卵圆孔未闭患者隐源性卒中的危险因素  

Risk factors for cryptogenic stroke in patients with patent foramen ovale

作　　者：刘燕燕 宋秀娟[1] 万林姗 张静[1] 马杰[2] 侯慧清[1] 王丽萍 迟冬雨 孙田新 张依格 Liu Yanyan;Song Xiujuan;Wan Linshan;Zhang Jing;Ma Jie;Hou Huiqing;Wang Liping;Chi Dongyu;Sun Tianxin;Zhang Yige(Department of Neurology,the Second Hospital of Hebei Medical University,Hebei Key Laboratory of Neurology,Shijiazhuang 050000,China;Department of Cardiovascular Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院神经内科,河北省神经病学重点实验室,石家庄050000 [2]河北医科大学第二医院心脏大血管外科,石家庄050000

出　　处：《国际脑血管病杂志》2022年第3期179-183,共5页International Journal of Cerebrovascular Diseases

基　　金：河北省医学科学研究课题计划(20211276)。

摘　　要：目的探讨卵圆孔未闭(patent foramen ovale,PFO)患者隐源性卒中(cryptogenic stroke,CS)的潜在危险因素。方法回顾性纳入2018年6月至2021年12月在河北医科大学第二医院心外科行PFO封堵治疗的患者。采用经食管超声心动图评估卵圆孔形态学特征和右向左分流(right to left shunt,RLS)。采用多变量logistic回归分析确定PFO患者CS的独立危险因素。结果共纳入203例PFO患者,年龄(41.9±14.3)岁,男性116例(57.1%);CS组102例,非卒中组101例。CS组年龄、体重指数、收缩压和舒张压以及男性、高血压、糖尿病、高脂血症和吸烟的患者构成比高于非卒中组,偏头痛患者比例低于非卒中组,差异均有统计学意义(P均<0.05);CS组PFO通道更长、更宽且更多合并静息RLS,差异均有统计学意义(P均<0.05)。多变量logistic回归分析显示,收缩压[优势比(odds ratio,OR)1.065,95%置信区间(confidence interval,CI)1.022~1.111;P=0.003]、PFO长度(OR 1.124,95%CI 1.004~1.258;P=0.043)以及静息RLS(OR 5.449,95%CI 2.283~13.004;P<0.001)是PFO患者CS的独立危险因素。结论收缩压、PFO长度以及存在静息RLS是PFO患者CS的独立危险因素。Objective To investigate the potential risk factors for cryptogenic stroke(CS)in patients with patent foramen ovale(PFO).Methods Patients underwent PFO closure in the Department of Cardiovascular Surgery,the Second Hospital of Hebei Medical University from June 2018 to December 2021 were enrolled retrospectively.Transesophageal echocardiography was used to evaluate the morphological characteristics of foramen ovale and right-to-left shunt(RLS).Multivariate logistic regression analysis was used to determine the independent risk factors for CS in patients with PFO.Results A total of 203 patients with PFO were enrolled.Their age was 41.9±14.3,and 116 patients(57.1%)were male.There were 102 patients in CS group and 101 patients in non-stroke group.The age,body mass index,systolic blood pressure and diastolic blood pressure,and the constituent ratios of male,hypertension,diabetes,hyperlipidemia and smoking of the CS group were significant higher than those of the non-stroke group(all P<0.05).The PFO channel of the CS group was longer,wider and more combined with resting RLS(all P<0.05).Multivariate logistic regression analysis showed that systolic blood pressure(odds ratio[OR]1.065,95%confidence interval[CI]1.022-1.111;P=0.003),PFO length(OR 1.124,95%CI 1.004-1.258;P=0.043)and resting RLS(OR 5.449,95%CI 2.283-13.004;P<0.001)were the independent risk factors for CS in patients with PFO.Conclusion Systolic blood pressure,PFO length and the presence of resting RLS are the independent risk factors for CS in patients with PFO.

关 键 词：卒中 卵圆孔 未闭 超声心动描记术 经食管 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R541.1[医药卫生—临床医学]