CAJ | 학술논문

目的探讨女性生殖系统恶性肿瘤合并脑梗死患者的临床特点及其可能的发病机制。方法分析2007年1月至2013年12月在广西医科大学第一附属医院因生殖系统恶性肿瘤住院接受治疗期间发生脑梗死的女性患者的临床资料。结果本组符合条件的患者9例，占同期1780例女性生殖系统恶性肿瘤的0．51％，年龄39～58岁，平均年龄51．56±7．20岁。肿瘤类型分别为子宫内膜癌4例、宫颈癌3例、卵巢癌2例，且所有患者肿瘤已经发生远处转移，其中血浆癌抗原125（CA-125）升高8例（88．89％），CA-199升高7例（77．78％）。脑梗死发生与肿瘤确诊后的9～42d，平均25．44±10．24d。9例患者中，6例（66．67％）患者无传统的脑卒中危险因素，6例（66．67％）外周血D-二聚体水平升高，6例（66．67％）脑内出现2个及以上分属于不同动脉供血区的病灶。脑梗死发病后90d 5例（55．56％）死亡。结论多数患者缺少传统的脑卒中危险因素，外周血D-二聚体、癌抗原水平升高，脑内出现涉及多条动脉供血区的多发性梗死灶，预后不良等可能是女性生殖系统肿瘤并发脑梗死的临床特点，并且血液高凝状态是其可能的发病机制之一。
목적탐토녀성생식계통악성종류합병뇌경사환자적림상특점급기가능적발병궤제。방법분석2007년1월지2013년12월재엄서의과대학제일부속의원인생식계통악성종류주원접수치료기간발생뇌경사적녀성환자적림상자료。결과본조부합조건적환자9례，점동기1780례녀성생식계통악성종류적0．51％，년령39～58세，평균년령51．56±7．20세。종류류형분별위자궁내막암4례、궁경암3례、란소암2례，차소유환자종류이경발생원처전이，기중혈장암항원125（CA-125）승고8례（88．89％），CA-199승고7례（77．78％）。뇌경사발생여종류학진후적9～42d，평균25．44±10．24d。9례환자중，6례（66．67％）환자무전통적뇌졸중위험인소，6례（66．67％）외주혈D-이취체수평승고，6례（66．67％）뇌내출현2개급이상분속우불동동맥공혈구적병조。뇌경사발병후90d 5례（55．56％）사망。결론다수환자결소전통적뇌졸중위험인소，외주혈D-이취체、암항원수평승고，뇌내출현섭급다조동맥공혈구적다발성경사조，예후불량등가능시녀성생식계통종류병발뇌경사적림상특점，병차혈액고응상태시기가능적발병궤제지일。
Objective To investigate the clinical features of its potential pathogenesis of ischemic stroke the patients with female reproductive system malignant tumors .Methods The clinical data of of ischemic stroke patients with female reproductive system malignant tumor who were suffered from acute ischemic stroke and were admitted to the first affiliated hospital of Guangxi medical university from January 2007 to December 2013, were reviewed. Results Nine ischemic stroke patients with female reproductive system malignant tumor age from 39 to 58 year old and mean age (51.56 ±7.20) year old were enrolled, which accounted for 0.51%of the 1780 patients with female reproductive system malignant tumor at the same period .All of the reproductive system malignant tumor of the patient were metastasis and the subtypes of tumor involved endometrial adenocarcinoma (4cases),cervical adenocarcinoma (3 cases),and ovarian adenocarcinoma(2 cases).Of them,8 patients (88.89%)with elevated plasma CA125 level,7 patients(77.78%)with elevated plasma CA199.Ischemic stroke occurred from 9 days to 42days(and mean day 25.44 ±10.24) after malignant tumor determined .Six patients ( 66.67%) lack conventional vascular risks , with elevated plasma D-dimer level , and with two or more than two lesions in multiple artery supply regions in their brain .At 90 days after the cerebral infarction , 5 patients(55.56%) died.Conclusion It is suggested that the clinical feature of ischaemic stroke patients with female reproductive system malignant tumors include lack of conventional vascular risks, with a higher D-dimer level,CA125,CA199 levels, with two or more than two lesions in multiple arterial regions in their brain ,and poor prognosis .Coagulopathy may responsible for the pathogenesis .