| 张东东,王正飞.介入封堵联合抗血小板药物治疗对卵圆孔未闭相关隐源性卒中病人炎症反应、血小板聚集及心功能的影响[J].安徽医药,2026,30(10):1976-1981. |
| 介入封堵联合抗血小板药物治疗对卵圆孔未闭相关隐源性卒中病人炎症反应、血小板聚集及心功能的影响 |
| The impact of inflammatory response, platelet aggregation and cardiac function of interventional occlusion combined with antiplatelet drug therapy for patients with patent foramen ovale-associated cryptogenic stroke |
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| DOI：10.3969/j.issn.1009-6469.2026.10.013 |
| 中文关键词: 卵圆孔，未闭 隐源性卒中 介入封堵 抗血小板治疗 炎症反应 血小板聚集 |
| 英文关键词: Foramen ovale, patent Cryptogenic stroke Interventional occlusion Antiplatelet therapy Inflammatory re-sponse Platelet aggregation |
| 基金项目:河南省医学科技攻关计划项目( LHGJ20220839) |
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| 中文摘要: |
| 目的探讨介入封堵联合抗血小板药物治疗卵圆孔未闭(PFO)相关隐源性卒中( CS)病人的临床疗效及可能作用机制。方法回顾性研究。收集 2021年 1月至 2023年 4月郑州市第七人民医院接受治疗的 PFO相关 CS病人 94例临床资料，根据治疗方法分为联合组(n=48)、对照组(n=46)。联合组给予介入封堵联合双联抗血小板治疗，对照组给予双联抗血小板治疗。治疗 6个月，比较两组炎症反应、血小板聚集、心功能、缺血性事件。结果联合组病人中性粒细胞与淋巴细胞比值(NLR)1.54±0.32、小板与淋巴细胞比值( PLR)82.56±10.21、全身免疫炎症指数( SII)396.45±45.24、超敏 C反应蛋白( hs-CRP)(1.23±0.36)mg/L低于血对照组 1.80±0.41、96.45±12.33、434.53±60.12、(1.65±0.42)mg/L(P<0.05)。α-角(45.56±6.12)°、最大振幅(MA)(22.13±4.21)mm低于对照组( 52.43±6.34)°、(28.43±4.56)mm，AA途径诱导的血小板控制率( 85.36±10.15)%高于对照组( 67.54±9.26)%(P<0.05)。左室射血分数( LVEF)(73.14±5.12)%、左室搏出量(LVSV)(41.42±6.43)mL高于对照组(68.45±5.32)%、(38.72±6.14)mL，左室收缩末内径(LVESD)(36.42±4.25)mm、左室舒张末内径(LVEDD)(44.10±5.32)mm低于对照组(38.70±4.36)mm、(47.36±5.1)mm(P<0.05)。缺血性事件发生率 4.17%低于对照组 17.39%(χ2=4.32，P<0.05)。结论介入封堵联合抗血小板药物治疗能够改善 PFO相关 CS病人心功能，减少缺血性事件的发生，可能与拮抗炎症反应、抑制血小板聚集等因素有关。 |
| 英文摘要: |
| Objective To study clinical efficacy and possible mechanism of interventional occlusion combined with antiplatelet drugtherapy for patients with patent foramen ovale (PFO)-related cryptogenic stroke (CS).Methods Retrospective study. Clinical data of 94 patients with PFO-related CS in The 7th People's Hospital of Zhengzhou from January 2021 to April 2023 were collected. Accordingto the treatment method, they were divided into combined group (n = 48) and control group (n = 46). The combination group given inter-ventional therapy combined with dual antiplatelet therapy, while the control group given dual antiplatelet therapy. After 6 months oftreatment, inflammatory response, platelet aggregation, cardiac function and ischemic brain events were compared between two groups.Result The neutrophil-to-lymphocyte ratio (NLR) (1.54±0.32), platelet-to-lymphocyte ratio (PLR) (82.56±10.21), systemic immune-in-flammation index (SII) (396.45±45.24), and high-sensitivity C-reactive protein (hs-CRP) [(1.23±0.36) mg/L] in the combined groupwere lower than those in the control group [1.80±0.41, 96.45±12.33, 434.53±60.12, (1.65±0.42) mg/L, respectively] (P<0.05). The α -angle [(45.56±6.12)°], maximum amplitude (MA) [(22.13±4.21) mm] in the combined group were lower than those in the control group[(52.43±6.34)°, (28.43±4.56) mm], while platelet control rate induced by arachidonic acid (AA) pathway (85.36±10.15)% in the com-bined group was higher than that in the control group (67.54±9.26)% (P<0.05). The left ventricular ejection fraction (LVEF) [(73.14±5.12)%], left ventricular stroke volume (LVSV) [(41.42±6.43) mL] in the combined group were higher than those in the control group[(68.45±5.32)%, (38.72±6.14) mL], and the left ventricular end-systolic diameter (LVESD) [(36.42±4.25) mm], and left ventricular end-diastolic diameter LVEDD [(44.10±5.32) mm] in the combined group were lower than those in the control group [(38.70±4.36) mm,(47.36±5.1) mm] (P<0.05). Ischemic brain events (4.17%) in the combined group was lower than that in the control group (17.39%) (χ2= 4.32, P<0.05).Conclusion Interventional therapy combined with antiplatelet drug can improve cardiac function in PFO-related CS pa-tients, reduce ischemic brain events, which may be related to antagonism of inflammatory reaction and inhibition of platelet aggregation. |
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