真性红细胞增多症并发脑卒中的治疗(附16例报告)

Research on clinical treatment of polycythemia vera complicating with stroke(report of 16 cases)

目的探讨真性红细胞增多症(polycythemia vera,PV)并发脑卒中的治疗措施。方法对16例PV并发脑卒中患者的临床资料进行回顾性分析。结果16例中并发脑梗死14例(87.5%),并发短暂性脑缺血发作2例(12.5%),均符合PV的临床表现及体征。影像学检查显示脑梗死主要为多发小梗死灶,常见于脑叶、基底节、内囊。应用HeamoncticsMCS+全自动细胞分离机采集患者的红细胞,同时口服羟基脲0.5g,每日3次,4周后脑卒中痊愈13例,显著改善3例。结论PV并发脑卒中主要见于多发性小梗死灶。一旦明确诊断,应用红细胞单采术可迅速使患者红细胞恢复至正常水平,辅以羟基脲治疗效果较好。

Objective To explore the clinical treatment of polycythemia vera （PV） complicating with stroke. Methods Clinical data of 16 cases of PV complicating with stroke were analysed retrospectively. Results ①Among the 16 cases, 14 （87.5%） were PV with cerebral infarctionm, two （12.5%） were with transient ischemic attack, which all met with PV diagnosis criteria.②Imageology examinations showed that most cerebral infarction were small infarction fous, which commonly located in lobe of brain, basal ganglia and eapsula interna. ③13 cases were recovered and three case were obviously impoved after treatment with therapeutic erythropheresis and orally hydroxycarbamide （0.5, tid） for four weeks. Conclusions Multiple small cerebral infarction is most common in PV complicating with stroke. Applied therapeutic erthropheresis with orally hydroxycarbamide has a good therapeutic effect for the patients, which deserves to be popularizing clinically.