右心声学造影在隐源性卒中患者中的应用价值

Application value of contrast transthoracic echocardiography in patients with cryptogenic stroke

目的:探讨右心声学造影(cTTE)在隐源性卒中(CS)患者中的应用价值。方法:选取我院2019年12月—2021年2月收治的42例CS患者,所有患者均行cTTE检查,根据检查结果分为阳性组及阴性组,并分析两组的临床特点及影像学特征。结果:cTTE阳性组18例,cTTE阴性组24例,cTTE检出卵圆孔未闭(PFO)的阳性率为42.86%。cTTE阳性组合并原发性高血压病及糖尿病的比例、最大病灶直径、初始NIHSS评分、病灶数目均显著低于cTTE阴性组,cTTE阳性组累及后循环、累及皮层下区域的比例均显著高于cTTE阴性组,差异均有统计学意义(P<0.05)。结论:PFO与CS患者有密切关系,对临床及影像学上怀疑存在PFO的CS患者,应积极运用cTTE检查进行PFO筛查,有助于明确诊治并改善患者预后。

Objective To explore the application value of contrast transthoracic echocardiography(cTTE)in patients with cryptogenic stroke(CS).Methods A total of 42 CS patients who have undergone cTTE examinations in our hospital from December 2019 to February 2021 were recruited.The patients were divided into cTTE positive group and cTTE negative group according to the examination results.The clinical and radiological features of the two groups were analyzed.Results There were 18 cases in the cTTE positive group and 24 cases in the cTTE negative group.The positive rate of patent foramen ovale(PFO)detected by cTTE was 42.85%.The proportion of cTTE positive group combination with essential hypertension and diabetes,initial NIHSS score,largest lesion diameter,number of lesions were significantly lower than those of the cTTE negative group,and the proportions of the posterior circulation and subcortical areas involvement in the cTTE positive group were significantly higher than those of the cTTE negative group(P﹤0.05).Conclusion PFO is closely related to CS patients.For CS patients who are suspected of having PFO in clinical and radiological studies,cTTE examination should be actively used for PFO screening which help clear diagnosis and treatment,and improve the prognosis of patients.