右心声学造影对隐源性脑卒中青年患者卵圆孔未闭右向左分流的诊断效果研究  

Study on the Diagnostic Effect of Right Heart Acoustic Contrast Echocardiography on Right to Left Shunting of Patent Foramen Ovale in Young Patients with Cryptogenic Stroke

作　　者：姜社甜 闫卫 张娜 雷媛媛 马少增 刘杰 李圆圆 JIANG Shetian;YAN Wei;ZHANG Na;LEI Yuanyuan;MA Shaozeng;LIU Jie;LI Yuanyuan(Department of Ultrasound Medicine,Zhumadian Central Hospital,463000,China;Department of Neurology,Zhumadian Central Hospital,463000,China)

机构地区：[1]驻马店市中心医院超声医学科,河南驻马店463000 [2]驻马店市中心医院神经内科,河南驻马店463000

出　　处：《临床医学工程》2025年第4期366-369,共4页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20231014)。

摘　　要：目的探讨右心声学造影(c-TTE)对隐源性脑卒中青年患者卵圆孔未闭(PFO)右向左分流的诊断效果。方法选取2020年1月至2024年6月我院神经内科收治的76例隐源性脑卒中青年患者,均接受c-TTE和经颅多普勒发泡试验(c-TCD)检查,并以经食管超声心动图(TEE)诊断结果为金标准,分析两种检查方式对PFO右向左分流的诊断效能。结果c-TTE诊断PFO右向左分流阳性31例、阴性41例,c-TCD诊断PFO右向左分流阳性27例、阴性49例。c-TTE诊断PFO右向左分流的特异度为93.18%,与c-TCD的86.36%比较差异无统计学意义(P>0.05);c-TTE诊断PFO右向左分流的灵敏度、准确度分别为87.50%、90.79%,均明显高于c-TCD的65.63%、77.63%(P<0.05)。Kappa检验分析结果显示,c-TTE诊断PFO右向左分流与金标准的一致性较高(Kappa=0.810,P<0.001),c-TCD诊断PFO右向左分流与金标准的一致性中等(Kappa=0.531,P<0.001)。结论c-TTE对隐源性脑卒中青年患者PFO右向左分流的诊断效能高于c-TCD,在临床诊断中具有重要的价值。Objective To explore the diagnostic effect of right heart acoustic contrast echocardiography(c-TTE)in right to left shunting of patent foramen ovale(PFO)in young patients with cryptogenic stroke.Methods 76 young patients with cryptogenic stroke admitted to our neurology department from January 2020 to June 2024 were selected and given c-TTE and c-TCD.Taking the diagnostic results of transesophageal echocardiography(TEE)as the gold standard,the diagnostic efficacy for right to left shunting of PFO between the two examination methods was analyzed.Results 31 positive cases and 41 negative cases were diagnosed by c-TTE for right to left shunting of PFO,and 27 positive cases and 49 negative cases were diagnosed by c-TCD for right to left shunting of PFO.The diagnostic specificity of c-TTE for right to left shunting of PFO was 93.18%,which had no statistical difference with 86.36%of c-TCD(P>0.05).The diagnostic sensitivity and accuracy of c-TTE for right to left shunting of PFO were 87.50%and 90.79%,respectively,significantly higher than 65.63%and 77.63%of c-TCD(P<0.05).Kappa test analysis results showed that c-TTE in the diagnosis of right to left shunting of PFO had higher consistency with the gold standard(Kappa=0.810,P<0.001),while c-TCD in the diagnosis of right to left shunting of PFO had moderate consistency with the gold standard(Kappa=0.531,P<0.001).Conclusions The diagnostic efficacy of c-TTE for right to left shunting of PFO in young patients with cryptogenic stroke is higher than that of c-TCD,and it has important value in clinical diagnosis.

关 键 词：右心声学造影 隐源性脑卒中 卵圆孔未闭 右向左分流 诊断效能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]