摘要
目的分析卵圆孔未闭(PFO)患者D-二聚体、右向左分流与隐源性脑卒中(CS)的相关性。方法回顾性分析武汉大学人民医院2021-05—2022-07收治的78例卵圆孔未闭患者,经c-TCD检查,其中CS组48例,非CS组30例。比较2组患者基本资料情况,统计分析PFO患者发生CS的危险因素。结果CS组入院时高D-二聚体者占29.17%,非CS组为6.67%(OR=5.346,95%CI:1.724~16.257,P=0.004);CS组中永久性右向左分流者占72.92%,非CS组为26.67%(OR=6.872,95%CI:2.517~16.053,P<0.001),差异均有统计学意义。CS组患者的吸烟比例29.17%(14/48)和高血压的比例31.25%(15/30)均高于非CS组的13.33%(4/48)和16.67%(5/30),差异有统计学意义(P<0.05),CS组患者的SBP为(132.31±15.74)mmHg,高于非CS组的(118.23±13.57)mmHg,且CS组患者E/A、D-dimer(高)、永久性RLS、大量RLS的比例均高于非CS组,差异均有统计学意义(P<0.05)。结论卵圆孔未闭患者处于高D-二聚体水平或合并永久性右向左分流是卵圆孔未闭患者发生隐源性脑卒中的独立危险因素,可增加缺血性脑卒中发生风险,对此类患者应及早进行脑卒中的预防。
Objective To analyze the correlation between D-dimer,right to left shunt and cryptogenic stroke(CS)in patients with patent foramen ovale(PFO).Methods A retrospective analysis was conducted on 78 patients with patent foramen ovale admitted to Renmin Hospital of Wuhan University from May 2021 to July 2022.After c-TCD examination,48 patients were selected as the CS group and 30 patients were selected as the non-CS group.The basic information of two groups were compared,statistical analysis on the collected data was conducted,and the risk factors for CS in PFO patients were identified.Results 29.17%of patients in the CS group had high D-dimer levels upon admission,compared to 6.67%in the non-CS group(OR=5.346,95%CI:1.724-16.257,P=0.004),72.92%of patients in the CS group had permanent right to left shunting,compared to 26.67%in the non CS group(OR=6.872,95%CI:2.517-16.053,P<0.001),and the differences were statistically significant.The smoking rate of patients in the CS group was 29.17%(14/48)and the proportion of hypertension was 31.25%(15/30),both higher than those in the non-CS group(13.33%(4/48)and 16.67%(5/30),respectively),with statistical significance(P<0.05).The SBP of patients in the CS group was(132.31±15.74)mmHg,which was higher than that in the non-CS group(118.23±13.57)mmHg.In addition,the proportion of E/A,D-dimer(high),permanent RLS,and large RLS in the CS group was higher than that in the non-CS group,with statistical significance(P<0.05).Conclusion Patients with patent foramen ovale who have high levels of D-dimer or permanent right to left shunting are independent risk factors for cryptogenic stroke and can increase the risk of ischemic stroke.Early prevention of stroke should be taken for such patients.
作者
王月
杨柳
张雨息
甘泉
肖哲曼
WANG Yue;YANG Liu;ZHANG Yuxi;GAN Quan;XIAO Zheman(Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《中国实用神经疾病杂志》
2025年第2期157-160,共4页
Chinese Journal of Practical Nervous Diseases
基金
国家自然科学基金项目(编号:81971055)。
