| 经颅多普勒超声发泡试验筛查卵圆孔未闭致隐源性脑卒中的应用价值 |
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| 引用本文： | 毛樱,王芳,池菊芳,钟芳芳.经颅多普勒超声发泡试验筛查卵圆孔未闭致隐源性脑卒中的应用价值[J].中华全科医学,2022,20(6):1016-1018. |
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| 作者姓名： | 毛樱 王芳 池菊芳 钟芳芳 |
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| 作者单位： | 1.绍兴市人民医院特殊检查室，浙江 绍兴 312000 |
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| 基金项目： | 浙江省卫生健康科技计划项目2021KY360 |
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| 摘 要： | 目的 分析经颅多普勒超声发泡试验(C-TCD)筛查卵圆孔未闭(PFO)致隐源性脑卒中(CS)的应用价值。 方法 选取2017年1月—2021年6月绍兴市人民医院收治的204例CS患者，所有患者均行C-TCD与经食管超声心动图(TEE)检查，比较其PFO阳性检出率；根据C-TCD的PFO检出情况，将阳性者纳入阳性组，阴性者纳入阴性组，分析阳性组患者的微气泡信号分级，比较2组患者的血管分布区影像特征(前循环、后循环、前后联合循环、大脑前动脉、大脑中动脉、椎基底动脉)及各区域影像学特征(皮层/皮层下区域、深部灰质区域、幕下区域)。 结果 C-TCD的PFO阳性检出率为55.39%(113/204)，高于TEE检查42.65%(87/204)，P＜0.05]。C-TCD检出PFO阳性113例，其中包括0级26例(23.01%)，Ⅰ级34例(30.09%)，Ⅱ级27例(23.89%)，Ⅲ级26例(23.01%)。阳性组与阴性组前循环、后循环、前后联合循环、大脑前动脉、大脑中动脉、椎基底动脉的分布比较差异无统计学意义(均P＞0.05)。阳性组皮层/皮层下区域的检出率为57.52%，高于阴性组的27.59%(P＜0.05)；阳性组深部灰质区域的检出率为22.12%，低于阴性组的40.23%(P＜0.05)；阳性组幕下区域的检出率为14.16%，与阴性组的16.09%相近(P＞0.05)。 结论 C-TCD在PFO致CS筛查中可发挥一定的作用，患者病变多分布于皮层/皮层下区域，可作为CS病因筛查手段。
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| 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 筛查 应用价值 |
| 收稿时间： | 2021-12-03 |
Application value of transcranial Doppler ultrasound foaming test in screening cryptogenic stroke caused by patent foramen ovale |
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| Affiliation: | Special Examination Room of Shaoxing People's Hospital, Shaoxing, Zhejiang 312000, China |
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| Abstract: | Objective To analyse the application value of transcranial Doppler ultrasound foaming test (C-TCD) in screening cryptogenic stroke (CS) caused by patent foramen ovale (PFO). Methods A total of 204 patients with CS treated in Shaoxing People's Hospital from January 2017 to June 2021 were examined by C-TCD and transoesophageal echocardiography (TEE), and the positive detection rate of PFO was compared. According to the PFO detection of C-TCD, the positive patients were included in the positive group, and the negative patients in the negative group. The microbubble signal classification of the patients in the positive group was analysed, and the imaging characteristics of the vascular distribution areas (anterior circulation, posterior circulation, combined anterior and posterior circulation, anterior cerebral artery, middle cerebral artery and vertebrobasilar artery) and each region were compared between the two groups. Results The positive rate of PFO in C-TCD was 55.39% (113/204), which was higher than that in TEE (42.65%, 87/204, P < 0.05). A total of 113 cases of PFO were positive in C-TCD, including 26 cases of grade 0 (23.01%), 34 cases of grade Ⅰ (30.09%), 27 cases of grade Ⅱ (23.89%) and 26 cases of grade Ⅲ (23.01%). There was no significant difference in the distribution of anterior circulation, posterior circulation, combined anterior and posterior circulation, anterior cerebral artery, middle cerebral artery and vertebrobasilar artery in the positive and negative groups (P>0.05). The detection rate of cortical/subcortical area in the positive group was 57.52%, which was higher than that in the negative group (27.59%), P < 0.05. The detection rate of deep grey matter in the positive group was 22.12%, which was lower than that in the negative group (40.23%), P < 0.05. The detection rate of infratentorial area in the positive group was 14.16%, which was close to that in the negative group (16.09%), P>0.05. Conclusion C-TCD has a certain application value in the screening of CS caused by PFO. Patients' lesions are mostly distributed in cortical/subcortical areas, which can be used as a means of screening the aetiology of CS. |
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