卵圆孔未闭患者缺血性脑血管病复发情况的分析

Analysis of the recurrence of ischemic cerebrovascular disease in patients with patent foramen ovale

目的观察伴有卵圆孔未闭(PFO)的缺血性卒中或短暂性脑缺血发作患者的复发情况,以了解PFO在脑缺血发生过程中的作用。方法连续选取2008年3月—2009年3月,首都医科大学宣武医院神经内科住院的,15～55岁缺血性卒中或短暂性脑缺血发作患者71例进行研究,均行经食管超声心动图检查,其中PFO组49例,非PFO组22例,比较12个月内两组缺血性脑血管病复发情况。结果随访12个月时,PFO组共有8例复发脑缺血,而非PFO组仅有1例复发。①PFO组与非PFO组3、6、12个月时复发率分别为6.12%,0;10.20%,4.55%和16.33%,4.55%,差异均无统计学意义(P=0.322,P=0.428,P=0.168)。②PFO组患者缺血性脑血管病累计复发率较非PFO组患者具有增高趋势,但差异尚未达到统计学意义(P=0.065),其OR值为3.76(95%CI:0.834～16.946),亦未达到统计学意义(P=0.085)。结论存在PFO的缺血性脑血管病患者的复发率有增高趋势,但尚不能够确定PFO可以增加再发脑缺血的概率。

Objective To observe the recurrence of is,hemic stroke or transient ischemic attack in patients with patent foranicn ovale （PFO） in order to investigate the effect of PFO in the occurrence of eerebral ischemia. Methods Seventy-one palients with ischemic stroke or transient ischemic attack （aged 15 to 55 years） admined in the Department of Neurology, Xuan Wu Hospital from March 2008 to March 2009 were selected. They were all examined by transesophageal echocardiography. There were 49 patients in a PFO group and 22 in a non-PFO group. The recurrence of ischemic cerehrovascular attack within 12 months in both groups was compared. Results Cerebral ischemia reoccurred in 8 patients in the PFO group, Mille onh one reocurretlcc in the non-PFO group.The recucrenee rates at 3, 6, and 12 months in the PFO and non-PFO groiq）s were 6. 12%vs. 0.00% , 10.20% vs. 4.55% , and 16.33% vs. 4.55% , respectively, and there were no significant differences （P= 0. 322, P = 0. 428, and P =0. 16g）. （2））The cumulative recurrencc rate of ischemic cerehrovascular disease in the PFO group was higher than that in the non-PFO group, but the difference was not statistically significant （ P = 0. 065）. The risk ratio was 3.76 （95% CI 0.834 to 16.946）, the difference was also not statistically significant （P = 0.085）. Conclusion The recurrence tale of ischemie cerebrovascnlar disease in patients with PFO tends to increase, but the probability of PFO in increasing the recurrence of cerebral ischemia still not able to he determined.