21例肝癌合并脑梗死患者临床特点观察

摘要/Abstract

摘要： 目的探讨肝癌合并脑梗死患者临床特点。方法回顾性分析山东省泰山医院2018年2月至2020年6月收治的21例肝癌合并脑梗死患者的临床资料,记为脑梗死组;并选择同期在本院进行治疗的120例肝癌未合并脑梗死患者的临床资料,记为对照组。对肝癌合并脑梗死患者进行单因素分析;Logistic回归分析法分析肝癌合并脑梗死患者的影响因素;对肝癌合并脑梗死患者的临床特点进行分析。结果脑梗死组淋巴结转移患者构成比及血小板、癌胚抗原(CEA)、甲胎蛋白(AFP)、D-二聚体(D-D)水平均高于对照组(χ²/t=7.64、9.71、14.41、45.43、20.11,P均<0.05);Logistic回归分析结果显示,血小板、AFP、D-D均为肝癌合并脑梗死的独立危险因素(OR=4.104、4.076、4.987,P均<0.05);21例肝癌合并脑梗死患者中,合并高血压、合并糖尿病、合并高脂血症分别为7例(33.3%)、5例(23.8%)、6例(28.6%),单一病灶7例(33.3%),两个及两个以上不同动脉区病灶14例(66.7%);脑梗死小病灶13例(61.9%)、中病灶6例(28.6%)、大病灶2例(9.5%);血液生化检查结果显示血小板、AFP、D-D水平升高病例数分别为17例(81.0%)、13例(61.9%)、16例(76.2%)。结论血小板、AFP、D-D水平升高是肝癌合并脑梗死发生的独立危险因素,21例肝癌合并脑梗死患者表现为多存在非传统脑卒中危险因素、两个及两个以上不同动脉区病灶、小病灶、血小板、AFP及D-D水平升高临床特点。

关键词: 肝癌, 脑梗死, 危险因素, 血小板, 甲胎蛋白, D-二聚体

Abstract: Objective To investigate the clinical characteristics of liver cancer patients complicated with cerebral infarction.Methods Twenty-one patients with liver cancer and cerebral infarction, and 120 patients with liver cancer admitted to our hospital between February 2018 and June 2020 were enrolled in our retrospective study as cerebral infarction group and control group. Univariate and logistic analyses were used to analyze the clinical characteristics of liver cancer complicated with cerebral infarction, and the influencing factors for cerebral infarction in patients with liver cancer.Results The ratio of lymph node metastasis, the levels of platelet, carcinoembryonic antigen (CEA), alpha fetoprotein (AFP) and D-Dimer (D-D) in cerebral infarction group were higher than those in control group (χ²/t=7.64, 9.71, 14.41, 45.43, 20.11, all P<0.05). Multivariate logistic regression analysis showed that platelet, AFP and D-D were independent risk factors for cerebral infarction in patients with liver cancer (OR=4.104, 4.076, 4.987, all P<0.05). In cerebral infarction group, the number of patients complicated with hypertension, diabetes and hyperlipidemia were 7 (33.3%), 5 (23.8%) and 6 (28.6%), respectively. There were 7 cases (33.3%) with single lesion, 14 cases (66.7%) with ≥ 2 arterial regions, 13 cases (61.9%) with small lesions, 6 cases (28.6%) with moderate lesions, and 2 cases (9.5%) with large lesions. The numbers of cases with elevated levels of platelet, AFP and D-D were 17 (81.0%), 13 (61.9%) and 16 (76.2%), respectively.Conclusion The increased levels of platelet, AFP and D-D were the independent risk factors for cerebral infraction in patients liver cancer. The clinical characteristics of 21 patients with liver cancer and cerebral infraction were non-traditional stroke risk factors, 2 or more arterial lesions, small lesions and elevated levels of platelet, AFP and D-D.

Key words: Liver cancer, Cerebral infarction, Risk factors, Platelet, Alpha fetoprotein, D-dimer

杨庆玺, 苏吉亮, 孙忠文, 刘元勋, 胡文娟. 21例肝癌合并脑梗死患者临床特点观察[J]. 肝脏, 2021, 26(6): 642-645.

YANG Qing-xi, SU Ji-liang, SUN Zhong-wen, LIU Yuan-xun, HU Wen-juan. Clinical characteristics of 21 liver cancer patients complicated with cerebral infarction[J]. Chinese Hepatolgy, 2021, 26(6): 642-645.

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