以脑卒中首诊的真性红细胞增多症的特点

The character of polycythemia vera visiting as stroke for the first time

目的:探讨以脑卒中首诊的真性红细胞增多症的特点。方法:回顾分析11例患者的症状体征,实验室检查及治疗转归。结果:(1)11例真性红细胞增多症患者均以脑卒中首诊,其中脑梗死8例、出血性脑梗死1例、短暂性脑缺血发作1例、脑出血1例。(2)8例脑梗死中腔隙性脑梗死4例、分水岭梗死1例、大面积脑梗死1例、脑叶梗死2例;1例出血性脑梗死位于右侧顶枕叶,1例脑出血位于左侧丘脑。(3)经针对原发病和脑卒中的双重治疗后,全部患者病情缓解,1例出院后4个月复发。结论:(1)并发脑卒中以缺血性多见,最常见类型是腔隙性梗死,且多累及双侧。(2)该病并发的脑卒中治疗上具有特殊性,因此早期确诊对改善患者预后具有决定性的意义。

Objective： To study the character of time. Methods： The symptom, sign, laboratorial polycythemia vera （PV） visiting as stroke for the first data,treatment and turnover of 11 patients were retrospectively analyzed. Results： （1）All the 11 patients visited as stroke for the first time,including 8 cerebral infarction ,one hemorrhagic infarction, one transient ischemic attach and one cerebral hemorrhage. （2）There were 4 lacunar infarction,one watershed infarction, one large area infarction and 2 lobar infarction in all the 8 cerebral infarction;One hemorrhagic infarction located in right parietal and occipital lobe,the other cerebral hemorrhage located in left thalamus. （3）All the patients＇ conditions were released after treatment of protopathy and stroke.One patient recurred 4 months after discharge. Conclusion： （1）Ischemic stroke is common in stroke following with PV,the most frequent type is lacunar infarction,which always involved in bilateral area. （2）Stroke following with PV has specificity in treatment, so early diagnosis has crucial significance in the prognosis of patients.