经颅多普勒超声发泡试验检测在隐源性脑卒中卵圆孔未闭中的诊断价值  

Diagnostic value of transcranial Doppler ultrasound foam test in the diagnosis of patent foramen ovale in cryptogenic stroke

作　　者：李影 刘立斌 陈娜 王琳 李勃 刘佳 徐丽丽 杨海华 LI Ying;LIU Li-bin;CHEN Na(Department of Neurology,Daxing Teaching Hospital,Capital Medical University,Beijing 102600,China)

机构地区：[1]首都医科大学大兴教学医院神经内科,北京102600

出　　处：《临床和实验医学杂志》2025年第1期74-77,共4页Journal of Clinical and Experimental Medicine

基　　金：首都卫生发展科研专项项目(编号:首发2023-2Y-004);北京市大兴区人民医院科技项目(编号:4202132394)。

摘　　要：目的探讨经颅多普勒超声(TCD)发泡试验检测在隐源性脑卒中患者卵圆孔未闭(PFO)中的诊断价值。方法回顾性选取2018年7月至2024年7月首都医科大学大兴教学医院收治的100例不明原因型的青年隐源性脑卒中患者作为本次研究对象。所有患者均采用经食管超声心动图(TEE)及TCD发泡试验进行检查,分析两种检测方式对PFO患者的检出率,分析TCD发泡试验与TEE检测PFO患者阳性率分布情况,并对两种检测方式在PFO患者进行PFO右向左分流的半定量进行分析,采用受试者操作特征(ROC)曲线分析TCD发泡试验和TEE在PFO诊断的特异度与敏感度。结果TCD发泡试验对PFO的检出率为42.00%,TEE对PFO的检出率为23.00%;TCD发泡试验与TEE对PFO的检出率比较,差异有统计学意义(P<0.05)。TCD发泡试验检测的PFO中阳性患者42例,阴性患者58例,阳性率为42.00%;TEE检测的PFO中阳性患者23例,阴性患者77例,阳性率为23.00%;与TEE检测比较,TCD检测的PFO中阳性率较高,差异有统计学意义(P<0.05)。经ROC曲线分析,TCD发泡试验诊断PFO的曲线下面积为0.815,敏感度为90.16%,特异度为91.62%;TEE诊断PFO的曲线下面积为0.803,敏感度为82.16%,特异度为87.57%。在隐源性脑卒中患者合并PFO的诊断中,TCD发泡试验比TEE检测的诊断效能更高(P<0.05)。结论与TEE相比,TCD发泡试验对隐源性脑卒中患者PFO有更高的诊断价值,且操作简便,推荐其在临床检测中推广使用。Objective To explore the diagnostic value of transcranial Doppler(TCD)foam test in the diagnosis of patent foramen ovale(PFO)in patients with cryptogenic stroke.Methods A retrospective study was conducted on 100 young patients with cryptogenic stroke of unknown origin admitted to Daxing Teaching Hospital,Capital Medical University from July 2018 to July 2024.All participants were examined by trans esophageal echocardiography(TEE)and TCD foam test,and the detection rate of the two detection methods in PFO patients was analyzed,and the positive distribution of TCD foam test and TEE in PFO patients were analyzed,and the right-left shingles of PFO in PFO patients were semi-quantitatively analyzed by the two detection methods.The specificity and sensitivity of TCD foam test and TEE in PFO diagnosis was analyzed using receiver operating characteristic(ROC)curve.Results The detection rate of PFO by TCD foam test was 42.00%,and that by TEE was 23.00%.The detection rate of PFO by TCD foam test and TEE was statistically significant(P<0.05).PFO detected by TCD foam test was positive in 42 cases and negative in 58 cases,the positive rate was 42.00%.TEE detected 23 positive patients,77 negative patients,positive rate of 23.00%;compared with TEE detection,TCD detection of PFO positive rate was higher,the difference was statistically significant(P<0.05).The area under the curve of TCD foam test was 0.815,the sensitivity was 90.16%,and the specificity was 91.62%.The area under the curve of TEE for diagnosing PFO was 0.803,the sensitivity was 82.16%,and the specificity was 87.57%.In the diagnosis of cryptogenic stroke patients with PFO,the diagnostic efficiency of TCD foaming test was higher than that of TEE(P<0.05).Conclusion TCD is not only effective in the detection of PFO disease patients,but also easy to operate and has a high detection rate.It is recommended to be popularized in clinical detection.

关 键 词：经颅多普勒超声发泡试验 卵圆孔未闭 隐源性脑卒中 经食管超声心动图 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]