中青年缺血性卒中患者卵圆孔未闭发生情况分析

Analysis of the occurrence of patent foramen ovale in young patients with ischemic stroke

目的探讨中青年缺血性卒中患者卵圆孔未闭(PFO)的发生情况。方法选择2006年10月—2010年1月,首都医科大学宣武医院门诊或住院的中青年缺血性卒中患者198例,根据经食管超声心动图检查确定是否存在PFO,分为PFO组和无PFO组。其中PFO组125例,无PFO组73例。经食管超声心动图及右心声学造影检查,观察卵圆孔未闭的发生情况。对所有患者行卒中相关危险因素的检查。结果①PFO组患者的年龄低于无PFO组[(37±10)岁,(43±10)岁],差异有统计学意义,P<0.05。②在卒中相关危险因素比较中,PFO组患者的高血压、糖尿病、吸烟史、高脂血症等比例均低于无PFO组,差异均有统计学意义,P<0.05。③PFO组中有18例(14.4%)合并房间隔瘤,无PFO组中有5例(6.8%)合并房间隔瘤,PFO组合并房间隔瘤的比例高于无PFO组,差异有统计学意义,P=0.018。④PFO组无任何危险因素的比例高于无PFO组,差异有统计学意义,P<0.05。结论卵圆孔未闭可能是中青年缺血性卒中患者重要的发病原因。

Objective To investigate the occurrence of patent foramen ovale （PFO） in young patients with ischemic stroke. Methods A total of 198 consecutive young patients with ischemic stroke were selected from either the outpatient or inpatient department of Xuanwu Hospital, Capital Medical University from October 2006 to January 2010. They were divided into a PFO group （ n = 125 ） and a non-PFO group （ n = 73 ） according to whether the existence of PFO on tranesophageal echocardiography. The occurrence of PFO was observed by tranesophageal echocardiography and right heart contrast echocardiography. The examinations of the related risk factors were performed in all the patients. Results ①The patients in the PFO group were younger than those in the non-PFO group （37 ± 10 vs. 43 ±10）. The diffe-rence was statistically significant （ P 〈 0.05 ）. ②The stroke-related risk factors, such as the proportions of patients with hypertension, diabetes mellitus, smoking history, and hypercholesterolemia in the PFO group were lower than those in the non-PFO group. The differences were statistically significant （P 〈 0.05 ）. ③Eighteen patients （14.4%） were complicated with atrial septal aneurysm in the PFO group, and only 5 patients（6. 8% ） in the non-PFO group. The difference was statistically significant （P = 0. 018 ）.④The proportion of patients without any risk factors in the PFO group was higher than that in the non-PFO group. The difference was statistically significant （ P 〈0. 05 ）. Conclusion PFO may be an important cause of isehemie stroke in young patients.