高原低氧地区中青年隐源性脑卒中与卵圆孔未闭的相关性分析

目的探讨卵圆孔未闭(PFO)在高海拔低氧环境下导致中青年隐源性脑卒中(CS)发病情况。方法选择世代居住青海地区或长期居住>10年原因不明的缺血性脑卒中中青年患者156例(观察组)。同时在体检中心选择与观察组信息相匹配的健康人群160例为对照组。根据心脏彩超(TTE)及其声学造影(c-TTE)结果,把观察组和对照组分别划分为PFO组与非PFO组,观察各组PFO直径及右向左分流量大小,记录患者一般资料、脑血管病相关危险因素、入出院时美国国立卫生研究院卒中量表(N丨HSS)评分等,并统计分析c结果观察组PFO检出率为46.1%,平均PFO直径(2.2±0.45)mm,中、大量右向左分流(RLS)者占比59.7%,明显高于对照组26.8%检出率,且PFO直径偏小、RLS偏小,平均直径为(1.0±0.38)mm,中、大量RLS占30.2%。结论(1)高原低氧地区中青年隐源性脑卒中与卵圆孔未闭存在相关性,隐源性脑卒中患者中存在PFO的几率较一般人群大。(2)高原低氧地区PFO可作为缺血性脑卒中另一个重要危险因素(3)高原低氧地区PFO患者中RLS、PFO直径越大的中青年患者发生脑卒中可能性越大。

Objective To explore the incidence of cryprogenic stroke(CS)in young and middle-aged people caused by Patent foramen ovale(PFO)in high alitude and hypoxia environment.Methods In this study,156 young and middle-aged patients with ischemic stroke of unknown origin who had visited Qinghai Provincial People's Hospital from Janwary 2013 to March 2019 and lived in Qinghai area for generations or lived for more than 10 years for a long time were selected(the study group).At the same time.160 cases of general population matched with the information of the study group were selected as the control group in the physical examination center.According to the results of TTE and c-tte,the study group and the control group were divided into PFO group and non PFO group respectively.PFO diameter and right to left fractional flow were observed in each group.The general information of patients,risk factors of cerebrovascular disease,NIHSS score at adnmission and discharge were recorded and amalyzed satistically.Results The detection rate of PFO was 46.1%,the average diameter of PFO was(2.2±0.45)mm,and 59.7%of patients with moderate and large right to left shunt(RLS),which was significandly higher than that of 26.8%(43/160)of the control group.PFO diameter was smaller and RLS was smaller,with an average diameter of(10±0.38)mm.The proportion of medium and large RLS was 30.2%(13/43).Conclusions 1.There is a certain crrelation between cryptogenic stroke and patent foramen ovale in young and middle-aged people in high altitude hypoxia area.The probability of PFO in patients with cryptogenic stroke is higher than that in general population.2.PFO may be another important risk factor for ischemic stroke in high altitude hypoxia area.3.The larger the diameter of RLS and PFO in PFO patients in high aliude hypoxia area,the higher the pssbilit of stroke.