摘要
据估算,约1/4的成人存在卵圆孔未闭(PFO)。长期以来认为PFO不会造成临床后果。近年来,越来越多的研究发现,PFO患者发生脑卒中、偏头痛、外周动脉栓塞、减压病等风险较正常人群呈数倍升高,其致病作用才引起了广大专家和学者的关注。经皮PFO封堵术安全、有效,但PFO人群基数大,为规范PFO封堵术的临床应用,在借鉴国内外最新研究的基础上,结合我国具体情况,国内本领域专家形成了《卵圆孔未闭处理策略中国专家建议》,以供参考。
Patent foramen ovale （PFO） is a common development anomaly that allows for the passage of blood and other substances from the right-sided （venous） to the left （arterial） circulation. During recent years, the pathogenic effects of PFO have aroused the attention of experts and scholars. PFO is associated with eryptogenic stroke, migraine and platypnea orthodeoxia syndrome, but uncertainty remains about the exact relationship and the best management. Percutaneous closure of PFO is safe and effective, and this procedure has been definitely proven to be better than medical therapy. Paradoxical embolism is a rare event occurring over decades rather than years. None of the 4 randomized trials published carried enough patients or was followed up for long enough to reach superiority endpoints. All data, however, point to a benefit of PFO closure. They are outweighed by the sup y prevented events of paradoxical embolisms, such as stroke, transient ischemic attacks, or other systemic embolisms. Medical treatment with perhaps the exception of lifelong oral anticoagulation provides less protection. A 10-year follow-up of a comparative study reports that the annual mortality in the patients with PFO closure （0.4%） is significantly lower than that in those with medical treatment （ 1.1%, P 〈0. 05）. However, the evidence-based research is still controversia.
出处
《心脏杂志》
CAS
2015年第4期373-379,共7页
Chinese Heart Journal
关键词
卵圆孔未闭
封堵
卒中
patent foramen ovale
cryptogenic stroke
transcatheter closure
