文章摘要
叶楠,柴旭兵,闫俊,等.经颅多普勒发泡试验结合反常性栓塞风险量表在卵圆孔未闭合并不明原因卒中筛查中的应用价值[J].安徽医药,2021,25(12):2500-2503.
经颅多普勒发泡试验结合反常性栓塞风险量表在卵圆孔未闭合并不明原因卒中筛查中的应用价值
The application value of contrast-enhanced transcranial Doppler combined with risk of paradoxical embolism scale in the screening of patent oval foramen with unexplained stroke
  
DOI:10.3969/j.issn.1009-6469.2021.12.039
中文关键词: 卒中  卵圆孔,未闭  超声心动描记术,经食管  经颅多普勒发泡试验  反常性栓塞风险量表  应用价值
英文关键词: Stroke  Foramen ovale, patent  Echocardiography, transesophageal  Contrast-enhanced transcranial Doppler  Risk of paradoxical embolism  Application value
基金项目:
作者单位E-mail
叶楠 西安市第五医院神经内分泌科陕西西安 710000  
柴旭兵 西安市第五医院神经内分泌科陕西西安 710000 bhx76e@163.com 
闫俊 西安市第五医院神经内分泌科陕西西安 710000  
权莹星 西安市第五医院神经内分泌科陕西西安 710000  
高亚亚 西安市第五医院神经内分泌科陕西西安 710000  
杨莹 西安市第五医院神经内分泌科陕西西安 710000  
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中文摘要:
      目的探讨经颅多普勒发泡试验( c-TCD)结合反常性栓塞风险量表(RoPE)评分在卵圆孔未闭合并不明原因卒中筛选的价值。方法回顾性分析 2013年 9月至 2019年 10月西安市第五医院收治的脑卒中病人 217例为研究对象,根据卵圆孔未闭诊断“金标准”食管超声心动图(TEE)分为卵圆孔未闭组(62例)和非卵圆孔未闭组(155例)收集两组一般资料,分析两组 c-TCD[c-TCD阳性率、右向左分流( RLS)分流量]、 RoPE评分情况; Spearman相关分析法评估卵圆孔,未闭合并不明原因卒中病人 RoPE评分与 c-TCD阳性率、 RLS分流量的相关性。结果两组性别、年龄、高血压史、糖尿病史、高血脂史、吸烟史、偏头痛史、发病至核磁共振检查时间均差异无统计学意义( P>0.05)。非卵圆孔未闭组 c-TCD微泡数量阳性例数(4例)与卵圆孔未闭组 c-TCD微泡数量阳性例数( 48例)比较差异有统计学意义( P<0.05)。非卵圆孔未闭组 RoPE评分( 6、7、8、9、10分)分别有 49、48、 34、18、6例与卵圆孔未闭组 RoPE评分( 6、7、8、9、10分)分别有 8、7、8、15、24例比较差异有统计学意义( P<0.05)。 Spearman相关分析显示,卵圆孔未闭合并不明原因卒中病人 RoPE评分与 c-TCD阳性率、 RLS分流量呈正相关( rs=0.896、0.876,P<0.001)。结论 c-TCD结合 RoPE量表可用于卵圆孔未闭合并不明原因卒中的筛选,具有一定价值。
英文摘要:
      Objective To explore the value of contrast-enhanced transcranial Doppler (c-TCD) combined with risk of paradoxical embolism (RoPE) score in the screening of patent oval foramen with unexplained stroke.Methods A retrospective analysis was con.ducted of 217 stroke patients treated in Xi′an Fifth Hospital from September 2013 to October 2019, and according to the "gold stan.dard" transesophageal echocardiography (TEE) for the diagnosis of patent oval foramen, they were assigned into patent oval foramengroup (n=62) and non-patent oval foramen group (n=155). The general information of patients in both groups were collected, and the c-TCD [c-TCD positive rate, right to left shunt (RLS) flow] and RoPE score of the two groups were analyzed; Spearman correlation analy.sis was used to evaluate the correlation between RoPE score and c-TCD positive rate, RLS flow in patients with patent oval foramen and unexplained stroke.Results There were no significant differences in gender, age, history of hypertension, diabetes, hyperlipidemia,smoking, and migraine, and the time from onset to MRI examination between the two groups (P>0.05). There was a significant differ. ence in the number of positive c-TCD microbubbles between the non-patent oval foramen group and the patent oval foramen group ((4 cases vs. 48 cases; P<0.05). The RoPE scores (6, 7, 8, 9, 10 points) of the non-patent oval foramen group were found in 49, 48, 34, 18, 6cases, respectively, while the RoPE scores (6, 7, 8, 9, 10 points) of the patent oval foramen group were found in 8, 7, 8, 15, 24 cases re.spectively, which indicated statistically significant difference (P<0.05). Spearman correlation analysis results showed that RoPE scoreof patients with patent oval foramen with unexplained stroke was positively correlated with c-TCD positive rate and RLS flow (rs=0.896, 0.876, P<0.001).Conclusion C-TCD combined with RoPE scale can be used for the screening of patent oval foramen with unex.plained stroke, which is of certain value.
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