经食管超声心动图联合右心声学造影诊断成人卵圆孔未闭及分级的价值研究  

Diagnostic value of transesophageal echocardiography combined with contrast transthoracic echocardiography for patent foramen ovale and its grading in adults

作　　者：罗欣 徐艳 聂金花 彭喜华 李志强 LUO Xin;XU Yan;NIE Jinhua;PENG Xihua;LI Zhiqiang(Department of Functional,Yichun People's Hospital,Jiangxi Province,Yichun 336000,China)

机构地区：[1]江西省宜春市人民医院功能科,江西宜春336000

出　　处：《中国当代医药》2024年第9期33-35,39,共4页China Modern Medicine

基　　金：江西省宜春市科技计划项目(2022ZDJH6118)。

摘　　要：目的 分析经食管超声心动图(TEE)联合右心声学造影(cTTE)联合对成人卵圆孔未闭(PFO)及分级的诊断价值。方法 选择2022年1月至10月宜春市人民医院收治的60例不明原因脑卒中、偏头痛、胸闷患者作为研究对象,均行cTTE和TEE检查。以手术结果作为金标准,分析TEE联合cTTE诊断PFO的效能;比较TEE联合cTTE检出PFO中最大直径;比较确诊PFO患者经TEE联合cTTE检查在不同状态下PFO-右向左分流(RLS)分级确诊率。结果 60例研究对象经手术确诊PFO患者52例,以手术结果作为金标准,TEE联合cTTE诊断PFO的敏感度和特异度为90.38%和87.50%,Kappa值为0.643,具有较好的一致性。52例确诊PFO患者在Vasalva状态下,TEE联合cTTE检出PFO-RLS分流量Ⅰ级、Ⅱ级、Ⅲ级与静息状态下比较,差异无统计学意义(P>0.05)。结论TEE联合cTTE能有效诊断PFO和PFO-RLS分级,对诊断PFO并指导下一步的治疗具有重要的价值。Objective To analyze the diagnostic value of transesophageal echocardiography(TEE)combined with contrast transthoracic echocardiography(cTTE)for patent foramen ovale(PFO)and its grading in adults.Methods A total of 60 pa-tients with unexplained stroke,migraine and chest distress admitted to Yichun People's Hospital were enrolled as the re-search objects between January and October 2022.All underwent cTTE and TEE.Taking surgical results as the golden standard,the diagnostic efficiency of TEE combined with cTTE for PFO was analyzed.The maximum diameter of PFO by TEE combined with cTTE,and PFO right-to-left shunt(RLS)grading in PFO patients under different states were compared.Results In the the 60 research objects,surgical results showed that there were 52 cases with PFO.Taking surgical results as the golden standard,sensitivity,specificity and Kappa value of TEE combined with cTTE in the diagnosis of PFO were 90.38%,87.50%and 0.643,showing good consistency.In 52 patients with confirmed PFO in Vasalva state,TEE combined with cTTE detected PFO-RLS grade I,II and II shingles compared with resting state,there was no significant difference(P>0.05).Conclusion TEE combined with cTTE can effectively diagnose PFO and PFO-RLS grading,which has great value in the diagnosis of PFO and guidance of the next treatment.

关 键 词：右心声学造影 经食管超声心动图 卵圆孔 诊断价值 

分 类 号：R541[医药卫生—心血管疾病]