前列腺癌合并急性脑梗死的临床特点及病因分析

doi:10.3969/j.issn.1673-5765.2021.02.006

摘要/Abstract

摘要：

目的分析前列腺癌合并急性脑梗死的临床特点，探讨其相关危险因素。方法本研究为病例对照研究，前列腺癌合并急性脑梗死组收集2010年1月-2019年10月于首都医科大学附属北京世纪坛医院连续就诊的前列腺癌合并急性脑梗死患者，前列腺癌无脑梗死组按年龄匹配（1∶1）同时期泌尿外科住院被确诊为前列腺癌且未曾发生过脑梗死的患者。分析前列腺癌合并急性脑梗死的临床特点，比较两组患者传统血管危险因素、实验室检查及肿瘤相关治疗间的差异，采用多因素logistic回归分析前列腺癌合并急性脑梗死的影响因素。结果两组各纳入43例患者。前列腺癌合并急性脑梗死组年龄71～93岁，平均82.2±4.8岁；腔隙性脑梗死（病灶＜10 mm）占74.4%（32/43），前、后循环同时受累多发性脑梗死占23.3%（10/43)。多因素logistic回归分析显示，高脂血症（OR 7.494，95%CI 1.371～40.971）、D-二聚体升高（OR 1.012， 95%CI 1.003～1.021）、放射性粒子植入治疗（OR 0.144，95%CI 0.037～0.557）是前列腺癌合并急性脑梗死的独立影响因素。结论前列腺癌合并急性脑梗死患者年龄较大，以小病灶、多发性梗死灶常见。高脂血症和D-二聚体升高是前列腺癌合并急性脑梗死独立危险因素，放射性粒子植入治疗是前列腺癌合并急性脑梗死的独立保护因素。

文章导读： 前列腺癌发生脑梗死的患者年龄较大，以单发、腔隙性梗死多见。高脂血症和D-二聚体和放射性粒子植入治疗是前列腺癌患者发生脑梗死的独立影响因素。

关键词: 前列腺癌; 脑梗死; 危险因素

Abstract:

Objective To analyze the clinical characteristics and related risk factors of acute cerebral infarction in prostate cancer patients. Methods A retrospective analysis was performed for the data of consecutive acute cerebral infarction patients with prostate cancer at Beijing Shijitan Hospital, Capital Medical University from January 2010 to October 2019, with the age-matched prostate cancer patients without cerebral infarction from Department of Urinary Surgery during the same period as the control group at a ratio of 1:1. The clinical features of cerebral infarction in prostate cancer were analyzed, and multivariate logistic regression was used to analyze the influencing factors for cerebral infarction in prostate cancer. Results A total of 86 patients were included, with 43 cases in each group. The mean age was 82.2±4.8 years (range 71 to 93 years) in cerebral infarction group, and the imaging results showed lacunar cerebral infarction (lesion <10 mm) accounted for 74.4% (32/43), the multiple infarctions with anterior and posterior circulation involved simultaneously accounted for 23.3% (10/43). Multivariate analysis showed that hyperlipidemia (OR 7.494, 95%CI 1.371-40.971), elevated serum D-dimer (OR 1.012, 95%CI 1.003-1.021), radioactive seed implantation (OR 0.144, 95 %CI 0.037-0.557) were independent influencing factors for cerebral infarction in prostate cancer patients. Conclusions The acute cerebral infarction patients with prostate cancer were elder, and the small infarcts and multifocal infarcts were more common types of infarcts. The hyperlipidemia, D-dimer and radioactive seed implantation were independent influencing factors for cerebral infarction in prostate cancer.

Key words: Prostate cancer; Ischemic stroke; Risk factor

杨启舟，付睿，王莉莉，向思京，高凤莲，张丽霞. 前列腺癌合并急性脑梗死的临床特点及病因分析[J]. 中国卒中杂志, 2021, 16(02): 141-146.

YANG Qi-Zhou, FU-Rui, WANG Li-Li, XIANG Si-Jing, GAO Feng-Lian, ZHANG Li-Xia. Clinical Features and Etiological Analysis of Acute Cerebral Infarction in Prostate Cancer Patients[J]. Chinese Journal of Stroke, 2021, 16(02): 141-146.

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