不明原因晕厥与心脏卵圆孔未闭高度相关

Unexplained Syncope Highly Correlated with Heart Patent Foramen Ovale

目的探讨不明原因晕厥与卵圆孔未闭的相关性。方法选取61例不明原因晕厥的门诊及住院患者,进行右心声学造影检查,筛查是否合并卵圆孔未闭,并对检查结果进行统计学分析,确定不明原因晕厥与卵圆孔未闭之间是否存在某种关联。结果 61例不明原因晕厥患者中46例（男21例,女25例）为心脏卵圆孔未闭患者（75.41%）。46例患者中,30例静息状态下及Valsalva动作后均发生右向左分流,16例仅在Valsalva动作后出现分流;少量分流7例,中量分流5例,大量分流34例;13例在运动中起病,22例在腹压变化时起病,11例在静息状态下起病。26例患者行经导管卵圆孔未闭封堵术治疗,术后随访1~6个月,仅有2例患者再发晕厥一次,余患者均未再发晕厥。结论心脏卵圆孔未闭为不明原因晕厥常见的诱因,不明原因晕厥与心脏卵圆孔未闭高度相关,不明原因晕厥患者应常规筛查心脏右向左分流。

Aim To evaluate the relationship between unexplained syncope and patent foramen ovale（PFO）.Methods 61 patients with unexplained syncope（both out patient and in patient） were chosen,and then documented PFO by echocardiography through air-mixed saline.Finally the data was collected and analyzed by chi-square test method to make sure whether unexplained syncope was associated with PFO.Results In the 61 patients with unexplained syncope,46 cases were diagnosed as PFO,the positive rate was 75.41%.All cases were detected to occur right-to-left shunt（RLS） after the valsalva maneuver,among them,7 cases small shunt（10 microbubbles,MBs）,4 cases moderate shunt（10 MBs）,and 34 cases large shunt（all of the LA was opacified）.Of the 46 cases,30 were found RLS not at rest but after the valsalva maneuver.In the 46 patients with PFO,syncope attacked during exercise in 13 cases,22 cases lost consciousness when the abdominal pressure was changed,and the residual fell illness in the resting state.26 patients underwent the interventional closure and were followed up for 1 month to half a year,none but 2 patients with the episodes of syncope again.Conclusion PFO may be a common cause to unexplained syncope.Unexplained syncope is highly correlated with heart PFO.The RLS in heart should be screening first in patients with unexplained syncope.