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目的探讨真性红细胞增多症(polycythemia vera,PV)并发脑卒中的治疗措施。方法对16例PV并发脑卒中患者的临床资料进行回顾性分析。结果16例中并发脑梗死14例(87.5%),并发短暂性脑缺血发作2例(12.5%),均符合PV的临床表现及体征。影像学检查显示脑梗死主要为多发小梗死灶,常见于脑叶、基底节、内囊。应用HeamoncticsMCS+全自动细胞分离机采集患者的红细胞,同时口服羟基脲0.5g,每日3次,4周后脑卒中痊愈13例,显著改善3例。结论PV并发脑卒中主要见于多发性小梗死灶。一旦明确诊断,应用红细胞单采术可迅速使患者红细胞恢复至正常水平,辅以羟基脲治疗效果较好。
Objective To investigate the treatment of polycythemia vera (PV) complicating stroke. Methods The clinical data of 16 patients with PV complicating stroke were retrospectively analyzed. Results 16 cases were complicated by cerebral infarction in 14 cases (87.5%) and transient ischemic attack in 2 cases (12.5%), which were all in line with the clinical manifestations and signs of PV. Imaging studies showed that cerebral infarction is mainly multiple small infarcts, common in the lobar, basal ganglia, internal capsule. Patients were collected using HeamoncticsMCS + automatic cell separator red blood cells, while oral hydroxyurea 0.5g, 3 times a day, 4 weeks after stroke recovered in 13 cases, a significant improvement in 3 cases. Conclusion PV complicated with stroke is mainly seen in multiple small infarction. Once a clear diagnosis, the application of erythrocyte apheresis can quickly make patients with red blood cells returned to normal levels, supplemented with hydroxyurea treatment is better.