Objective: To explore the risk factors for lung cancer-related cerebral infarction. Methods: The hospitalized active lung cancer patients on anti-cancer therapy with no traditional stroke risk factors, who experienced an acute cerebral infarct in the First Affiliated Hospital of Guangxi Medical University from January 2005 to December 2015, were consecutively collected as the LCRS (lung cancer-related stroke) group. The active lung cancer patients without cerebral infarction hospitalized at the same peroid matched with the LCRS group for age and gender were collected as the LC (lung cancer) group. Clinical data from the two groups were analyzed. Results: A total of 139 LCRS patients and 139 LC patients were enrolled in the study, with 110 male and 29 female in each group, and there were no significant difference for the mean age between the LCRS group (52.1±10.4 years old ) and the LC group (52.1±10.1 years old). Two or more acute ischemic lesions of the brain were showed by MRI in most patients in the LCRS group (117 cases, 84.2%). Compared with the LC group, more patients in the LCRS group were found with adenocarcinoma, metastasis, elevated plasma D-dimer, CA125 and CA199 levels [88 cases (63.3%) vs 47 cases (33.8%); 98 cases (70.5%) vs 56 cases (40.3%); (468.38±291.37) μg/L vs (277.59±191.22) μg/L; (221.42±146.34) U/ml vs (106.84±69.97) U/ml; (254.68±185.84) U/ml vs (97.15±63.64) U/ml; with all P<0.001]. By logistic regression analysis of multiple factors, the elevated plasma D-dimer, CA125 and CA199 levels were showed to be independent risk factors for the cerebral infarction (OR=1.003, 95%CI 1.001-1.004; OR=1.006, 95%CI 1.003-1.010; OR=1.011, 95%CI 1.007-1.015). Conclusions: The elevated plasma D-dimer, CA125 and CA199 levels are the risk factors for the lung cancer related cerebral infarction, which may lead to hypercoagulation and induce cerebral infarction eventually.
目的：探讨肺癌相关脑梗死的可能发病机制。方法：收集2005年1月至2015年12月在广西医科大学第一附属医院住院治疗的肺癌相关脑梗死(肺癌尚未治愈，同时合并急性脑梗死且无高血压、糖尿病及高脂血症等常见卒中危险因素)患者的临床资料，同时选择同期住院治疗的相同例数且年龄、性别相匹配的单纯肺癌患者作为对照。结果：共纳入符合条件的肺癌相关脑梗死患者139例，男110例，女29例，年龄(52.1±10.4)岁；单纯肺癌患者139例，男110例，女29例，年龄(52.1±10.1)岁。肺癌相关脑梗死组中多数患者[117例(84.2%)]头颅MRI显示累及不同动脉供血区的2个及以上脑梗死病灶。与单纯肺癌组相比，肺癌相关脑梗死组中更多患者的肺癌组织学类型为腺癌，发生远处转移比例及血浆D-二聚体、CA125和CA199水平更高[88例(63.3%)比47例(33.8%)；98例(70.5%)比56例(40.3%)；(468.38±291.37)μg/L比(277.59±191.22)μg/L；(221.42±146.34)U/ml比(106.84±69.97)U/ml；(254.68±185.84)U/ml比(97.15 ± 63.64)U/ml；P均<0.001]。多因素logistic回归分析显示，血浆D-二聚体、CA125、CA199水平升高是肺癌患者发生脑梗死的独立危险因素(OR＝1.003，95%CI 1.001～1.004；OR＝1.006，95%CI 1.003～1.010；OR＝1.011，95%CI 1.007～1.015)。结论：肺癌相关脑梗死的发生与血浆D-二聚体、CA125和CA199水平升高相关，肺癌可能通过提高血液的凝固性，最终导致脑梗死的发生。.
Keywords: Cerebral infarction; Lung neoplasms; Pathogenesis; Risk factors.