卵圆孔未闭所致急性脑梗死患者人口学特征、临床及影像学等特征分析

doi:10.3969/j.issn.1004-583X.2023.06.003

摘要/Abstract

摘要：

目的分析卵圆孔未闭导致脑梗死患者的人口学特征、临床及影像学特征等方面的特点。方法收集汇总2020年6月29日至2022年6月15日住院的120例由PFO导致脑梗死患者的临床资料,包括其人口学特征(年龄,性别)、NIHSS评分、血清化验指标、影像学显示病灶(病灶位置分布,个数、病灶体积)等,并同时回顾性收集同时期的120例无卵圆孔未闭脑梗死患者的上述各项资料,并将二者的上述数据进行比较分析。结果 PFO所致脑梗死患者较非PFO所致脑梗死患者年龄整体偏小[(66.00±13.75)岁 vs (71.50±10.75)岁, P <0.05]、 N1HSS评分相对较低[(5.08±3.78) 分 vs (6.89±4.29)分, P <0.05]、血清同型半胱氨酸(homocysteine, Hey)值更高[(11.98±5.74) μmol/L vs (10.04±4.40) μmol/L, P <0.05]。头颅影像学特点方面, PFO所致脑梗死组中, 病灶位于后循环者所占比例、小病灶(梗死灶<10 mm)所占比例均高于非PFO所致脑梗死组( P <0.05) 。结论与非PFO所致脑梗死相比,PFO所致脑梗死多发生在后循环,以小梗死灶为主,症状程度相对较轻,发病年龄相对较小。

关键词: 卵圆孔, 未闭, 脑梗死, 隐源型卒中, 右向左分流

Abstract:

Objective To analyze the demographic, clinical and imaging characteristics of patients with acute cerebral infarction(ACI) caused by patent foramen ovale(PFO). Methods From June 29, 2020 to June 15, 2022, the clinical data including their demographic characteristics (age, sex), the National Institutes of Health Stroke Scale (NIHSS) scores, serum laboratory indicators, imaging lesions (location, number and volume of lesions) were collected form 120 ACI patients with cerebral infarction caused by PFO and 120 ACI patients without PFO.The above data of the two were assessed. Resultss The ACI patients with PFO has significantly younger age ([66.00±13.75] vs [(71.50±10.75)], P <0.05), lower the NIHSS score([5.08±3.78]vs [6.89±4.29], P <0.05) and higher the serum homocysteine (Hcy) value([11.98±5.74] μmolL vs [10.04±4.40 ] μmolL, P <0.05) than those without PFO. In brain imaging, the proportion of lesions in the posterior circulation territory and the numbers of small lesions (infarct≤10mm) in ACI patients with PFO were significantly higher than those without PFO( P <0.05).Conclusion Compared with those without PFO, ACI patients with PFO mostly occurs lesions in the posterior circulation territory, and they has mainly small infarcts, relatively mild symptoms and relatively younger onset age.

Key words: foramen ovale, patent, brain infarction, cryptogenic stroke, right-to-left shunt

中图分类号:

R541.1

张学谦, 李阳, 徐国栋, 吕佩源. 卵圆孔未闭所致急性脑梗死患者人口学特征、临床及影像学等特征分析[J]. 临床荟萃, 2023, 38(6): 500-503.

Zhang Xueqian, Li Yang, Xu Guodong, Lyu Peiyuan. Analysis of demographic, clinical and imaging in patients with acute cerebral infarction caused by patent foramen ovale[J]. Clinical Focus, 2023, 38(6): 500-503.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2023.06.003

https://huicui.hebmu.edu.cn/CN/Y2023/V38/I6/500

图/表 3

表1 两组临床基线资料比较

Tab.1 Comparison of clinical baseline data between groups

组别	例数	性别[例(%)]		年龄 (岁)
组别	例数	男	女	年龄 (岁)
PFO致脑梗死组	120	74(61.7)	46(38.3)	66.00±13.75
非PFO致脑梗死组	120	69(57.5)	51(42.5)	71.50±10.75
$t$ /χ²值		0.433		4.087
$P$ 值		0.511		0.000

表1 两组临床基线资料比较

Tab.1 Comparison of clinical baseline data between groups

组别	例数	性别[例(%)]		年龄 (岁)
组别	例数	男	女	年龄 (岁)
PFO致脑梗死组	120	74(61.7)	46(38.3)	66.00±13.75
非PFO致脑梗死组	120	69(57.5)	51(42.5)	71.50±10.75
$t$ /χ²值		0.433		4.087
$P$ 值		0.511		0.000

表2 两组神经功能缺损程度及血清Hcy水平比较($\bar{x}±s$)

Tab.2 Comparison of NIHSS and Hcy level between groups($\bar{x}±s$)

组别	例数	入院时NIHSS评分 (分)	血同型半胱氨酸 (μmol/L)
PFO致脑梗死组	120	5.08±3.78	11.98±5.74
非PFO致脑梗死组	120	6.89±4.29	10.04±4.40
$t$ 值		3.478	2.94
$P$ 值		0.001	0.004

表2 两组神经功能缺损程度及血清Hcy水平比较($\bar{x}±s$)

Tab.2 Comparison of NIHSS and Hcy level between groups($\bar{x}±s$)

组别	例数	入院时NIHSS评分 (分)	血同型半胱氨酸 (μmol/L)
PFO致脑梗死组	120	5.08±3.78	11.98±5.74
非PFO致脑梗死组	120	6.89±4.29	10.04±4.40
$t$ 值		3.478	2.94
$P$ 值		0.001	0.004

表3 两组临床影像学特点比较[例(%)]

Tab.3 Comparison of clinical imaging between groups[cases(%)]

组别	例数	梗死部位		梗死灶大小
组别	例数	位于前循环	位于后循环	>10 mm	≤10 mm
PFO致脑梗死组	120	44(36.7)	76(63.3)	41(34.1)	79(65.8)
非PFO致脑梗死组	120	62(51.7)	58(48.3)	56(46.7)	64(53.3)
χ²值		5.475		3.893
$P$ 值		0.013		0.033

表3 两组临床影像学特点比较[例(%)]

Tab.3 Comparison of clinical imaging between groups[cases(%)]

组别	例数	梗死部位		梗死灶大小
组别	例数	位于前循环	位于后循环	>10 mm	≤10 mm
PFO致脑梗死组	120	44(36.7)	76(63.3)	41(34.1)	79(65.8)
非PFO致脑梗死组	120	62(51.7)	58(48.3)	56(46.7)	64(53.3)
χ²值		5.475		3.893
$P$ 值		0.013		0.033

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