| 摘要: |
| 目的 分析卵圆孔未闭（PFO）合并隐源性卒中与PFO合并偏头痛患者的经食管超声心动图和右心声学造影声像图特征，探究与隐源性卒中相关的危险因子，为其病因学提供解剖依据。
方法 回顾性分析2018年1月至2021年4月在首都医科大学附属北京天坛医院就诊的隐源性卒中（CS）患者及偏头痛（MA）患者，且均已完成经食管超声心动图（TEE）及经食管右心声学造影（cTEE）检查，明确PFO诊断。收集两组患者的一般资料及声像图资料，包括性别、年龄、抽烟史、饮酒史、静息状态下和瓦氏动作后卵圆孔入口、出口，卵圆瓣长度、原发隔摆动幅度、继发隔厚度及来源于PFO的右向左分流（PFO-RLS）。采用倾向性评分方法（PSM）对两组患者进行相关变量的匹配，匹配比例为1：1。分析匹配后两组患者声像图特征差异并对隐源性卒中的发生进行logistic危险因素分析。
结果 PSM匹配后两组间患者年龄、性别、抽烟史、饮酒史比较，差异均无统计学意义（P>0.05）。TEE检查结果显示，静息状态下及瓦氏动作后CS组PFO入口、出口均大于MA组，差异有统计学意义（P均＜0.05）。两组间卵圆瓣长度、继发隔厚度及原发隔摆动幅度差异均无统计学意义（P均＞0.05）；cTEE检查结果显示，瓦氏动作后两组间PFO-RLS程度，差异无统计学意义（P＞0.05）。多因素逻辑回归分析显示，瓦氏动作后的PFO入口、出口是隐源性卒中发生的独立危险因子。
结论 PFO合并隐源性卒中患者卵圆孔的入口、出口均大于PFO合并偏头痛患者，瓦氏动作后差异更加显著。与PFO合并偏头痛患者相比，隐源性卒中患者瓦氏动作后PFO入口、出口内径更大。 |
| 关键词: 卵圆孔未闭 偏头痛 隐源性卒中 经食管超声心动图 |
| DOI： |
| 投稿时间：2022-05-17修订日期：2022-11-29 |
| 基金项目:无 |
|
| Analysis of transesophageal echocardiographic features of patent foramen ovale in the cryptogenic stroke and the migraine |
| yuhangyuan,yangjing,liyongjia,zhanghuiqin,fuqiang,gongxiping,dulijuan |
| () |
| Abstract: |
| Objective Analyzing the transesophageal echocardiographic features of patent foramen ovale (PFO) in the cryptogenic stroke(CS) and the migraine(MA) to provide anatomical basis for etiological analysis. Methods From January 2018 to April 2021, the patients of CS and the patients of MA who had been diagnosed with PFO by the transesophageal echocardiography and the contrast transesophageal echocardiography at Beijing Tiantan Hospital affiliated to Capital Medical University were enrolled. All patients’ data were collected including age, gender, smoking, drinking, the width of inlet and outlet of PFO, swing of septum primum, length of PFO’ tunnel, thickness of septum secundum, and the degree of right-to-left shunting(RLS) from PFO at resting state and Valsalva maneuver. A propensity score matching analysis was performed at a ratio of 1: 1. Features of transesophageal echocardiographic were compared between the groups after matching. Logistic regression analysis were conducted to explore the factors of cryptogenic stroke. Results The two matched groups had no significant differences in age, gender, smoking, drinking (P>0.05). At the resting state and Valsalva maneuver, the inlet and outlet width of PFO measured by TEE in the CS were larger than those in the MA, the difference were statistically significant (P＜0.05). The thickness of the secondary septum, the length of PFO’ tunnel and the swing of primary septum between two groups were not significant different (P＞0.05); The PFO-RLS between two groups was not significant different (P＞0.05); Multivariate analysis showed that inlet and outlet of PFO at Valsalva maneuver were independent predictors of cryptogenic stroke. Conclusions The width of inlet and outlet of PFO in the cryptogenic stroke with PFO were larger than those in migraine with PFO, especially at Valsalva maneuver. The inlet and outlet of PFO at Valsalva maneuver examined by transesophageal echocardiography in patients of cryptogenic stroke were lager than those in migraineur. |
| Key words: Patent Foramen Ovale Stroke Migraine Transesophageal Echocardiography |
