超声心动图评价Chiari’s网合并卵圆孔未闭与缺血性脑卒中的关系

Evaluation of the relationship between Chiari’s mesh combined with patent foramen ovale and ischemic stroke by echocardiography

目的 探讨超声心动图评估Chiari＇s网（Chiari＇s network, CN）合并卵圆孔未闭（Patent foramen ovale, PFO）与缺血性脑卒中的关系。方法 回顾性分析自2013年1月-2016年12月我院根据临床表现和影像学检查诊断为缺血性脑卒中患者558例，其中房颤（atrial fibrillation，AF）组265例，非房颤组（non-atrial fibrillation，N-AF）293例。分别采用经胸超声心动图（transthoracic echocardiography，TTE）或经食道超声心动图（transesophageal echocardiography，TEE）选取四腔心切面、右心室流入道切面、右室流出道切面、双心房上下腔静脉切面，并结合右心声学造影检查，分析CN 和PFO与发生缺血性脑卒中的关系。结果 在缺血性脑卒中患者中，AF组合并N-PFO＋N-CN患者病例数所占比例明显高于N-AF合并N-PFO＋N-CN患者，AF组合并PFO患者病例数所占比例明显低于无合并N-AF的患者， PFO＋CN合并N-AF患者病例数所占比例明显高于PFO＋ CN合并AF患者，以上差异均具有统计学意义（p〈0.05）；在N-AF患者中，合并PFO＋ CN患者病例数所占比例明显高于合并N-PFO＋N-CN、PFO、CN患者。结论 本研究提示CN与PFO可作为缺血性脑卒中病因之一，超声心动图可快捷、准确的诊断CN与PFO，结合右心声学造影对缺血性脑卒中的病因学研究提供客观依据。

Objective The aim of this study was to investigate the correlation between Chiari network （CN） ＆ patent foramen ovale （PFO） and ischemic stroke by echocardiography. Materials and methods 558 patients with ischemic stroke were collected in the Xinjiang Uygur Autonomous Region hospital of traditional Chinese medicine from January 2011 to December 2016, who were divided into two groups： 265 patients with atrial fibrillation （AF）, 293 patients with non-atrial fibrillation （N-AF）. All patients were examined by transthoracic echocardiography （TTE） or transesophageal echocardiography （TEE） from four chamber view, right ventricular inflow tract view, right ventricular outflow tract view, or double atrium superior vena cava section views, combined with right heart contrast echocardiography examination. Then the relationship between the present of CN and PFO was explored. Results In ischemic stroke patients, AF patients combined with N-PFO＋N-CN were significantly higher than the N-AF patients combined with N-PFO＋N-CN, AF patients combined with PFO were significantly lower than N-AF, PFO＋CN patients combined with N-AF were significantly higher than the CN and PFO＋ in patients with AF （p〈0.05）. In the patients with N-AF, the patients with PFO＋ CN were significantly higher than patients with N-PFO＋N-CN, PFO and CN. Conclusion This study suggests that CN and PFO can be used as one of the causes of ischemic stroke; echocardiographic combined with right heart contrast echocardiography can be the fast and accurate methods to diagnose CN and PFO, and provide an objective basis for the etiology of ischemic stroke .