经颅多普勒发泡试验联合经胸超声心动图声学造影在筛查卵圆孔未闭所致隐源性脑卒中的临床价值  

Clinical value of transcranial Doppler foam test combined with transthoracic echocardiography in screening for cryptogenic stroke caused by patent foramen ovale

作　　者：张珍[1] 杜敢琴[1] 段利科[2] ZHANG Zhen;DU Gan-qin;DUAN Li-ko(Neurology Department,The First Affiliated Hospital,Henan University of Science and Technology,Luoyang 450052,China;Ultrasound Department,The First Affiliated Hospital,Henan University of Science and Technology,Luoyang 450052,China)

机构地区：[1]河南科技大学第一附属医院神经内科,河南洛阳471000 [2]河南科技大学第一附属医院超声科,河南洛阳471000

出　　处：《实用医院临床杂志》2024年第2期90-94,共5页Practical Journal of Clinical Medicine

基　　金：河南省重大科技专项立项项目(编号:221100210500)。

摘　　要：目的探讨经颅多普勒发泡试验(c-TCD)联合经胸超声心动图声学造影(c-TTE)在筛查卵圆孔未闭(PFO)所致隐源性脑卒中(CS)的临床价值。方法169例CS患者均行c-TCD及c-TTE检查,分析c-TCD、c-TTE单独及联合对于PFO及阳性检出情况、对PFO的诊断效能及下右向左分流(RLS)分级情况的作用。结果与c-TCD比较,联合检测的静息阳性率升高(P<0.05),与c-TTE比较,联合检测的静息阳性率及Valsalva阳性率均升高(P<0.05)。联合诊断PFO的灵敏度及特异度均高于c-TCD、c-TTE单独诊断(P<0.05)。与c-TCD比较,联合检测对RLS 0级、I级的检出率降低,对RLSⅡ级、Ⅲ级的检出率升高(P<0.05),与c-TTE比较,联合检测对RLSⅢ级的检出率升高(P<0.05)。结论c-TCD联合c-TTE能够提高CS患者的PFO及PFO-RLS中大量分级的检出率,提高对PFO的诊断效能。Objective To explore the clinical value of transcranial Doppler foam test(c-TCD)combined with transthoracic echocardiography contrast acoustics(c-TTE)in screening for cryptogenic stroke(CS)caused by patent foramina ovale(PFO).Methods One hundred and sixty-nine with CS underwent the examination of c-TCD and c-TTE.The role of c-TCD and c-TTE alone and in combination on PFO positive detection and diagnostic efficacy of PFO as well as right-to-left shunt(RLS)levels was analyzed.Results Compared with c-TCD,the resting positive rate of the combination detection was higher(P<0.05).Compared with c-TTE,both resting and Valsalva positive rates of the combination detection were higher(P<0.05).The sensitivity and specificity of combined diagnosis of PFO were higher than that of c-TCD and c-TTE alone(P<0.05).Compared with c-TCD,the detection rate of RLS 0 and I levels was decreased while the detection rate of RLSⅡandⅢlevels was increased(P<0.05).Compared with c-TTE,the detection rate of RLSⅢlevel by the combination detection was increased(P<0.05).Conclusions c-TCD combined with c-TTE diagnosis can improve the detection rate of PFO in CS patients and the detection rate of middle to high levels of PFO-RLS.It also improves the diagnostic efficiency of PFO.

关 键 词：卵圆孔未闭 隐源性脑卒中 经颅多普勒发泡试验 经胸超声心动图声学造影 右向左分流 诊断 

分 类 号：R743.3[医药卫生—神经病学与精神病学]