右心声学造影对成人卵圆孔未闭诊断效能及卵圆孔未闭与隐源性缺血性脑卒中的关系

Diagnostic efficacy of contrast echocardiography of right heart in adults with patent foramen ovale and the relationship between patent foramen ovale and cryptogenic ischemic stroke

目的:研究右心声学造影对成人卵圆孔未闭(patent foramen ovale,PFO)诊断效能及PFO与隐源性缺血性脑卒中(cryptogenic stroke,CS)的关系。方法:采用随机数字表法,选取我院2021-01~2022-05收治的106例CS患者及107例性别、年龄相匹配的非卒中患者,将其分为两组,分别是CS组106例和对照组107例。先后采用经食管超声心动图((trans esophageal echocardiography,TEE)和右心声学造影检查对照组及CS组PFO发生率,并对PFO发生率及CS危险因素进行分析。结果:右心声学造影检查中,CS组检出阳性58例(54.72%),对该部分患者行TEE检查,结果显示58例患者中,阳性检出例数为54例(50.94%),阴性4例(3.77%),阳性检出率对比无显著差异(P>0.05)。对照组阳性检出例数为2例(1.87%),对该部分患者行TEE检查,结果显示2例患者中,检出阳性1例(0.93%),阴性1例(0.93%),阳性检出率对比无显著差异(P>0.05);但CS组PFO检出率明显高于对照组(P<0.05);静息状态下启动右心声学造影,CS组RLS例数19例(17.92%)多于对照组1例(0.93%)(P<0.05),Valsalva动作后启动右心声学造影,CS组RLS总例数58例(54.72%)明显多于对照组2例(1.87%)(P<0.05),而CS组RLS分级2、3级例数明显较多(P<0.05)。结论:右心声学造影用于诊断PFO效能显著,对于全面评估PFO及查找CS相关发病因素均大有裨益。

Objective:To investigate the diagnostic performance of right heart contrast echocardiography in adults with patent foramen ovale(PFO)and the relationship between PFO and cryptogenic ischemic stroke(CS).Methods:Using the random number table method,106 CS patients and 107 gender-and age-matched non-stroke patients admitted to our hospital from January 2021 to May 2022 were selected and divided into two groups,the CS group 106 cases and the control group 107 cases.Transesophageal echocardiography(TEE)and right heart contrast echocardiography were successively used to examine the incidence of PFO in the control group and CS group,and the incidence of PFO and risk factors for CS were analyzed.Results:The number of positive cases in CS group was 58(54.72%),and TEE examination was performed on these patients.The results showed that among the 58 patients,54(50.94%)were positive and 4 were negative(There was no significant difference in the positive detection rate(P>0.05).The number of positive detection cases in the control group was 2(1.87%).TEE examination was performed on some patients.The number of cases was 1(0.93%),and the number of negative cases was 1(0.93%),and there was no significant difference in the positive detection rate(P>0.05);however,the detection rate of PFO in the CS group was significantly higher than that in the control group(P<0.05);right heart contrast echocardiography was started in the resting state,19 cases(17.92%)of RLS cases in the CS group were more than 1 case(0.93%)in the control group(P<0.05).Right heart contrast echocardiography was started after the Valsalva maneuver.The total number of RLS cases in CS group,58 cases(54.72%),was significantly more than 2 cases in control group(1.87%)(P<0.05),while the number of RLS grades 2 and 3 in CS group was significantly higher(P<0.05).Conclusion:Right heart contrast echocardiography is effective in diagnosing PFO,and it is of great benefit to comprehensively assessing PFO and finding CS-related pathogenic factors,and can be widely used in clinical practice.