RoPE量表联合超声卵圆孔高危特征在隐源性卒中的应用  

Application of RoPE scale combined with ultrasonic high risk characteristics of foramen ovale in cryptogenic stroke

作　　者：贾志军[1] 廖书生[1] 徐翔翔 倪显达[1] JIA Zhijun;LIAO Shusheng;XU Xiangxiang;NI Xianda(Department of Ultrasound,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州医科大学附属第一医院超声科,浙江温州325000

出　　处：《中国现代医生》2023年第28期51-54,74,共5页China Modern Doctor

基　　金：温州市科技局基础性医疗卫生科技项目(Y2020824)。

摘　　要：目的探讨反常性栓塞风险(risk of paradoxical embolism,RoPE)量表联合多模态超声高危卵圆孔特征在隐源性卒中(cryptogenic stroke,CS)的应用价值。方法回顾性分析2021年1月至2022年5月温州医科大学附属第一医院确诊的卵圆孔未闭(patent foramen ovale,PFO)患者248例,根据脑部CT或磁共振成像结果,将诊断为不明原因卒中或短暂性脑缺血发作的患者纳入CS组(n=105),其余患者纳入非CS组(n=143)。采用多因素分析探讨PFO患者发生CS的超声影像特征,并与RoPE量表相结合建立综合评分。结果多因素Logistic回归分析显示,卵圆孔≥2mm、隧道长度≥8mm、原发隔高移动性、原发隔抖动、大量右向左分流(静息状态下)、合并永存下腔静脉瓣、左房间隔囊袋样结构均是PFO患者发生CS的独立危险因素(P<0.05)。综合评分诊断PFO患者发生CS的曲线下面积为0.872(95%CI:0.828~0.916),综合评分≥10分的PFO患者为CS的高危人群。结论RoPE量表联合多模态超声高危卵圆孔特征可用于CS病因的筛查与治疗方案的选择。Objective To explore application value of risk of paradoxical embolism(RoPE)scale combined with high risk foramina ovale characteristics of multimodal ultrasound in cryptogenic stroke(CS).Methods A retrospective analysis was performed on 248 patients with patent foramen ovale(PFO)diagnosed in the First Affiliated Hospital of Wenzhou Medical University from January 2021 to May 2022.Patients diagnosed with unexplained stroke or transient ischemic attack were included in CS group(n=105)and the remaining patients were included in non-CS group(n=143)based on brain CT or magnetic resonance imaging results.The ultrasonographic characteristics of CS in PFO patients were investigated by multivariate analysis,and the comprehensive score was established by combining with RoPE scale.Results Multivariate Logistic regression analysis showed foramen ovale≥2mm,tunnel length≥8mm,high septum primum mobility,septum primum jitter,large right to left shunt at rest,eustachian valve and left atrial septal pouch structure were all independent risk factors for CS in PFO patients(P<0.05).The area under the curve for CS in PFO patients diagnosed by comprehensive score was 0.872(95%CI:0.828-0.916),and PFO patients with comprehensive score≥10 points were high-risk groups for CS.Conclusion RoPE scale combined with high risk foramen ovale characteristics of multimodal ultrasound can be used for the etiology screening and treatment of CS.

关 键 词：反常性栓塞风险量表 多模态超声 卵圆孔未闭 隐源性卒中 

分 类 号：R541.1[医药卫生—心血管疾病]