卵圆孔未闭患者的隐源性卒中:潜在机制和预防策略

Cryptogenic stroke in patients with patent foramen ovale:potential mechanisms and prevention strategies

卵圆孔未闭(patent foramen ovale, PFO)是一种先天性心脏病,见于约25%的健康成年人。近年来,越来越多的研究表明PFO与隐源性卒中(cryptogenic stroke, CS)关系密切。尽管目前认为反常性栓塞是CS发病的主要机制之一,但确切机制仍存在着争议。此外,PFO患者CS的治疗也是争论的焦点。近期临床试验表明,PFO封堵术在预防卒中复发方面明显优于单纯药物治疗,尤其是对于右向左分流量较大以及合并房间隔瘤的患者。文章对PFO患者CS的潜在机制和预防策略进行了综述。

Patent foramen ovale(PFO)is a congenital heart disease that occurs in about 25%of healthy adults.In recent years,more and more studies have shown that PFO is closely associated with cryptogenic stroke(CS).Although it is currently believed that paradoxical embolism is one of the main mechanisms of the pathogenesis of CS,but the exact mechanism is still controversial.In addition,the treatment of CS in patients with PFO is also the focus of controversy.Recent clinical trials have shown that PFO occlusion is significantly better than drug therapy alone in preventing stroke recurrence,especially for patients with a large right-to-left shunt and atrial septal tumor.This article reviews the potential mechanisms and prevention strategies of CS in patients with PFO.