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目的探讨急性早幼粒细胞白血病所致脑梗死患者的发病机制及临床特点。方法对1例以急性早幼粒细胞白血病为病因的脑梗死患者的诊治过程进行报道,并结合相关文献分析急性早幼粒细胞白血病所致脑梗死的发病机制及临床特点。结果脑梗死以急性早幼粒细胞白血病作为病因较少见,除了神经功能缺损的表现,还有凝血功能障碍的表现,发病机制包括肿瘤细胞淤积造成血管阻塞、促凝物质的表达增加、凝血级联反应的激活、血浆P-选择素的活性增强等。结论应提高对以急性早幼粒细胞白血病为病因的脑梗死的认识,详细的病史和辅助检查有助于早期诊治,尤其是缺乏常见危险因素的年轻脑梗死患者,以免延误诊治。
Objective To investigate the pathogenesis and clinical features of acute promyelocytic leukemia patients with cerebral infarction. Methods One case of acute promyelocytic leukemia in patients with cerebral infarction is reported in the course of diagnosis and treatment, and combined with relevant literature analysis of acute promyelocytic leukemia-induced cerebral infarction pathogenesis and clinical features. Results Cerebral infarction with acute promyelocytic leukemia as a rare cause, in addition to the performance of neurological deficits, as well as the performance of coagulation disorders, pathogenesis, including tumor cell deposition caused by vascular obstruction, increased expression of procoagulant, coagulation grade Activation of cascade reactions, enhanced plasma P-selectin activity and the like. Conclusions Awareness of acute cerebral infarction with acute promyelocytic leukemia should be increased. Detailed medical history and laboratory examinations should be helpful for early diagnosis and treatment, especially for young patients with cerebral infarction who lack common risk factors to avoid delay diagnosis and treatment.