引用本文:陈文鑫,黄妙珊,陈汉杰,吴学良,张泽微,李 鑫,方洪明.经颅多普勒超声发泡试验与经胸心脏超声心动图检查对中青年隐源性卒中卵圆孔未闭诊断价值比较[J].中国临床新医学,2018,11(3):234-237.
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经颅多普勒超声发泡试验与经胸心脏超声心动图检查对中青年隐源性卒中卵圆孔未闭诊断价值比较
陈文鑫,黄妙珊,陈汉杰,吴学良,张泽微,李 鑫,方洪明
515300 广东,普宁市人民医院神经内科(陈文鑫,黄妙珊,陈汉杰,吴学良,李 鑫,方洪明),B超科(张泽微)
摘要:
[摘要] 目的 比较经颅多普勒超声(transcranial doppler,TCD)发泡试验与经胸心脏超声心动图(transthoracic echocardiography,TTE)检查中青年隐源性卒中(cryptogenic ischemic stroke,CS)的价值。方法 选取普宁市人民医院2015-08~2017-08依据TOAST分型诊断鉴别为隐源性卒中患者110例,年龄18~60岁,对比患者TCD发泡试验、TTE结果阳性率及患者一般资料特征、卒中危险因素、影像学特点。结果 TCD发泡试验卵圆孔未闭(PFO)的阳性检出率(44.5%)与TTE的阳性检出率(31.8%)差异明显;随PFO程度加重两种方法检出率均逐渐增高。TCD发泡试验阴性者年龄与阳性者无明显差异(P>0.05),发病原因多为高血压与高胆固醇及吸烟。阳性患者与阴性患者相比并无明显的传统致脑卒中疾病危险原因;TCD发泡试验阳性患者与阴性患者梗死病灶血管分布无明显差异,阳性患者梗死病灶多发于皮层或皮层下区域,而阴性患者则多发于深部灰质区域。结论 TCD发泡试验能够较好检测出PFO导致的中青年隐源性卒中,阳性病灶多位于皮层或皮层下区域,对卒中病因诊断具有重要价值。
关键词:  经颅多普勒超声发泡试验  卵圆孔未闭  隐源性卒中  中青年
DOI:10.3969/j.issn.1674-3806.2018.03.07
分类号:R 741
基金项目:揭阳市医学科学技术研究课题(编号:201767)
Comparison of transcranial Doppler(TCD) foam test and transthoracic echocardiography in diagnosis of cryptogenic ischemic stroke in middle-aged and young patients
CHEN Wen-xin, HUANG Miao-shan, CHEN Han-jie, et al.
Department of Neurology, the People′s Hospital of Puning City, Guangdong 515300, China
Abstract:
[Abstract] Objective To compare transcranial Doppler(TCD) foam test and transthoracic echocardiography(TTE) in diagnosis of cryptogenic ischemic stroke(CS) in middle-aged and young patients.Methods 110 patients(aged 18 to 60 years old) with cryptogenic ischemic stroke in our hospital from August 2015 to August 2017 were selected according to the TOAST classification. The positive rate and the characteristics of general information and risk factors of stroke patients and imaging characteristics of TCD foaming test and TTE results were compared.Results The positive rate of TCD foaming test(44.5%) was significantly higher than that of TTE(31.8%). The detection rates of the two methods were gradually increased. There was no significant difference in age between the patients with negative TCD foaming test and those with positive result(P>0.05). High blood pressure, high blood cholesterol and smoking were the risk factors. The positive patients had no obvious stroke caused by traditional risk factors compared to those with negative result. There was no significant difference in vascular lesion distribution between the positive and negative infarction patients. The lesions in the patients with positive infarction mostly occurred in the cortex or subcortical region, while the lesions in the negative patients were prone to be in deep gray areas.Conclusion TCD foam test is better to find the cause of cryptogenic stroke in young and middle-aged patients with patent foramen ovale. The most of positive multiple lesions are in the cortical or subcortical regions, which has an important value in the etiological diagnosis of stroke.
Key words:  Transcranial Doppler(TCD) foam test  Patent foramen ovale  Cryptogenic stroke  Middle-aged and young people