卵圆孔未闭患者发生神经系统合并症的相关性分析  

Neurological complications in patients with patent foramen ovale:a correlation analysis

作　　者：丁富霞 孙守刚[2] Ding Fuxia;Sun Shougang(Second Clinical Medical School,Lanzhou University,Lanzhou 730030,China;不详)

机构地区：[1]兰州大学第二临床医学院,兰州730030 [2]兰州大学第二医院心血管内科,兰州730030

出　　处：《中国循证心血管医学杂志》2025年第1期59-63,67,共6页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：甘肃省科技重点研发计划项目(22YF7FA088);兰州市人才创新创业项目(2023-1-30)。

摘　　要：目的探讨卵圆孔未闭(PFO)形态、孔径,右向左分流(RLS)级别、类型与PFO患者发生神经系统合并症之间的关系。方法回顾性分析279例PFO患者临床资料,根据患者是否合并偏头痛、脑卒中、不明原因晕厥等神经系统疾病将患者分为有合并症组(181例)和无合并症组(98例)。按规范采集研究对象的经胸超声心动图(TTE)/经食道超声心动图(TEE)、经颅多普勒超声发泡试验(cTCD),并收集患者临床资料,结合患者TTE/TEE、cTCD结果判断PFO形态、孔径,RLS级别、类型与神经系统合并症的关系。结果两组间年龄、性别、PFO孔径方面相比,无明显差异(P>0.05)。与无合并症组PFO患者相较,合并症组PFO患者复杂型PFO占比更大,RLS级别更高,且固有型RLS占比更大,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果表明复杂型PFO(OR=3.843,95%CI:2.176~6.787,P<0.001)、高级别RLS(OR=2.482,95%CI:1.499~4.109,P<0.001)、固有型RLS(OR=7.424,95%CI:3.369~16.361,P<0.001)是PFO患者发生神经系统合并症的独立危险因素,而PFO孔径与神经系统合并症没有相关性。结论复杂型PFO、高级别RLS、固有型RLS是PFO患者发生神经系统合并症的独立危险因素,而PFO孔径与神经系统合并症无关。Objective To investigate the relationship among morphology,pore diameter,grades of right-to-left shunt(RLS)and types of patent foramen ovale(PFO)and neurological complications in PFO patients.Methods The clinical materials from PFO patients(n=279)were retrospectively analyzed,and they were divided into groupwith complications(n=181)and group without complications(n=98)according to they had or not neurological complicationsincluding migraine,stroke and unexplained syncope.The image materials of transthoracic echocardiography(TTE),transesophageal echocardiography(TEE)and contrast-enhanced transcranial Doppler(cTCD),and clinical data were collected.The relationship among morphology,pore diameter,grades of RLS and types of PFO and neurological complications based on results of TTE/TEE and cTCD.Results The comparisons in age,gender and PFO pore diameter had no significant differences between 2 groups(P>0.05).The percentages of complex PFO,high RLS grade and inherent RLS were higher in group without complications than those in groupwith complications(P<0.05).The results of multi-factor Logistic regression analysis showed that complex PFO(OR=3.843,95%CI:2.176~6.787,P<0.001),high RLS grade(OR=2.482,95%CI:1.499~4.109,P<0.001)and inherentRLS(OR=7.424,95%CI:3.369~16.361,P<0.001)were independent risk factors for neurological complications,and PFO pore diameter was not correlated to neurological complications.Conclusion Complex PFO,high RLS grade and inherent RLS are independent risk factors for neurological complications,and PFO pore diameter is not correlated to neurological complications.

关 键 词：卵圆孔形态 卵圆孔孔径 右向左分流 卵圆孔未闭 神经系统合并症 

分 类 号：R541.1[医药卫生—心血管疾病]