A large amount of research evidence has shown a correlation between cerebral infarction and malignant tumors, and malignant-tumor-related embolic stroke is the main type of malignant-tumor-related cerebral infarction. Hypercoagulation is considered to be the main mechanism. However, due to the complexity of the pathogenesis, the optimal diagnosis, treatment, and prevention strategies remain unclear. This review summarizes the published literature on the concepts, mechanisms, clinical manifestations, laboratory and imaging examinations, treatment and prevention of malignant-tumor-related embolic cerebral infarction, to clearly understand this disease and provide ideas for early recognition, reasonable diagnosis and treatment, improvement of prognosis, and further research of this disease.
ObjectiveTo explore the relationship between plasma homocysteine level and intracranial artery atherosclerosis in patients with cerebral infarction. MethodsA total of 120 patients with cerebral infarction diagnosed between January and December 2013 were selected.Plasma homocysteine level was analyzed and intracranial artery was detected by DSA. ResultsIntracranial artery atherosclerosis can be found in most of patients with cerebral infarction.Moreover,Plasma Hcy level of patients with large cerebral artery atherosclerosis was much higher than others (P<0.05).The much higher Plasma Hcy level,the severe intracranial artery atherosclerosis were found in internal carotid artery and cerebral middle artery (P<0.05). ConclusionIntracranial artery atherosclerosis is common in patients with cerebral infarction.Occurrence of intracranial artery atherosclerosis is positively correlated with plasma homocysteine level.Plasma homocysteine level may be a risk factor of intracranial artery atherosclerosis in patients with cerebral infarction.
目的：研究外伤性脑梗死患者血小板P选择素动态变化的临床意义。方法：用流式细胞仪测定42例外伤性脑梗死患者，50例无脑梗死外伤患者及40例正常对照者外周血血小板P选择素。结果：急性期(1周内)外伤性脑梗死患者P选择素明显高于无梗死脑外伤患者和健康对照组(Plt;0.01)。14 d时，外伤性脑梗死患者血小板P选择素表达，与无梗死脑外伤患者和健康对照组无显著差异(Pgt;0.005)。结论：P选择素参与外伤性脑梗死的病理过程，测定它们有利于外伤性脑梗死的早期诊治，改善预后。
Objective To review the association between chlamydia pneumoniae (CP) infection and cerebral infarction. Methods We electronically searched MEDLINE, BIOSIS, VIP database, and China Full Text Journal Database from Jan. 1990 through Dec. 2007 to identify case-control studies about the association of CP and cerebral infarction. The quality of the included studies was assessed and the RevMan 4.2 software was used for meta-analyses. Results A total of 22 studies were included. The results of meta-analyses showed: ① When the microimmunofluorescence (MIF) method was used to examine CP antibody in serum, the positive rate of the cerebral infarction group was higher than that of the control group when the positive infection was defined by IgA≥1?16 [n=8, OR=2.18, 95%CI (1.49 to 3.49), Plt;0.0001]; but when positive infection was defined by IgA≥1?32 (n=3), IgG≥1?32 (n=6), or IgG≥1?64 (n=5), there were no significant differences in the positive rate between the two groups [OR (95%CI) were 1.47 (0.97 to 2.24), 1.24 (0.82 to 1.86), and 1.23 (0.98 to 1.55), respectively]; ② When the ELISA method was used to examine CP-IgG antibody in serum, the positive rate of the cerebral infarction group was higher than that of the controlled group [n=8, OR=2.40, 95%CI (1.42 to 4.06), P=0.000 2]. ③ The acute and chronic CP infections were associated with the incidence of cerebral infarction [n=4, OR=7.22, 95%CI (2.68 to 19.49); n=4, OR=4.30, 95%CI (3.40 to 7.40)]. Conclusion ① The association between CP infection and cerebral infarction is determined by the positive criterion. IgA antibody is more sensitive than the IgG antibody. When the positive infection is determined by IgA≥1?16, CP infection is associated with cerebral infarction. ② The results of ELISA for examining CP-IgG support the association between CP infection and cerebral infarction. ③ Both acute and chronic CP infections are associated with cerebral infarction, but these associations needed to be proven by more scientific studies.
Objective To assess the effectiveness and safety of sodium ozagrel combined with edaravone for cerebral infarction. Methods Such databases as PubMed (1995 to 2010), EMCC (1995 to 2010), CBM (1995 to 2010), CNKI (1995 to 2010), and VIP (1989 to 2010) were searched to collect randomized controlled trials (RCTs) of odium ozagrel combined with edaravone for cerebral infarction. Then the retrieved studies were screened according to the predefined inclusion and exclusion criteria, the data were extracted, the quality of the included studies was evaluated, and meta-analyses were performed by using the Cochrane Collaboration’s RevMan 5.0 software. Results A total of 32 RCTs involving 3 059 cases were involved, among which 1 559 cases were in the treatment group and the other 1500 were in the control group. All studies with comparable baseline data reported the application of random methods without explaining the detailed methods, the blinding method and the allocation concealment. The results of meta-analyses indicated that sodium ozagrel combined with edaravone had significant differences in the effective rate for cerebral infarction compared with both single sodium ozagrel (OR=3.51, 95%CI 2.70 to 4.57) and routine treatment (OR=3.77, 95%CI 2.58 to 5.52), and it had significant differences in treating the defect of neurological function compared with both sodium ozagrel (WMD= –4.26, 95%CI –4.97 to –3.55) and routine treatment (WMD= –3.89, 95%CI –4.96 to –2.82). In addition, Sodium ozagrel combined with edaravone was superior to sodium ozagrel (WMD=13.57, 95%CI 9.84 to 17.30) in improving the ability of daily living. Conclusion This systematic review shows that sodium ozagrel combined with edaravone is quite effective in treating cerebral infarction, and it can improve the nerve dysfunction. This conclusion should be treated cautiously for the poor quality and higher possibility of bias in the included studies which may impact on the power of proof, so more double-blind RCTs with high quality are expected to provide high-quality evidence.
