合并卵圆孔未闭的隐源性脑卒中患者的临床研究

摘要

Objective To investigate the relationship between patent foramen ovale and cryptogenic stroke and to explore the clinical features of CS with PFO and PFO effects of transcatheter closure on the prognosis of CS.Methods 70 patients with cryptogenic stroke underwent transthoracic echocardiography (c-TTE) were selected from July 2014 to October 2015.The patients were divided into non-PFO group(n=38) and PFO group (n=32) according to whether received the implementation of PFO closure,then divided PFO patients into blocking PFO patients(n=15) and non blocking PFO patients (n=17).The relevant clinical data were analyzed and compared.PFO patients were telephone followed-up whether have recurrence of stroke after 6 months of discharge.Results NIHSS score of PFO group (2.56 ± 1.44) was significantly lower than that of non-PFO group (6.23 ± 1.65)(P ＜0.01).PFO group without stroke risk factors was significantly higher than that of non-PFO group (P＜0.01).The rate of stroke recurrence in blocking PFO group patients was significantly lower than non-blocking PFO group (P＜0.05).Conclusion PFO has a close relationship with CS,and the incidence of recurrent stroke can be decreased by implementation of PFO closure.%目的 研究卵圆孔未闭(PFO)与隐源性脑卒中(CS)的关系,并探讨合并PFO的CS的临床特点及介入封堵术对其预后影响.方法 选取我院2014年7月至2015年10月收治的隐源性脑卒中患者70例,均行经胸超声心动图声学造影(c-TTE)后,分为PFO组32例和非PFO组38例;将PFO组患者分为PFO封堵组15例,PFO未封堵组17例,收集相关临床资料进行回顾性分析与比较;PFO组患者出院6个月后电话随访有无脑梗死复发.结果 本文CS患者的PFO患病率为45.71％.PFO组的美国国立卫生研究院卒中量表(NIHStroke Scale,NIHSS)评分为(2.56±1.44)分,低于非PFO组的(6.23±1.65)分(P＜0.01);非PFO组患者中合并其他脑卒中危险因素的比例高于PFO组(P＜0.01);PFO组患者脑梗死常为多发性(P＜0.05);PFO封堵组患者脑卒中复发率低于PFO未封堵组(P＜0.05).结论 PFO与CS的发生关系密切,PFO的介入封堵治疗可能会减少脑卒中复发.