手振生理盐水右心声学造影在诊断卵圆孔未闭的应用价值  

Application Value of Hand Vibration Normal Saline Right Heart Contrast Echocardiography in the Diagnosis of Patent Foramen Ovale

作　　者：阿迪莱·艾赛提 帕尔哈提·吐尔逊[1] 比拉里·艾山[1] 牛铭 ASATI Adilly;TUERXUN PaerhatI;AISHAN Bilari;NIU Ming(Department of Cardiology,the Fourth Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830000,China)

机构地区：[1]新疆医科大学第四附属医院心内科,新疆乌鲁木齐830000

出　　处：《临床研究》2022年第4期151-153,共3页Clinical Research

基　　金：先天性卵圆孔未闭致偏头痛机制代谢组学研究(2021D01C220)。

摘　　要：目的探索手振生理盐水右心声学造影(cTTE)在诊断卵圆孔未闭(PFO)的应用价值。方法选取2018年10月至2021年12月期间就诊的PFO患者66例作为研究对象。所有患者均完成经胸超声心动图(TTE)及食管超声心动图(TEE)或cTTE检查。比较3种方法对PFO检出率,不同直径PFO的检出率。结果3种方法对PFO阳性检出率比较差异有统计学意义(χ^(2)=13.216,P<0.05),cTTE、TEE、TTE阳性检出率分别为96.97%,86.36%,81.82%。PFO≥3 mm者cTTE和TEE检出率均为100%,TTE为71.43%。2 mm≤PFO<3 mm者cTTE、TTE、TEE检出率分别为92.86%、28.57%、100.00%,差异有统计学意义(χ^(2)=9.376,P<0.05),PFO<2 mm者cTTE、TTE、TEE检出率分别为97.78%、26.67%、80.00%,差异有统计学意义(χ^(2)=8.597,P<0.05)。cTTE诊断PFO的阳性预测值、阴性预测值、灵敏度、特异度分别为0.912、0.854、0.960、0.750,TTE分别为0.885、0.774、0.840、0.563,TEE分别为0.908、0.832、0.920、0.625,差异均有统计学意义(χ^(2)=6.321、5.881、6.234、5.218,P<0.05)。结论卵圆孔未闭患者采用cTTE检查和TEE检查均具有较高的应用价值,而cTTE操作简单,对仪器设备要求较低,值得在基层医院应用。Objective To explore the value of hand vibration normal saline right heart contrast echocardiography(ctte)in the diagnosis of patent foramen ovale(PFO).Methods A total of 66 patients with PFO treated in our hospital from October 2018 to December 2021 were selected as the research object.All patients completed transthoracic echocardiography(TTE)and esophageal echocardiography(TEE)or cTTE.The detection rates of PFO and PFO with different diameters were compared.Results There was significant difference in the positive detection rate of PFO between the three methods(χ^(2)=13.216,P<0.05).The positive rates of cTTE,TEE and TTE were 96.97%,86.36%and 81.82%respectively.The detection rates of cTTE and TEE in patients with PFO≥3 mm were 100%,and TTE was 71.43%.The detection rates of cTTE,TTE and TEE in patients with 2 mm≤PFO<3 mm were 92.86%,28.57%and 100.00%respectively(χ^(2)=9.376,P<0.05).The detection rates of cTTE,TTE and TEE in patients with PFO<2 mm were 97.78%,26.67%and 80.00%respectively(χ^(2)=8.597,P<0.05).The positive predictive value,negative predictive value,sensitivity and specificity of cTTE in the diagnosis of PFO were 0.912,0.854,0.960 and 0.750,TTE were 0.885,0.774,0.840 and 0.563,TEE were 0.908,0.832,0.920 and 0.625,respectively(χ^(2)=6.321,5.881,6.234,5.218,P<0.05).Conclusion Both cTTE and TEE have high application value in patients with patent foramen ovale.However,cTTE has simple operation and low requirements for instruments and equipment,which is more worthy of popularization and application in grass-roots hospitals.

关 键 词：卵圆孔未闭 右心声学造影 经食管超声心动图 经胸超声心动图 

分 类 号：R814.43[医药卫生—影像医学与核医学]