以急性脑梗死为首发表现的Trousseau综合征12例临床分析

Clinical analysis of Trousseau syndrome with acute cerebral infarction as the first manifestation of 12 cases

目的提高Trousseau综合征的诊治水平,减少误诊误治。方法回顾分析我院收治的12例Trousseau综合征患者的临床表现、影像学表现及治疗效果。结果12例患者均为首发急性脑梗死起病,D-二聚体升高10例,头部MRI均为累及多根脑动脉供血区的多部位急性脑梗死;肺癌7例,胰腺腺癌1例,乳腺癌2例,卵巢癌2例;6例患者予以抗凝治疗,6例放弃治疗。结论不符合单根脑动脉供血分布的急性脑梗死,应积极查找原因,老年患者尤其警惕Trousseau综合征,予以正确治疗,避免反复发作加重病情。

Objective To improve the skills of diagnosis and treatment of Trousseau syndrome in order to reduce misdiagnosis and mistreatment.Methods Twelve cases admitted in our hospital and subsequently proved Trousseau syndrome were retrospectively analyzed,including their clinical characteristics,radiography results,and treatment effect.Results Twelve cases began as acute cerebral infarction,associated with increased D-dimer in ten cases and multiple acute infarction involving multiple arterial innervation region in MR of all cases.Among twelve cases,seven cases of lung cancer,one case of pancreatic cancer,two cases of breast cancer and two cases of ovarian cancer were finally diagnosed.Then,six patients were treated with anticoagulant therapy and six abandoned.Conclusion If the lesions’distribution of acute cerebral infarction doesn’t conform to the conventional and single arterial innervation region in aged patients,doctors should search causes actively,especially should be vigilant about Trousseau syndrome,in order to treat correctly and prevent recurrent episodes that aggravate the disease.