有症状和无症状卵圆孔未闭患者经食管超声心动图特征比较*

Assessment of morphology of patent foramen ovale with transesophageal echocardiography in symptomatic and asymptomatic patients*

摘要:

目的 比较有症状和无症状卵圆孔未闭患者经食管超声心动图的特征。方法 选取2018年1月—12月在郴州市第一人民医院就诊的有症状的卵圆孔未闭患者（隐源性卒中或短暂性脑缺血发作）64例（有症状组）和无症状的卵圆孔未闭患者（经食道超声心动图偶然发现卵圆孔未闭）92例（无症状组）。患者年龄均<55岁。比较两组患者的临床和人口学特征，并评估卵圆孔形态学特征，包括卵圆孔高度和长度、间隔偏移距离、原发间隔和继发间隔厚度。结果 有症状组与无症状组比较，卵圆孔高度（3.0±0.7）mm vs （2.1± 0.4）mm，继发隔厚度（6.1±1.2） mm vs （3.4±0.9）mm和间隔偏移距离（8.3±1.2）mm vs （4.2±1.3） mm均增加（P?<0.05）。两组患者卵圆孔长度和原发间隔厚度差异无统计学意义（P?>0.05）。与无症状组患者比较，有症状组患者长/高比值（3.1±0.4） mm vs （5.8±1.1） mm较小（P?<0.05）。结论 卵圆孔较高、间隔活动度较高、继发隔较厚有助于对<55岁的卵圆孔未闭患者隐源性卒中或短暂性脑缺血发作发生风险进行分层。

Abstract:

Objective To compare the characteristics of transesophageal echocardiography in symptomatic (history of cryptogenic stroke or transient ischemic attack) and asymptomatic patients with patent foramen ovale. Methods Symptomatic patients (with cryptogenic stroke or TIA) with PFO and asymptomatic patients with PFO who were incidentally diagnosed by transesophageal echocardiography were enrolled to this retrospective study in the condition that they were aged younger than 55 years. Not only the clinical and demographic characteristics of 2 groups were compared, but also their morphological features including the length and height of tunnel, atrial septal excursion distance, thickness of septum primum, and thickness of septum secundum. Results The height of PFO (3.0 ±?0.7)?mm VS (2.1?±?0.4)?mm, thickness of septum secundum (6.1?±?1.2)?mm VS (3.4?±?0.9)?mm, and septal excursion distance (8.3?±?1.2) mm VS (4.2?±?1.3) mm, were found to be greater in the symptomatic group than those in the asymptomatic group (P??0.05). The ratio of length to height of PFO tunnel was less in the symptomatic group (3.1?±?0.4)?mm VS (5.8?±?1.1)?mm, (P?