| 摘要: |
| 目的 探讨经食管右心声学造影（contrast transesophageal echocardiography, cTEE）在检测先兆性偏头痛（migraine aura, MA）患者右向左分流（right-to-left shunt, RLS）及鉴别其来源中的作用，并研究不同部位RLS在MA病因学中的意义。方法 对107例MA患者及45例健康志愿者进行cTEE检查，在静息状态和Valsalva动作时观察有无RLS及其来源，并进行半定量分级。结果 MA组RLS总阳性率高于对照组（69.2% vs 17.8%，P＜0.05），其中单纯卵圆孔未闭所致右向左分流（patent foramen ovale right-to-left shunt, PFO-RLS）、单纯肺内右向左分流（intra-pulmonary right-to-left shunt, P-RLS）及两者共存的阳性率分别为10.3%、19.6%、39.3%，均高于对照组（4.4%、8.9%、4.4%，P＜0.05）。另外，组间中+大量RLS也有显著差异（P＜0.05）。结论 P-RLS和PFO-RLS在MA的病因学中都具有重要的意义，cTEE是两者的诊断、鉴别及定量直观、有效的方法。 |
| 关键词: 先兆性偏头痛 经食管右心声学造影 卵圆孔未闭 肺内右向左分流 |
| DOI： |
| 投稿时间：2023-01-10修订日期：2023-05-05 |
| 基金项目:深圳市卫生计生系统科研项目；苗苗培育计划启动项目 |
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| Evaluation of assessment of right-to-left shunt by contrast transesophageal echocardiography in patients with migraine with aura |
| Li Ping,Zhu Yong-sheng,Luo Xiu-xia,Su Jin,Ge Quan-rong,Chen Yan |
| (Department of Ultrasonography,Shenzhen Hospital of Southern Medical University,Shenzhen,Guangdong,518000) |
| Abstract: |
| Objective To investigate the role of contrast transesophageal echocardiography (cTEE) in detecting right-to-left shunt (RLS) and identifying its sources in migraine aura (MA), and to study the significance of different RLS types in the etiologies of MA. Methods 107 patients with MA and 45 were enrolled. cTEE was applied to identify whether there were RLS and their sources at rest and during Valsalva maneuver respectively, and to semi-quantitatively grade the shunts.?Results The total incidence of RLS of the patients with MA was higher than that in normal control group (69.2% versus 17.8%, P < 0.05). Besides, the ratio of patients with only PFO-RLS (patent foramen ovale right-to-left shunt, PFO-RLS), only P-RLS (intra-pulmonary right-to-left shunt, P-RLS), and both P-RLS and PFO-RLS detected in MA patients were 10.3%, 19.6%, 39.3%, which were all higher than those in control group (4.4%, 8.9%, 4.4%, all P < 0.05). Furthermore, the ratio of moderate or above RLS in MA group was significantly higher (P < 0.05) than that in healthy volunteers. Conclusion Both P-RLS and PFO-RLS have significant roles in etiologies of MA. cTEE is an objective and effective method for the diagnosis, differentiation, and quantitative analysis of RLS. |
| Key words: migraine with aura contrast transesophageal echocardiography of right heart patent foramen ovale intra-pulmonary right-to-left shunt |
