is not always simple, and screening tests (platelet count, prothrombin and fibrinogen levels) can remain within normal limits during chronic forms, as a result of a subjacent inflammatory syndrome, frequently associated with cancer. Two other specific serum tests are therefore of fundamental interest: assay of fibrin degradation products and tests for soluble complexes.
3例脑梗死患者在肿瘤出现任何临床表现之前，就已显示存在癌源性弥散性血管内凝血（DIVC）。这些消耗性凝血病的神经系统表现几乎总是呈现弥漫性脑病的症状，即弥散性微梗死的表现；然而，中型动脉闭塞导致的短暂性或持续性局灶性缺血性意外事件也是可能的，而且这一情况在无细菌性血栓性心内膜炎时也会出现。DIVC的生物学诊断并非总是简单易行，由于常与癌症相关的潜在炎症综合征，在慢性形式下，筛查试验（血小板计数、凝血酶原和纤维蛋白原水平）可能仍在正常范围内。因此，另外两项特异性血清试验具有至关重要的意义：纤维蛋白降解产物测定和可溶性复合物检测。
