日常活动致未闭卵圆孔开放的相关性研究

The Study on the Relationship between Daily Activity and Patent Foramen Ovale

目的研究使右心房压力升高的日常活动(如腹带过紧、叹气、负重)与卵圆孔未闭(PFO)的相关性。方法纳入2014年-2015年间行经颅多普勒超声(TCD)发泡试验结果阳性的患者122例。根据随机数字表法随机分为3组:腹带组(41例)、叹气组(41例)、举重组(40例),分别进行腹带过紧、叹气、负重情况下TCD发泡试验。分别记录上述3种情况下的右向左分流的情况,并与常规TCD发泡试验时右向左分流的情况比较。结果 1将叹气组与腹带组或举重组的阳性率分别进行比较,差异有统计学意义(χ2=10.5、7.40,P<0.01);将腹带组与举重组的阳性率进行比较,差异无统计学意义(χ2=0.314,P>0.05)。3组阳性率的比较为叹气组>腹带组>举重组。2将3组间的静息、Valsalva动作与叹气时右向左分流两两进行比较。其中叹气组中,叹气时的分流量较静息时明显增加,分流量大小的比较为Valsalva动作时>叹气时>静息时。结论使右心房压力升高的日常活动(如腹带过紧、叹气、负重过紧),均可引起右向左分流量的增加,其中以叹气时阳性率最高,为研究PFO与不明原因卒中的发病机制提供一定的理论基础。

Objective To study the relation between daily activity that can make right atrium pressure rise （such as abdominal belt, sighs, weight lifting） and patent foramen ovale （PFO）. Methods A total of 122 cases of positive patients by the routine transcranial Doppler （TCD） foaming test between 2014 and 2015 were collected. Forty-one patients underwent TCD foaming test in the case of abdominal belt, 41 in the case of sighs, and 40 in the case of weight lifting. We recorded the right to left shunting of the above three cases, and compared them with the normal TCD foam test. Results There was a significant difference in the positive rate between the sigh group and abdominal belt group, and between the sigh group and weight lifting group （x2=10.5, 7.40; P 〈 0.01）. The positive rate in the abdominal belt group was not significantly different from that of the weight lifting group （X2=0.314, P 〉 0.05）. In the sigh group, the sigh shunting volume was significantly higher than that when the patients were at rest. The shunting volume was the biggest when the patients had Valsalva movement, followed by sighing and resting. Conclusions The daily activity that can make right atrium pressure rise （such as abdominal belt, sighs, weight lifting） can increase the shunting flow from the right to the left. The highest positive rate occurs when patients sigh. This study can provide a certain theoretical basis for the pathogenesis of patent foramen ovale and cryptogenic stroke.