伴卵圆孔未闭的脑梗死患者左心房增大与脑梗死病灶分布及分流量之间的关系

The relationship between the enlargement of left atrium and the distribution of cerebral infarction lesions, shunt volume in cerebral infarction patients with patent foramen ovale

目的观察伴卵圆孔未闭(PFO)的脑梗死患者左心房增大与脑梗死病灶分布及分流量之间的关系。方法选择我院2018年2月~2019年10月收治的脑梗死患者,经影像学证实存在新发梗死病灶,其中99例经食道超声、右心声学造影以及是否能配合Valsava动作等明确诊断存在PFO,同时通过多普勒超声心动图测量左心房内径,其中左心房内径增大26例,设为观察组,左心房内径正常73例,设为对照组。同时记录患者基线资料(年龄、性别、高血压病、糖尿病、冠心病、卒中、吸烟、饮酒等),根据患者头颅MRI或CT记录并比较患者新发梗死病灶的分布情况。结果两组梗死病灶的影像学分布(皮层及皮层下梗死、多发性梗死、双侧梗死、前后循环梗死、大面积梗死)及PFO分流量为中大量的患者比例相比差异无统计学意义(P>0.05)。结论伴PFO的脑梗死患者左心房增大与PFO分流量无关,同时左心房内径大小也不影响脑梗死病灶分布。

Objective To observe the relationship between the enlargement of left atrium and the distribution of cerebral infarction lesions,shunt volume in cerebral infarction patients with patent foramen ovale(PFO).Methods Ninty-nine cerebral infarction patients with PFO admitted to our hospital from Feb 2018 to Oct 2019 were collected.All the 99 patients were diagnosed with PFO by transesophageal echocardiography,right heart contrast echocardiography and Valsava maneuver.Meanwhile,the inner diameter of the left atrium was measured by Doppler echocardiography.Among them,26 patients with enlarged left atrium diameter were set as observation group,and 73 patients with normal left atrium diameter were set as control group.At the same time,baseline data including age,gender,hypertension,diabetes,coronary heart disease,apoplexy,smoking,alcohol consumption were recorded,and the distribution of new infarction was confirmed and compared by head MRI or CT.Results The distribution of infarction including cortical and subcortical infarction,multiple infarction,bilateral left and right infarction,anteriorposterior circulation infarction,large infaretion and proportion of patients whose PFO shunt volume was middle and large between the two groups had no significant difference(P>0.05).Conclusion Enlargement of left atrium is not concerned with the shunt volume of PFO in patients with cerebral infarction,and left atrial diameter don’t affect the distribution of cerebral infarction lesions.