介入封堵术治疗卵圆孔未闭合并偏头痛青年卒中临床疗效  

The clinical efficacy of interventional closure surgery on patent foramen ovale associated with migraine in young stroke patients

作　　者：于恺 刘静[1] 陈超[1] 李耀汝 姚磊[3] 张军[1] YU Kai;LIU Jing;CHEN Chao;LI Yao-ru;YAO Lei;ZHANG Jun(Department of Cardiology,Cangzhou Central Hospital,Cangzhou 061000,China;Department of Neurology,Cangzhou Central Hospital,Cangzhou 061000,China;Department of Ultrasound,Cangzhou Central Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市中心医院心血管内科,河北沧州061000 [2]沧州市中心医院神经内科,河北沧州061000 [3]沧州市中心医院超声科,河北沧州061000

出　　处：《临床军医杂志》2024年第6期585-588,共4页Clinical Journal of Medical Officers

基　　金：2020沧州市科技计划自筹经费项目(204106083)。

摘　　要：目的探讨介入封堵术治疗卵圆孔未闭(PFO)合并偏头痛青年卒中的临床疗效。方法选取自2019年7月至2021年12月就诊于沧州市中心医院的149例PFO合并偏头痛的青年卒中患者为研究对象。根据治疗方式不同将患者分为A组(n=79)和B组(n=70)。A组行常规治疗方法。B组行介入封堵术。记录两组患者治疗后2年的临床预后。分别于治疗前及治疗后6个月采用头痛影响测试量表(HIT-6)和视觉模拟评分(VAS)进行头痛评价,比较两组患者血清纤维蛋白原、D-二聚体和血同型半胱氨酸(Hcy)水平。结果B组患者治疗后2年短暂性脑缺血发生率、脑血管事件发生率均低于A组,差异均有统计学意义(P<0.05)。两组患者治疗后6个月HIT-6评分、VAS评分均降低,且B组低于A组,差异有统计学意义(P<0.05)。B组治疗后6个月纤维蛋白原、D-二聚体、Hcy水平低于A组,差异有统计学意义(P<0.05)。结论介入封堵治疗可降低PFO合并偏头痛的青年卒中患者卒中复发风险,改善头痛症状,且能降低血清纤维蛋白原和D-二聚体水平,同时降低血Hcy水平,改善临床预后。Objective To investigate the clinical effect of interventional closure in the treatment of patent foramen ovale(PFO)with migraine in young apoplexy.Methods A total of 149 young stroke patients with PFO complicated with migraine admitted to Cangzhou Central Hospital from July 2019 to December 2021 were selected as the study objects.The patients were divided into group A(n=79)and group B(n=70)according to different treatment methods.Group A received conventional treatment.Group B underwent interventional closure.Clinical outcomes within 2 years after treatment were recorded in both groups.Headache impact test-6(HIT-6)and visual analogue scale(VAS)were used to evaluate headache before and 6 months after treatment,respectively.Serum fibrinogen,D-dimer and blood homocysteine(Hcy)levels were assessed before and 6 months after treatment.Results The incidence of transient cerebral ischemia and cerebrovascular events 2 years after treatment in group B was lower than that in group A,and the differences were statistically significant(P<0.05).The HIT-6 score and VAS score of two groups were decreased 6 months after treatment,and group B was lower than group A,the difference was statistically significant(P<0.05).The levels of fibrinogen,D-dimer and Hcy in group B were lower than those in group A 6 months after treatment,and the differences were statistically significant(P<0.05).Conclusion Interventional closure treatment can reduce the risk of stroke recurrence in young patients with PFO,alleviate headache symptoms,and decrease levels of serum fibrinogen,D-dimer,and homocysteine,thus improving clinical outcomes.

关 键 词：介入封堵术 卵圆孔未闭 青年卒中 偏头痛 临床疗效 

分 类 号：R742[医药卫生—神经病学与精神病学] R541[医药卫生—临床医学]