不明原因缺血性脑卒中患者卵圆孔未闭和主动脉粥样硬化斑块的对比研究

目的 应用经食管超声心动图(TEE)探查卵圆孔未闭(PFO)及主动脉内粥样硬化复杂斑块(CA)并分析PFO及CA在不同年龄组与特发性缺血性脑卒中(CIS)的关系,寻找CIS的原因.方法 研究对象包括经TEE检查的229例CIS患者为病例组;314例无脑卒中病史但行TEE的患者作为对照组.对比分析这两组患者的不同年龄组PFO及主动脉内不同部位CA的发生率.结果 (1)与对照组相比,CIS患者的PFO发生率在年龄＜55岁及≥55 岁患者中均明显增高.(2)CA的发生率在年龄＜55岁及≥55 岁中差别均不明显.(3)多元回归分析显示 PFO 与2个年龄组CIS的发生均独立相关.结论 在导致CIS的可能致病因素中卵圆孔未闭较主动脉复杂斑块更有预测意义,而TEE检查是CIS病因诊断的可行手段.

The Comparison of Patent Foramen Ovale and Aortic Atherosclerosis in Patients with Cryptogenic Cerebral Ischemic Stroke

Objective To investigate the relationship of patent foramen ovale(PFO)and complex atheromas(CA)in the ascending aorta and aortic arch detected by transesophageal echocardiography(TEE)in different age groups with Cryptogenic ischemic stroke(CIS).Methods TEEs in 229 consecutive patients with CIS(CIS group)were compared to TEEs in 314 patients with valve disease or endocarditis but without history of stroke(control group).The prevalence of PFO and CA in the ascending and aortic arch was determined in all patients and compared between CIS and control patients in different age.Results The prevalence of PFO was significantly higher in patients with CIS than that in control patients aged <55 and ≥55 yrs.The prevalence of CA was similar in both groups.Multivariate analysis showed that PFO was independently related with CIS in the two groups.Conclusions We found a significant relationship between PFO and CIS both in younger(<55 yrs)and older(≥55 yrs)patients.CA in the ascending aorta and aortic arch did not appear to be related with CIS.TEE is a useful method in examining CIS.