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目的探讨真性红细胞增多症(PV)并发脑卒中的临床特点及治疗方法。方法对21例PV并发脑卒中患者的临床资料进行回顾性分析。结果PV并发脑梗死16例(76.2%),其中多发性脑梗死13例(61.9%);短暂性脑缺血发作2例(9.5%);脑出血2例(9.5%);蛛网膜下腔出血(SAH)1例(4.8%)。脑梗死以多发小梗死灶多见(66.7%),常见于脑叶、基底节、内囊;脑出血的出血灶内密度不均匀,周边水肿明显。治疗后,脑卒中痊愈5例,显著进步15例,无效1例。结论PV并发脑卒中以脑梗死多见,以多发性梗死为主,并发脑出血和SAH较少,采用静脉放血加小剂量化疗治疗的效果较好。
Objective To investigate the clinical features and treatment of polycythemia vera (PV) complicated by stroke. Methods The clinical data of 21 patients with PV complicating stroke were retrospectively analyzed. Results Sixteen patients (76.2%) had PV complicated with cerebral infarction, of which 13 were multiple cerebral infarction (61.9%), 2 were transient ischemic attack (9.5%), 2 were intracerebral hemorrhage (9.5% Bleeding (SAH) in 1 case (4.8%). Cerebral infarction with multiple small infarction more common (66.7%), common in the lobar, basal ganglia, internal capsule; hemorrhage intracerebral hemorrhage heterogeneous density, peripheral edema. After treatment, stroke recovered in 5 cases, a significant improvement in 15 cases, 1 case of ineffective. Conclusions Cerebral infarction is more common in patients with PV complicating stroke, mainly with multiple infarcts, with fewer cerebral hemorrhages and SAH. The results of intravenous bloodletting and low dose chemotherapy are better.