卵圆孔未闭与中青年缺血性卒中的相关性研究  

Correlation between patent foramen ovale and ischemic stroke in young and middleaged patients

作　　者：冯丹[1] 项颖[1] 刘永宏[1] 吴建军[2] 来海欧[1] 王英莉[2] 邵琳[2] 任盼[2] 殷成龙[1] 祁占宁[1] 夏辉[1] 王飒[1] 

机构地区：[1]延安大学咸阳医院神经内科,陕西咸阳712000 [2]延安大学咸阳医院超声科,陕西咸阳712000

出　　处：《华西医学》2017年第5期674-678,共5页West China Medical Journal

基　　金：陕西省科技厅社会发展项目(S2017-SF-0118)

摘　　要：目的通过对中青年缺血性卒中危险因素的分析,进一步了解卵圆孔未闭(patent foramen ovale,PFO)与中青年缺血性卒中的相关性。方法选取2016年1月—2017年1月在神经内科初次就诊的年龄15~55岁的脑梗死患者83例,分为PFO组(42例)和无PFO组(41例),同时选取体检科健康受试者78例设为对照组。所有患者及健康受试者均行经颅多普勒超声发泡试验,观察PFO的发生情况及分流量大小。并调查患者的一般资料及脑血管病相关危险因素。结果 PFO组与无PFO组的年龄差异无统计学意义(P>0.05)。各危险因素中,PFO组与无PFO组嗜酒者比例差异无统计学意义(P>0.05),PFO组合并其余缺血性脑卒中的危险因素(高血压、糖尿病、吸烟、高脂血症、高同型半胱氨酸血症、颈动脉硬化)的比例均明显低于无PFO组,差异均有统计学意义(P<0.05)。脑梗死组与对照组右向左分流的等级资料进行秩和检验,差异有统计学意义(P﹤0.05),脑梗死组大、中分流率明显高于对照组。结论 PFO可能是中青年缺血性卒中的危险因素之一,PFO致缺血性卒中的发病机制可能与右向左分流的严重程度有关。Objective To know more about the correlation between patent foramen ovale （PFO） and ischemic stroke among young and middle-aged people through analysis on various risk factors of ischemic stroke. Methods Eighty-three patients with cerebral infarction from 15 to 55 years old diagnosed for the first time in the Department of Neurology of Xianyang Hospital between January 2016 and January 2017 were selected as the study subjects. They were divided into two groups, PFO group （n=42） and non-PFO group （n=41）. Seventy-eight heathy people from the Physical Examination Department of the same hospital were selected as controls. All patients and heathy subjects underwent transcranial Doppler （TCD） foaming experiments, and the occurrence and shunt volume of PFO were observed. General information and cerebrovascular disease risk factors of the patients were investigated. Results The age of subjects in PFO and non-PFO groups was not significantly different （P〉0.05）. Among the risk factors, there was no significant difference between the PFO and non-PFO groups in drinking history （P〉0.05）. The incidences of other ischemic stroke risk factors （hypertension, diabetes, smoking, hyperlipidemia, hyperhomocysteinemia, and carotid arteriosclerosis） in the PFO group were significantly lower than those in the non-PFO group （P〈0.05）. The rank sum test results showed that large and medium shunt rates of the cerebral infarction group were significantly higher than those of the control group （P〈0.05）.Conclusions PFO may be one of the cause of ischemic stroke in young and middle-aged people. Pathogenesis of ischemic stroke is likely to have a relationship with the severity of the shunt from right to left.

关 键 词：缺血性卒中 卵圆孔未闭 右向左分流 

分 类 号：R743.3[医药卫生—神经病学与精神病学]