195例正常人右向左分流发生率及特点的研究

【摘要】
目的 观察正常人不同年龄组右向左分流（right-to-left shunt,RLS）的发生率、分流量、分流类型,
以及比较两个年龄组RLS的特点。
方法 收集接受对比增强经颅多普勒超声（contrast-enhanced transcranial Doppler,cTCD）的正常人群
的临床资料。根据年龄将18～45岁纳入青年组,大于45岁纳入中年组。以肘前静脉注射激活的生理盐
水作为造影剂,结合Valsalva动作,行M模经颅多谱勒超声（power M-mode transcranial Doppler,mpTCD）
监测,诊断RLS并对分流量进行分级,分析不同分流量和分流类型（固有型和潜在型）在研究人群中
的分布特点。
结果 共195例正常人入组,RLS发生率为28.7%,其中小量分流39例（20%）。青年组RLS发生率为
28.9%（39/135）,中年组RLS发生率为28.3%（17/60）,两组RLS发生率及分流量分布差异无显著性,
且均以小量分流为主。固有型34例（60.7%）,潜在型22例（39.3%）。青年组固有型25例（64.0%）,潜
在型14例（35.9%）;中年组固有型9例（52.9%）,潜在型8例（47.1%）。组间分流类型差异无显著性。
结论 本研究所选人群中RLS发生率约为28.7%,且以小量分流者居多,青年人与中年人RLS发生率、
分流量、分流类型无差异。

Research of Incidence and Feature of Right-to-left Shunt in a Total of 195 Cases Normal Population

Objective To observe the incidence, shunt volume, shunt type of normal population, and compare RLS feature between two age groups. Methods Collect the clinical data of normal people who volunteered to undergo contrast-enhanced transcranial Doppler （cTCD）. They are classified into two groups：young group （18 to 45 years old） and middle age group （more than 45 years old）. Take the physiological saline activating via elbow intravenous injection as a contrast agent, and combine with Valsalva maneuver, diagnose RLS with mpTCD monitoring and grade the shunt volume. The distribution characteristics of different shunt volume and shunt type （the inherent and potential） in the study population were also analyzed. Results A total of 195 normal people were enrolled in our study, and RLS rate was 28.7%, with 39 cases as minor shunt （20%）. RLS rate in young group was 28.9%（39/135）, and RLS rate in middle age group 28.3%（17/60）. There were no statistical differences between two groups in RLS rate and shunt volume distribution, and minor shunts take a predominate percent in all those shunts. Thirty four cases were inherent type （60.7%）, and 22 cases potential type （39.3%）. In young group, 25 cases were inherent type （64.0%）, and 14 cases potential type （35.9%）;in middle age group, 9 cases were inherent type （52.9%）, and 8 cases potential type （47.1%）. There was no statistical difference between two groups in shunt type distribution. Conclusion The incidence of RLS in the selected population in our study is about 28.7%, and the minor shunt takes a predominate percent. There are no significant differences between young group and middle age group in RLS incidence, shunt volume and shunt type.