摘要
目的探讨经颅多普勒发泡试验(c-TCD)结合反常性栓塞风险量表(RoPE)评分在卵圆孔未闭合并不明原因卒中筛选的价值。方法回顾性分析2013年9月至2019年10月西安市第五医院收治的脑卒中病人217例为研究对象,根据卵圆孔未闭诊断“金标准”食管超声心动图(TEE)分为卵圆孔未闭组(62例)和非卵圆孔未闭组(155例),收集两组一般资料,分析两组c-TCD[c-TCD阳性率、右向左分流(RLS)分流量]、RoPE评分情况;Spearman相关分析法评估卵圆孔未闭合并不明原因卒中病人RoPE评分与c-TCD阳性率、RLS分流量的相关性。结果两组性别、年龄、高血压史、糖尿病史、高血脂史、吸烟史、偏头痛史、发病至核磁共振检查时间均差异无统计学意义(P>0.05)。非卵圆孔未闭组c-TCD微泡数量阳性例数(4例)与卵圆孔未闭组c-TCD微泡数量阳性例数(48例)比较差异有统计学意义(P<0.05)。非卵圆孔未闭组RoPE评分(6、7、8、9、10分)分别有49、48、34、18、6例与卵圆孔未闭组RoPE评分(6、7、8、9、10分)分别有8、7、8、15、24例比较差异有统计学意义(P<0.05)。Spearman相关分析显示,卵圆孔未闭合并不明原因卒中病人RoPE评分与c-TCD阳性率、RLS分流量呈正相关(r_(s)=0.896、0.876,P<0.001)。结论c-TCD结合RoPE量表可用于卵圆孔未闭合并不明原因卒中的筛选,具有一定价值。
Objective To explore the value of contrast-enhanced transcranial Doppler(c-TCD)combined with risk of paradoxical embolism(RoPE)score in the screening of patent oval foramen with unexplained stroke.Methods A retrospective analysis was conducted of 217 stroke patients treated in Xi'an Fifth Hospital from September 2013 to October 2019,and according to the"gold standard"transesophageal echocardiography(TEE)for the diagnosis of patent oval foramen,they were assigned into patent oval foramen group(n=62)and non-patent oval foramen group(n=155).The general information of patients in both groups were collected,and the c-TCD[c-TCD positive rate,right to left shunt(RLS)flow]and RoPE score of the two groups were analyzed;Spearman correlation analysis was used to evaluate the correlation between RoPE score and c-TCD positive rate,RLS flow in patients with patent oval foramen and unexplained stroke.Results There were no significant differences in gender,age,history of hypertension,diabetes,hyperlipidemia,smoking,and migraine,and the time from onset to MRI examination between the two groups(P>0.05).There was a significant difference in the number of positive c-TCD microbubbles between the non-patent oval foramen group and the patent oval foramen group((4 cases vs.48 cases;P<0.05).The RoPE scores(6,7,8,9,10 points)of the non-patent oval foramen group were found in 49,48,34,18,6 cases,respectively,while the RoPE scores(6,7,8,9,10 points)of the patent oval foramen group were found in 8,7,8,15,24 cases respectively,which indicated statistically significant difference(P<0.05).Spearman correlation analysis results showed that RoPE score of patients with patent oval foramen with unexplained stroke was positively correlated with c-TCD positive rate and RLS flow(r_(s)=0.896,0.876,P<0.001).Conclusion C-TCD combined with RoPE scale can be used for the screening of patent oval foramen with unexplained stroke,which is of certain value.
作者
叶楠
柴旭兵
闫俊
权莹星
高亚亚
杨莹
YE Nan;CHAI Xubing;YAN Jun;QUAN Yingxing;GAO Yaya;YANG Ying(Department of Neuroendocrinology,Xi'an Fifth Hospital,Xi'an,Shaanxi 710000,China)
出处
《安徽医药》
CAS
2021年第12期2500-2503,共4页
Anhui Medical and Pharmaceutical Journal
关键词
卒中
卵圆孔
未闭
超声心动描记术
经食管
经颅多普勒发泡试验
反常性栓塞风险量表
应用价值
Stroke
Foramen ovale,patent
Echocardiography,transesophageal
Contrast-enhanced transcranial Doppler
Risk of paradoxical embolism
Application value
