[中风患者的右向左分流与房间隔瘤：一项经食管对比超声心动图研究]

[Right-to-left shunt and atrial septal aneurysm in stroke patients: a contrast transesophageal echocardiographic study].

作者信息

Kanda N, Yasaka M, Otsubo R, Nagatsuka K, Minematsu K, Yamaguchi T

机构信息

Department of Medicine, National Cardiovascular Center, Osaka, Japan.

出版信息

Rinsho Shinkeigaku. 1998 Mar;38(3):213-8.

PMID:9711116

Abstract

BACKGROUND

Transesophageal echocardiography (TEE) has been used to detect cardiac abnormalities including right-to-left shunt (RLS) and atrial septal aneurysm (ASA). The aim of this study was to elucidate frequency of RLS and ASA detected by contrast-TEE, and to evaluate the role of these abnormalities in stroke patients.

METHODS AND RESULTS

We investigated prevalence of RLS and ASA in 504 patients suspected of stroke by using TEE. (mean age 62 +/- 12 y.o., stroke 491, non-stroke 13). The RLS was detected in 64 patients (12.7%), in whom 49 patients (9.7%) had the patent foramen ovale (PFO). The ASA was demonstrated in 10 patients (2.0%), and accompanied well with the RLS (six of the 10, 60%). The prevalent ratios of the RLS (33.8%), the PFO (26.8%), and the ASA (11.3%) in 71 patients with embolic stroke (brain embolism or TIA) of unknown cause were significantly higher than those in the other 433 patients (9.2%, 6.9%, 0.5%, respectively, p < 0.0001). Multiple logistic regression analysis showed that both the PFO and the ASA were independent risk factors (odds ratio: 3.8: p = 0.0002 and 16.6: p = 0.0008, respectively) for embolic stroke of unknown cause.

CONCLUSION

It seems that the RLS, PFO and the ASA play a roll in developing embolic stroke of unknown cause.

摘要

背景

经食管超声心动图（TEE）已被用于检测包括右向左分流（RLS）和房间隔瘤（ASA）在内的心脏异常。本研究的目的是阐明经对比剂增强TEE检测到的RLS和ASA的发生率，并评估这些异常在中风患者中的作用。

方法与结果

我们使用TEE调查了504例疑似中风患者中RLS和ASA的患病率。（平均年龄62±12岁，中风患者491例，非中风患者13例）。64例患者（12.7%）检测到RLS，其中49例患者（9.7%）存在卵圆孔未闭（PFO）。10例患者（2.0%）显示有ASA，且与RLS密切相关（10例中有6例，60%）。71例病因不明的栓塞性中风（脑栓塞或短暂性脑缺血发作）患者中RLS（33.8%）、PFO（26.8%）和ASA（11.3%）的患病率显著高于其他433例患者（分别为9.2%、6.9%、0.5%，p<0.0001）。多因素logistic回归分析显示，PFO和ASA都是病因不明的栓塞性中风的独立危险因素（优势比分别为：3.8，p = 0.0002；16.6，p = 0.0008）。