【摘要】 目的 探讨低场磁共振弥散加权成像（DWI）诊断急性脑梗死的价值。 方法 2007年7月-2009年9月对48例脑梗死患者行常规MRI扫描和DWI，分析不同时期脑梗死的DWI表现。 结果 在发病的超急性期及急性期，DWI病灶显示率均为100.0%，T2WI病灶显示率分别为37.5%、73.7%、100.0%。 结论 低场DWI对急性脑梗死的诊断准确率高，明显优于常规MRI。【Abstract】 Objective To investigate the diagnostic value of diffusion weighted imaging (DWI) in acute cerebral infarction. Methods From July 2007 to September 2009, 48 patients with ischemic stroke underwent conventional MRI and DWI, and the characteristics of DWI were analyzed. Results Abnormal DWI signals were displayed in all patients at hyperacute stage or acute stage, abnormal T2WI signals existed in 37.5%, 73.7%, and 100.0%, respectively. Conclusion DWI in low field MR is highly accurate in diagnosing acute cerebral infarction, which is superior to conventional MRI.
目的：探讨C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)在急性脑梗死中的作用及相互关系。方法：测定了32例脑梗死急性期患者和37例健康人的外周血CRP，TNF-α的含量水平。结果：脑梗死患者急性期CRP 及TNF-α明显升高且呈显著正相关。结论：CRP，TNF-α的升高在急性脑梗死发生发展中可能起一定的作用。
ObjectiveTo explore the clinical features and prognosis of ischemic cerebral infarction in young population,and to provide a reference for clinical prevention of cerebral infarction in young population. MethodsA total of 547 patients with ischemic cerebral infarction diagnosed between January 2008 and June 2013 were included,and the difference in clinical data and outcomes between young and old patients were retrospectively compared. ResultsThe 547 patients included 233 young and 314 old patients,and there were more male patients in young group.As compared to the old group,the proportion of hypertension was significantly lower in young group (51.9%,64.3%;P=0.004);while smoking (51.9%,5.7%;P=0.000) and alcoholism (53.2%,28.3%;P=0.000) were significantly higher in young group.Moreover,there were more patients with vascular malformations in young group than that in old group (7.3%,3.2%;P=0.028).And there were also more patients in young group received thrombolytic therapy and antiplatelet therapy (98.3%,86.9;P=0.000),and the prognosis of young patients was significantly better than that of old patients. ConclusionThe prognosis of young patients with ischemic stroke prognosis is relatively good,and changing bad habits would be an effective measure to prevent and reduce the occurrence of ischemic cerebral infarction in young population.
【摘要】 目的 探讨急性脑梗死溶栓治疗的疗效及安全性。 方法 2004年1月-2009年5月58例急性脑梗死患者，按接受尿激酶治疗时已发病时间分为3组，均接受尿激酶150万U加生理盐水150 mL静脉滴注溶栓治疗。分别在治疗后0、1、3、9 h进行神经功能评价，1、3、7 d进行神经功能评价及复查头颅CT。 结果 发病3 h内与发病3~6 h内溶栓治疗效差异无统计学意义（Pgt;0.05）；发病3 h内、3~6 h内与发病6~9 h尿激酶溶栓治疗疗效差异均有统计学意义（Plt;0.05）；发病6~9 h尿激酶溶栓治疗疗效差，多例并发脑出血，安全性差。 结论 发病6 h内的脑梗死患者，只要无禁忌证均应尽快行尿激酶溶栓治疗；发病6 h后的脑梗死患者，不宜尿激酶溶栓治疗；伴房颤者的溶栓治疗因样本量过小研究无意义，有待进一步研究。【Abstract】 Objective To discuss the efficacy and safety of thrombolytic therapy for acute cerebral infarction. Methods A total of 58 patients with acute cerebral infarction from January 2004 to May 2009 were enrolled in this study. Based on the onset time before accepting urokinase treatment, the patients were divided into three groups. All of them accepted thrombolytic treatment with 1.5 million U of urokinase and 150 ml of saline solution intravenously. Neurological function evaluation was carried out 0, 1, 3, and 9 hours after the treatment. Another neurological function evaluation and skull CT were done 1, 3, and 7 days later, respectively. Results There was no statistical difference between the efficacy of the treatment within 3 hours and between the 3rd hour and the 6th hour after the onset of the disease. However, there was a significant difference between the efficacy within 3 hours and between the 6th and 9th hour, and between the efficacy from the 3rd hour and 6th hour and from the 6th hour and the 9th hour after the onset of the disease. Between the 6th and the 9th hour after the onset, the efficacy and safety were poor with many cases of combined cerebral bleeding. Conclusions For patients within 6 hours after the onset of cerebral infarction, as long as no contraindications exists, thrombolytic therapy should be carried out as soon as possible; 6 hours after the onset, patients should not be treated with thrombolytic therapy. Further study is needed for patients combined with atrial fibrillation due to the small sample size in this study.