c-TCD诊断右向左分流对中青年隐源性卒中的临床价值  

The clinical value and superiority of c-TCD in the diagnosis of right to left shunt in young and middle-aged patients with cryptogenic stroke

作　　者：张燕娟 颜燕红[1] 惠品晶[1] ZHANG Yanjuan;YAN Yanhong;HUI Pinjing(Department of Ultrasound, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China)

机构地区：[1]苏州大学附属第一医院颈脑血管超声科,江苏苏州215006

出　　处：《西部医学》2020年第11期1694-1696,1701,共4页Medical Journal of West China

摘　　要：目的探讨c-TCD诊断右向左分流(RLS)在中青年隐源性卒中(CS)中的临床价值。方法选取2017年1月~2018年10月来我科检查的170例中青年CS患者为实验组,并选取同期54例健康志愿者为对照组。由经胸心脏超声心动图(TTE)与对比增强经颅多普勒超声(c-TCD)的检测结果进行诊断,同时对罹患RLS患者的分流量采取分级处理,比较两组RLS检出率的差异。结果实验组c-TCD诊断RLS总阳性率明显高于对照组(P<0.05),TTE诊断RLS总阳性率明显高于对照组(P<0.05)。实验组中c-TCD诊断RLS阳性率明显高于TTE(P<0.05)。结论隐源性卒中与RLS有相关性,应引起临床重视;c-TCD诊断RLS具有更高的检出率,可作为隐源性卒中的首选检查方法。Objective To study and analysis of the incidence ofRLS in CS patients,who were young and middle-aged people and analyze the correlation between the two and the difference of the detection rate of RLS between the two methods.Methods 170 young and middle-aged patients with CS who came to our department from January 2017 to October 2018 were selected as the experimental group,and 54 healthy volunteers were selected as the control group.The results of TTE and C TCD were used to diagnose RLS,and the difference of RLS detection rate between the two groups was compared.Results In the experimental group,the total positive rates of C TCD and TTE in diagnosing RLS were 60.6%and 47.6%,respectively.In the control group,the total positive rates of C TCD and TTE in diagnosing RLS were 24.1%and 18.5%.The total positive rate of RLS diagnosed by C TCD in the experimental group was significantly higher than that in the control group(P<0.05).The total positive rate of TTE in diagnosing RLS was significantly higher than that in the control group(P<0.05).In the experimental group,the positive rate of RLS diagnosed by C TCD was significantly higher than that by TTE(P<0.05).Conclusion There is a correlation between cryptogenic stroke and RLS,which should be paid more attention in clinical practice.C TCD has a higher detection rate in the diagnosis of RLS,which can be used as the first choice for cryptogenic stroke.

关 键 词：对比增强经颅多普勒超声 经胸心脏超声心动图 经食道超声心动图 隐源性卒中 右向左分流 

分 类 号：R743.3[医药卫生—神经病学与精神病学]