摘要
目的评价隐源性缺血性脑血管病（CICVD）患者复发脑缺血事件与卵圆孔未闭（patent foramen ovale，PFO）的相关性，探讨PFO对于缺血性脑血管病的临床意义。方法连续收集2008年1月至2011年3月于首都医科大学宣武医院神经内科住院的15～70岁CICVD患者，将其中完成经食管超声心动图检查的患者按其结果分为PFO组和非PFO组，通过随访观察，比较两组患者脑缺血事件的复发情况。结果两组患者共91例（PFO组57例，非PFO组34例），随访695（506，1142）d。PFO组患者随访15个月时脑缺血复发率较非PFO组明显增高[24．5％（12／49）与6．9％（2／29），X^2=4．391，P=0．036]。累计复发危险度曲线显示，PFO组患者的脑缺血事件复发风险较非PFO组明显增高（P=0．044），多因素Cox生存分析提示，伴有PFO是CICVD患者复发脑缺血事件的危险因素（OR=4．159，95％C11．178～14．689，P=0．027）。结论PFO的存在增加了CICVD患者复发脑缺血性事件的风险，是值得关注的重要缺血性脑血管病影响因素。
Objective To evaluate the relationship between recurrence of cryptogenic ischemic eerebrovascular disease （CICVD） and patent foramen ovale （PFO）, as wall as to access the clinical significance of PFO in isehemic cerebrovascular disease. Methods Consecutive patients with CICVD aged 15 to 70 years who were hospitalized in Department of Neurology, Xuanwu Hospital Capital Medical University from January 2008 to March 2011 were prospectively investigated. Identified by transesophageal echocardiography, patients were divided into two groups with respect to outcome： PFO group and non-PFO group. The recurrence of cerebral isehemic events was compared between the two groups after neurological follow-up. Results A total of 91 patients were recruited, including 57 patients with PFO and 34 patients without PFO. The follow-up period of two groups was 695 （506,1142） d. The recurrence rate at 15 months in patients with PFO （24. 5% （12/49）） was higher than those without PFO （6. 9% （2/29）, X^2 = 4. 391, P = 0. 036）. Cum hazard curve indicated that recurrence risk of cerebral ischemie events in patients with CICVD in PFO group was higher than that of patients in non-PFO group during the follow-up period （P = 0. 044）. Cox model used for multivariate survival analysis indicated that PFO was a risk factor for cerebral ischemic event recurrence among patients with CICVD （OR = 4. 159, 95% CI 1. 178--14. 689 ,P = 0. 027）. Conclusions PFO is associated with increased recurrence risk of cerebral ischemia in CICVD patients. In addition, PFO may be a significant factor for ischemic cerebrovaseular disease.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2013年第2期117-121,共5页
Chinese Journal of Neurology
关键词
脑缺血
脑血管障碍
复发
卵圆孔
未闭
Brain ischemia
Cerebrovascular disorders
Recurrence
Foramen ovale, patent
