TCD发泡试验联合cTTE右心声学造影对中青年偏头痛合并PFO的诊断价值

Diagnostic Value of TCD Bubble Test Combined with cTTE of Right Heart for Migraine Complicated with PFO in Young and Middle-Aged Patients

目的:分析经颅多普勒超声(TCD)发泡试验联合经胸超声心动图(cTTE)右心声学造影在中青年偏头痛合并卵圆孔未闭(PFO)诊断中的应用效果。方法:选取2020年1月至2022年6月在商丘市第一人民医院因偏头痛就诊的159例中青年患者,所有患者均行TCD发泡试验、cTTE右心声学造影及食道超声心动图(TEE)检查,并以TEE诊断结果为标准,评估TCD发泡试验、cTTE右心声学造影及两种方法联合诊断的效能。结果:TEE诊断出56例偏头痛患者合并有PFO,103例患者为单纯偏头痛;cTTE右心声学造影检测出42例偏头痛患者合并有PFO,TCD发泡试验检测出48例,TCD发泡试验联合cTTE右心声学造影检测出54例。TCD发泡试验联合cTTE右心声学造影诊断偏头痛合并PFO的灵敏度和特异度均高于cTTE右心声学造影、TCD发泡试验单独检测;TCD发泡试验的灵敏度高于cTTE右心声学造影,但特异度低于cTTE右心声学造影。结论:TCD发泡试验联合cTTE右心声学造影可为中青年偏头痛合并PFO的诊断提供更准确的参考。

Objective To analyze the effect of transcranial Doppler(TCD)bubble test combined with contrast-transthoracic echocardiography(cTTE)of right heart in the diagnosis of migraine complicated with patent foramen ovale(PFO)in young and middle-aged patients.Methods A total of 159 young and middle-aged patients with migraine treated in the First People's Hospital of Shangqiu from January 2020 to June 2022 were selected.TCD bubble test,cTTE of right heart and trans esophageal echocardiography(TEE)were performed in all patients,and TEE diagnostic result as the standood.To evaluate the diagnostic efficacy of TCD bubble test,cTTE of right heart and the combination of the two methods.Results TEE diagnosed 56 patients with migraine complicated with PFO,103 patients with migraine alone.42 migraine patients complicated with PFO were detected by cTTE of right heart,48 cases by TCD bubble test,and 54 cases by TCD bubble test combined with cTTE of right heart.The sensitivity and specificity of TCD bubble test combined with cTTE of right heart in the diagnosis of migraine with PFO were higher than that of cTTE of right heart and TCD bubble test alone.The sensitivity of TCD bubble test was higher than that of cTTE of right heart,but its specificity was lower than that of cTTE of right heart.Conclusion TCD bubble test combined with cTTE of right heart can provide a more accurate reference for the diagnosis of migraine complicated with patent foramen ovale in young and middle-aged patients.