右心声学造影联合c-TCD在卵圆孔未闭RLS分级中的临床意义  

Clinical significance of right heart contrast echocardiography combined with c-TCD in RLS grading of patent foramen ovale

作　　者：赵洁 禹海贺 王辉 Zhao Jie;Yu Haihe;Wang Hui(Zhengzhou 460 Hospital,Henan Zhengzhou 450000;988th Hospital of the Joint Lo gistics Support Force,Henan Zhengzhou 450000;The Fifth People's Hospital of Zhengzhou,Henan Zhengzhou 450000)

机构地区：[1]郑州四六〇医院,河南郑州450000 [2]联勤保障部队第九八八医院,河南郑州450000 [3]郑州市第五人民医院,河南郑州450000

出　　处：《辽宁医学杂志》2024年第6期72-76,共5页Medical Journal of Liaoning

摘　　要：目的 探讨右心声学造影(c-TTE)联合经颅多普勒发泡试验(c-TCD)在卵圆孔未闭右向左分流(RLS)分级中的临床意义。方法 回顾性选取2021年5月—2023年5月我院神经内科收治的疑似PFO-RLS患者105例,所选病例均进行c-TTE、c-TCD及经食管超声心动图(TEE)检查,以TEE检查为“金标准”,将患者分为PFO-RLS组(73例)、非PFO-RLS组(32例)。比较c-TTE结果、c-TCD结果及联合检查与TEE检查结果,比较不同检查方式诊断效能,分析不同检查方式与TEE检查RLS分级结果的一致性。结果 以TEE检查为“金标准”,c-TTE诊断灵敏度为89.04%、特异度为96.88%、准确率为91.43%,c-TCD诊断灵敏度为86.30%、特异度为88.57%、准确率为88.57%,联合诊断灵敏度为98.63%、特异度为90.63%、准确率为96.19%;与c-TTE、c-TCD单独诊断相比,联合诊断灵敏度较高,漏诊率较低,且联合诊断RLS分级结果的一致性最佳(P<0.05)。结论 c-TTE、c-TCD联合应用可提高PFO-RLS诊断灵敏度,降低漏诊率,且对RLS分级的评估价值较高,值得临床推广应用。Objective To investigate the clinical significance of contrast echocardiography(c-TTE)combined with tran-scranial Doppler bubble test(c-TCD)in the classification of right-to-left shunt(RLS)in patients with patent foramen ovale(PFO).Methods A total of 105 patients with suspected PFO-RLS admitted to the Department of Neurology of our hospital from May 2021 to May 2023 were retrospectively selected.All the selected patients underwent c-TTE,c-TCD and transesophageal echocardiography(TEE),with TEE as the"gold standard".The patients were divided into PFO-RLS group(n=73)and non-PFO-RLS group(n=32).The results of c-TTE,c-TCD,combined examination and TEE examination were compared.The diagnostic efficacy of different examination methods was compared,and the consistency of RLS grading re-sults between different examination methods and TEE examination was analyzed.Results Taking TEE as the"gold stand-ard",the diagnostic sensitivity,specificity and accuracy of c-TTE were 89.04%,96.88%and 91.43%,and the diagnostic sensitivity,specificity and accuracy of c-TCD were 86.30%,88.57%and 88.57%.The sensitivity,specificity and accuracy of combined diagnosis were 98.63%,90.63%and 96.19%,respectively.Compared with c-TTE and c-TCD alone,the com-bined diagnosis had a higher sensitivity and a lower missed diagnosis rate,and the consistency of the combined diagnosis of RLS grading results was the best(P<0.05).Conclusion The combination of c-TTE and c-TCD can improve the diagnos-tic sensitivity of PFO-RLS,reduce the rate of missed diagnosis,and has a high evaluation value for RLS classification,which is worthy of clinical application.

关 键 词：右心声学造影 经颅多普勒发泡试验 卵圆孔未闭 右向左分流 

分 类 号：R541.1[医药卫生—心血管疾病]