成人非偏头痛症状与卵圆孔未闭的相关性研究  

On Relationship Between Non-migraine Symptoms and Patent Foramen Ovale in Adults

作　　者：杨捷[1] 冯新恒[1] 朱文迪 陈少敏[1] 钟征 刘志鹏 Yang Jie;Feng Xinheng;Zhu Wendi(Department of Cardiovascular Medicine,Peking University Third Hospital,Beijing 100191,China;不详)

机构地区：[1]北京大学第三医院心血管内科,北京100191 [2]北京大学医学部护理学院,北京100191

出　　处：《中国微创外科杂志》2025年第3期141-147,共7页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨成人非偏头痛症状与卵圆孔未闭(patent foramen ovale,PFO)的相关性。方法回顾分析我院心血管内科超声心动图室2024年2~12月经胸超声心动图右心声学造影(contrast transthoracic echocardiography,cTTE)检查患者的临床资料,根据症状分为偏头痛症状组(n=527)、非偏头痛症状组(包括不明原因的头晕、耳鸣、一过性听力减退、晕厥、肢体麻木、一过性视野缺损症状,n=144)和无症状对照组(n=87)。比较3组PFO阳性率、PFO阳性患者右向左分流(right to left shunt,RLS)的差异;多因素logistic回归分析PFO阳性的独立相关因素。结果偏头痛症状组、非偏头痛症状组和无症状对照组PFO阳性率分别为85.0%(448/527)、84.0%(121/144)和26.4%(23/87),3组差异有显著性(χ^(2)=153.434,P=0.000),偏头痛症状组和非偏头痛症状组PFO阳性率显著高于无症状对照组(均P=0.000)。592例诊断PFO,3组RLS分级差异有显著性(H=18.762,P=0.000),偏头痛症状组和非偏头痛症状组RLS分级显著高于无症状对照组(均P=0.000)。多因素logistic回归分析显示,年龄≤40岁(OR=2.221,95%CI:1.515~3.256,P=0.000)、偏头痛(OR=3.373,95%CI:2.322~4.899,P=0.000)、头晕(OR=2.499,95%CI:1.694~3.685,P=0.000)和肢体麻木(OR=1.981,95%CI:1.052~3.729,P=0.034)与PFO阳性独立相关。结论头晕、肢体麻木等非偏头痛症状与成人PFO相关,对这些症状的患者进行cTTE检查是必要的。Objective To explore the correlation between non-migraine symptoms and patent foramen ovale(PFO)in adults.Methods A retrospective analysis was conducted on clinical data of patients who underwent contrast transthoracic echocardiography in the echocardiography room of the department of cardiovascular medicine in our hospital from February to December 2024.The patients were divided into a migraine symptom group(n=527),a non-migraine symptom group(including unexplained dizziness,tinnitus,transient hearing loss,syncope,limb numbness,and transient visual field defect symptoms,n=144),and an asymptomatic control group(n=87)based on their symptoms.Differences in PFO positive rates and right to left shunting(RLS)in PFO positive patients among the three groups were compared.Multivariate logistic regression was used to identify independent factors associated with PFO.Results The PFO-positive rates were 85.0%(448/527),84.0%(121/144),and 26.4%(23/87)in the migraine,non-migraine,and control groups,respectively,with significant differences among the three groups(χ^(2)=153.434,P=0.000).Both migraine and non-migraine groups had significantly higher PFO-positive rates than the control group(both P=0.000).Among the 592 patients diagnosed with PFO,the degree of RLS differed significantly among the three groups(H=18.762,P=0.000).Migraine and non-migraine groups showed higher RLS degree than the control group(both P=0.000).Multivariate analysis identified that age less than or equal to 40(OR=2.221,95%CI:1.515-3.256,P=0.000),migraine(OR=3.373,95%CI:2.322-4.899,P=0.000),dizziness(OR=2.499,95%CI:1.694-3.685,P=0.000),and limb numbness(OR=1.981,95%CI:1.052-3.729,P=0.034)were independent factors associated with PFO.Conclusions Non-migraine symptoms including dizziness and limb numbness correlate with PFO in adults.Contrast transthoracic echocardiography is recommended for patients presenting with such symptoms.

关 键 词：卵圆孔未闭 偏头痛 非偏头痛症状 经胸超声心动图右心声学造影 

分 类 号：R74[医药卫生—神经病学与精神病学]