摘要
目的探讨经颅彩色多普勒(cTCCD)发泡试验联合经胸超声心动图声学造影(cTTE)同步化检查在卵圆孔未闭相关神经症状病因筛查中的应用价值。方法选择我院神经内科主因偏头痛、不明原因脑梗死、突发晕厥、眩晕4种常见临床症状就诊的患者182例,应用cTCCD联合cTTE同步化检查观察是否存在卵圆孔未闭所致的右向左分流(PFO-RLS)及其分级,分析心内型右向左分流程度、房间隔形态与患者临床症状间的相关性。结果182例患者中,PFO-RLS阳性者109例,PFO-RLS阴性者73例,其中PFO-RLS阳性者中女性、存在房间隔摆动和具有长期吸烟史者比例均高于PFO-RLS阴性者(45.87%vs.30.13%,25.69%vs.6.84%,23.85%vs.10.69%),差异均有统计学意义(均P<0.05);但分别出现这三种相关因素的患者在PFO-RLS不同分级分布比较差异均无统计学意义;具有偏头痛、不明原因脑梗死、突发晕厥、眩晕患者在PFO-RLS不同分级的总体分布比较差异有统计学意义(HC=13.045,P=0.005),其中突发晕厥者存在大量PFO-RLS的比例高于不明原因脑梗死者(80.00%vs.20.25%),差异有统计学意义(P<0.05)。结论cTCCD联合cTTE同步化检查不仅可以提高卵圆孔未闭的检出率和诊断准确率,而且可以同时观察房间隔的形态及颅脑大脑中动脉结构,对神经内科常见4种不明原因临床症状的病因筛查具有较高临床参考价值。
Objective To explore the application value of contrast transcranial color Doppler(cTCCD)foaming test combined with contrast transthoracic echocardiography(cTTE)synchronization examination in the etiological screening of patent foramen ovale(PFO)related neurological symptoms.Methods A total of 182 patients with four common clinical symptoms(migraine,unexplained cerebral infarction,sudden syncope and vertigo)in the department of neurology of our hospital were selected.cTCCD combined with cTTE synchronization was used to observe the degree of right-to-left shunt caused by PFO(PFO-RLS),and the correlation between the degree of intracardiac right-to-left shunt,the shape of atrial septum and the clinical symptoms were analyzed.Results Among the 182 patients,109 cases were PFO-RLS positive and 73 cases were PFORLS negative.The proportion of women,patients with atrial septal swing and patients with long-term smoking history in PFORLS positive patients were higher than those in PFO-RLS negative patients(45.87%vs.30.13%,25.69%vs.6.84%,23.85%vs.10.69%),and there were statistically significant(all P<0.05).However,there were no significant difference in the proportion of patients with these three related factors in the distribution of PFO-RLS severity.There were significant differences in the overall distribution of PFO-RLS in patients with migraine,unexplained cerebral infarction,sudden syncope and vertigo(HC=13.045,P=0.005).The proportion of massive PFO-RLS shunt in patients with sudden syncope was significantly higher than that in patients with unexplained cerebral infarction(80.00%vs.20.25%,P<0.05).Conclusion cTCCD combined with cTTE synchronization examination can not only improve the detection rate and diagnostic accuracy of PFO,but also observe the shape of atrial septum and the structure of middle cerebral artery at the same time.The results are of high clinical reference value in the etiological screening of the etiology of PFO related neurological symptoms.
作者
王艺晓
刘禧
侯颖
梁媛
程洪瑜
王佳
WANG Yixiao;LIU Xi;HOU Ying;LIANG Yuan;CHENG Hongyu;WANG Jia(Department of Ultrasonic Medicine,Tangdu Hospital,Air Force Medical University,Xi’an 710038,China)
出处
《临床超声医学杂志》
CSCD
2021年第8期576-580,共5页
Journal of Clinical Ultrasound in Medicine
关键词
超声心动描记术
发泡试验
声学造影
超声检查
多普勒
经颅
偏头痛
脑梗死
晕厥
眩晕
Echocardiography
Foaming test
Contrast transthoracic
Ultrasonography,Doppler,transcranial
Migraine
Cerebral infarction
Syncope
Vertigo
