TCD发泡试验联合TTE在诊断卵圆孔未闭所致偏头痛及分流量分级中的作用  

The Role of TCD Foam Test Combined with TTE in Diagnosing Migraine Caused by Patent Foramen Ovale and Classification of Shunt

作　　者：黄海宁[1] 邓烨 邱敏瑜 Huang Haining;Deng Ye;Qiu Minyu(Department of Ultrasound,First People's Hospital of Huizhou City,Huizhou,Guangdong 516000)

机构地区：[1]惠州市第一人民医院超声科,广东惠州516000

出　　处：《现代医用影像学》2021年第4期643-646,共4页Modern Medical Imageology

基　　金：广东省惠州市科技专项,编号:200312234574612。

摘　　要：目的:观察经颅多普勒(ton crush day,TCD)发泡试验联合经胸超声心动图(transthoracic echocardiography,TTE)在诊断卵圆孔未闭(Patent Foramen Ovale,PFO)所致偏头痛及右向左分流(Right to left shunt,RLS)分级中的作用。方法:选取本院2019年2月-2020年2月收治的100例排除其它原因引发偏头痛患者设为研究对象,皆由经食管超声心动图(transesophageal echocardiography,TEE)检查确诊PFO所致偏头痛63例,均行TCD发泡试验以及TTE检查。比较TTE与TCD发泡试验检查灵敏度、特异度以及RLS分级。结果:TTE检查灵敏度为66.67%,特异度为86.49%,TTE和TEE检查检出率比较,差异具有统计学意义(P<0.05);TCD发泡试验检查灵敏度为80.95%,特异度为78.38%,TCD发泡试验和TEE检查检出率比较,无可比性(P<0.05)。TTE检查静息状态Ⅰ级(68.00%)、Ⅱ级(13.00%)、Ⅲ级(12.00%)、Ⅳ级(7.00%);Valsalva动作后Ⅰ级(53.00%)、Ⅱ级(21.00%)、Ⅲ级(16.00%)、Ⅳ级(10.00%);TTE检查Valsalva动作后阳性率高于静息状态,无统计学显著差异(P>0.05)。TCD发泡试验检查静息状态Ⅰ级(55.00%)、Ⅱ级(18.00%)、Ⅲ级(16.00%)、Ⅳ级(11.00%);Valsalva动作后Ⅰ级(41.00%)、Ⅱ级(24.00%)、Ⅲ级(20.00%)、Ⅳ级(15.00%)。TCD发泡试验检查Valsalva动作后阳性率高于静息状态,无统计学显著差异(P>0.05)。组间比较,皆无统计学显著差异(P>0.05)。结论:诊断PFO所致偏头痛在TTE基础上联合TCD发泡试验有效提高灵敏度与特异度,分流量分级更准确。Objective:To observe transcranial Doppler(ton crush day,TCD)foam test combined with transthoracic echocardiography(transthoracic echocardiography,TTE)in the diagnosis of patent Foramen Ovale(Patent Foramen Ovale,PFO)caused by migraine and right The role of Right to Left Shunt(RLS)classification.Methods A total of 100 patients who were admitted to our hospital from February 2019 to February 2020 who excluded migraines caused by other causes were selected as research subjects.All of them were diagnosed by transesophageal echocardiography(TEE)to diagnose migraine caused by PFO63 For example,TCD foam test and TTE inspection are performed.Compare TTE and TCD foam test to check sensitivity,specificity and RLS classification.Methods:A total of 100 patients who were admitted to our hospital from February 2019 to February 2020 who excluded migraines caused by other causes were selected as research subjects.All of them were diagnosed by transesophageal echocardiography(TEE)to diagnose migraine caused by PFO63 For example,TCD foam test and TTE inspection are performed.Compare TTE and TCD foam test to check sensitivity,specificity and RLS classification.Results:The sensitivity of TTE examination was 66.67%,and the specificity was 86.49%.The detection rate of TTE and TEE examinations was compared,and the difference was statistically significant(P<0.05);TCD foam test examination sensitivity was 80.95%and specificity was 78.38%.The detection rate of TCD foaming test and TEE inspection is incomparable(P<0.05).TTE check the resting state of class Ⅰ(68.00%),class Ⅱ(13.00%),class Ⅲ(12.00%),class Ⅳ(7.00%);after Valsalva action class Ⅰ(53.00%)%),class Ⅱ(21.00%)),grade Ⅲ(16.00%),grade Ⅳ(10.00%);the positive rate of Valsalva after TTE examination was higher than that of resting state,and there was no statistically significant difference(P>0.05).The TCD foam test examines the resting state of class Ⅰ(55.00%),class Ⅱ(18.00%),class Ⅲ(16.00%),class Ⅳ(11.00%);after Valsalva action,class Ⅰ(41.00%),class Ⅱ(24.00)%,

关 键 词：卵圆孔未闭 经颅多普勒发泡试验 经胸超声心动图 偏头痛 

分 类 号：R747.2[医药卫生—神经病学与精神病学]