| Objective: With the development of medical technology,the incidence and visiting rate of patients with malignant tumor and stroke are increasing,cancer-related stroke is also getting more and more attention from clinicians.Among the cancer distribution in China,the incidence and mortality of lung cancer are the highest,while the relationship between lung cancer and stroke is still under studying.This article aims to further clarify the pathogenesis of lung cancer associated stroke by comp aring and analyzing clinical characteristics of stroke patients with or without lung cancer.Methods: One hundred and twenty-nine patients were selected in this study who were diagnosed acute ischemic stroke with or without lung cancer in neurological department from October 2017 to October 2019.Among all the patients,51 patients with lung cancer were included as the case group(lung cancer associated stroke group,LCSG)and 79 patients without cancer history were included as the control group(acute is chemic stroke group,SG).The data collected in this study included sex,age,traditional cerebrovascular disease risk factors(TCDRFs),blood test index,imaging findings,etiological typing(the trial of org 10172 in acute stroke treatment,TOAST),prognosis evaluation.SPSS21.0 statistical software was used for analysis.Measurement data conforming to normal distribution were analyzed by t test,and counting data were analyzed by chi-square test or exact probability method.P < 0.05 was considered as a statistical difference.Results:1.General information: There was no significant statistical differences in age and gender distribution between two groups.2.TCDRFs:Compared with SG,TCDRFs was less and previous thromboembolic events were more common In LCSG.3.Blood test index: In LCSG,plasma D-dimer(mg/L,D-D)and fibrinogen degradation productions(FDP)were higher,the outcome were 3.61±5.29 VS 0.63±1.57,P=0.000 and 16.31±29.99 VS 1.63±3.73,P=0.000),while red blood count(×1012/L,RBC)and hemoglobin(g/L,Hb),homocysteine(mg/L,Hcy)were lower,the outcome were 4.20±0.59 VS 4.83±0.47,P=0.000,127.07±20.09 VS 144.22±28.19,P=0.000 and 13.69±6.48 VS 17.82±8.39,P=0.003).4.Symptom and prognosis evaluation: National Institude Of Health stroke score(NIHSS),modified Rankin Scale(m RS)and mortality of patients were higher in LCSG.5.Imaging findings: Patients in LCSG suggested that multivessel involvement was more common,and the infarcts were more likely to be multiple and to involve both the anterior and posterior circulations(acute multiple brain infarcts,AMBI).6.Etiological typing: The TOAST classification of LCSG was dominated by SUE(stroke of other undetermined etiology)(31cases,60.78%)and SOE(stroke of other determined etiology)(8cases,15.69%)while SG was dominated by LAA(large-artery atherosclerosis)(32cases,41.03%)and SAO(small-artery occlusion lacunar)(43cases,55.13%).5.Duration of stroke with lung cancer patients: Statistical analysis showed that the patients were more likely to suffer from acute ischemic stroke within 1 year after the diagnosis of lung cancer(41 cases,80.39%).Conclusions:1.There was no significant difference in the general demographic data of patients with lung cancer-related stroke compared with those without cancer-related history.2.Patients with lung cancer-related stroke are more likely to be hyp ercoagulability and have a higher risk of thromboembolic events.At the same time,blood test index verified patients have higher plasma D-D,FDP,lower RBC and Hb,and hyponatremia and hypoproteinemia are more common.Whether Hcy is related to lung cancer requires more clinical observations in the future.3.The imaging findings of patients with lung cancer-related stroke are more likely to involve AMBI and the NIHSS is higher and the prognosis at 3 months is worse,TOAST classification is dominated by SOE and SUE.4.Patients with lung cancer are most likely to have a stroke within 1 year of diagnosis. |
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