经颅多普勒超声在不明原因缺血性脑卒中的应用研究

目的探讨经颅多普勒超声(transcranial Doppler,TCD)技术结合生理盐水发泡试验在不明原因缺血性脑卒中患者卵圆孔未闭(PFO)筛查中的应用价值。方法收集51例55岁以下不明原因缺血性脑卒中患者,行TCD结合生理盐水发泡试验和经胸超声心动图(TTE)检查。结果 51例患者中,23例患者TCD检查栓子信号阳性,其中18例患者TTE检查发现PFO,而在28例TCD检查栓子信号阴性的患者中未发现PFO;TCD检查阳性患者中偏头痛发病率、合并下肢深静脉血栓比例以及房间隔瘤比例较阴性者高(P<0.05)。结论 TCD结合生理盐水发泡试验是筛查PFO的有效手段,可以作为不明原因缺血性脑卒中病因筛查的手段。

The walue of transcranial Doppler in assessing patent foramen ovale in cryptogenic stroke patients

Objective To evaluate transcranial Doppler(TCD) with antecubital administration of agitated saline contrast on the diagnosis patent foramen ovale(PFO) in cryptogenic stroke patients. Methods Fifty-one patients(less than 55 years old) with cryptogenic stroke were collected.PFO was detected by transthoracic echocardiography(TTE)and TCD.Clinically significant secondary right-to-left shunt(RLS) was defined on TCD with antecubital administration of agitated saline contrast. Results 28 of 51 patients showed negative signals in TCD detection and no PFO was detected by TTE.23 patients showed positive signals in TCD detection,and 18 of the 23 patients had PFO revealed by TTE.The incidence rates of migraine,arial septal aneurysm and deep vein thrombosis in lower limbs were higher in patients with positive TCD signal(P<0.05). Conclusions TCD with agitated saline contrast is sensitive in detecting a patent foramen ovale,it may be an effective screening technique for detecting the pathogeny of cryptogenic stroke.