文章摘要
卵圆孔未闭的解剖特征与隐源性脑卒中的关系
The relationship between anatomical characteristics of patent foramen ovale and cryptogenic stroke
投稿时间:2025-06-17  
DOI:10.3969/j.issn.1000-0399.2026.05.003
中文关键词: 卵圆孔未闭  隐源性脑卒中  偏头痛  房间隔膨出瘤  封堵治疗
英文关键词: Patent foramen ovale  Cryptogenic stroke  Migraine  Atrial septal aneurysm  Occlusion therapy
基金项目:安徽省2024年度高等学校省级质量工程项目(编号:2024jyxm0710)
作者单位
王保存 230022 安徽合肥 安徽医科大学第一附属医院心脏大血管外科 
张成鑫 230022 安徽合肥 安徽医科大学第一附属医院心脏大血管外科 
葛圣林 230022 安徽合肥 安徽医科大学第一附属医院心脏大血管外科 
龚文辉 230022 安徽合肥 安徽医科大学第一附属医院心脏大血管外科 
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中文摘要:
      目的 分析卵圆孔未闭的解剖特征与隐源性脑卒中的相关性,以指导临床治疗。方法 回顾性分析2018年6月至2024年12月于安徽医科大学第一附属医院心脏大血管外科确诊的438例卵圆孔未闭患者资料,均经头颅CT和/或MRI诊断为隐源性脑卒中。所有患者均在全身麻醉下行超声引导经皮卵圆孔未闭封堵术。按照卵圆孔大小分为小型卵圆孔未闭(n=304)和中大型卵圆孔未闭(n=134),按静息状态有无右向左分流分为无分流(n=349)和有分流(n=89),根据右心声学造影分级分为Ⅱ级(n=74)和Ⅲ级(n=364),根据卵圆孔未闭类型分为普通型(n=318)和复杂型(n=120)。比较各组间隐源性脑卒中发生率的差异,探讨卵圆孔未闭的解剖因素与隐源性脑卒中的关系。结果 排除年龄、体质量差异,大小卵圆孔未闭、静息有无分流、右心声学造影Ⅱ/Ⅲ级、不同卵圆孔未闭类型的患者隐源性脑卒中发生率组间比较,差异均有统计学意义(P<0.05)。结论 中大型卵圆孔未闭、静息存在右向左分流、右心声学造影Ⅲ级、复杂型卵圆孔未闭患者的隐源性脑卒中发生率更高,更应该在早期进行干预治疗。
英文摘要:
      Objective To analyze the correlation between the anatomical characteristics of patent foramen ovale(PFO) and cryptogenic stroke, and to guide clinical treatment. Methods A retrospective analysis was conducted on the data of 438 patients with PFO diagnosed in the Department of Cardiovascular Surgery of the First Affiliated Hospital of Anhui Medical University from June 2018 to December 2024. All patients were diagnosed with cryptogenic stroke by head CT and/or MRI. All patients underwent ultrasound-guided percutaneous PFO closure under general anesthesia. According to the size of the foramen ovale, they were divided into the small PFO(n=304) and medium to large PFO(n=134). According to the presence or absence of right-to-left shunt at rest, they were divided into the no shunt(n=349) and shunt group(n=89). According to the right heart contrast echocardiography grade, they were divided into the grade Ⅱ(n=74) and grade Ⅲ group(n=364). According to the type of PFO, they were divided into the common type(n=318) and complex type group(n=120). The differences in the incidence of cryptogenic stroke among the groups were compared, and the relationship between the anatomical factors of PFO and cryptogenic stroke was explored. Results After excluding the differences in age and body weight, the incidence of cryptogenic stroke was significantly different among patients with small and medium to large PFO, those with or without shunt at rest, those with grade Ⅱ and grade Ⅲ right heart contrast echocardiography, and those with common and complex types of PFO(P<0.05). Conclusion Patients with medium to large PFO, right-to-left shunt at rest, grade Ⅲ right heart contrast echocardiography, and complex type PFO have a higher incidence of cryptogenic stroke, thus intervention and treatment should be carried out earlier.
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