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cTTE联合TEE诊断卵圆孔未闭右向左分流的临床价值(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2017年第4期
页码:
455-459
栏目:
临床研究
出版日期:
2017-02-25

文章信息/Info

Title:
The clinical value of right to left shunt in patent foramen ovale by cTTE joint TEE
作者:
王 婧; 张小杉; 雪 梅; 胡燕华; 张 丹; 段莎莎
内蒙古医科大学附属医院超声科，内蒙古 呼和浩特 010050
Author(s):
WANG Jing;  ZHANG Xiao-shan;  XUE Mei;  HU Yan-hua;  ZHNAG Dan;  DUAN Sha-sha
Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia, China
关键词:
经胸超声心动图声学造影; 经食管超声心动图; 卵圆孔未闭; 右向左分流
Keywords:
transthoracic echocardiography contrast;  trans-esophageal echocardiography;  patent foramen ovale;  right to left shunt
分类号:
R541
DOI:
-
文献标识码:
A
摘要:
目的 应用胸超声心动图声学造影(cTTE)联合经食管超声心动图(TEE)检查，诊断卵圆孔未闭（PFO）引发右向左分流(RLS)的临床价值。方法 对246例临床疑似存反常栓塞的患者先行cTTE 检查观察并对比静息状态及Valsalva动作后RLS情况，并作分流程度的评估；对有RLS的患者再行TEE检查，观察PFO是否存在，测量PFO开放直径、观察PFO形态及其他伴随病变，最终明确PFO-RLS。对PFO-RLS病例组中PFO开放直径与RLS严重程度之间行关联性分析。结果 cTTE发现不同程度RLS 174例，无RLS 72例。Valsalva动作后比静息状态下RLS的检出率明显增高，差异有统计学意义（P< 0.01）。174例RLS患者TEE检出PFO患者163例，其中129例彩色多普勒存在房水平左向右分流，34例房水平分流不明显。163例PFO-RLS，PFO直径与RLS程度之间存在相关性，但呈低度关联（CP=0.34，P<0.05,）。结论 cTTE 能快速的发现房水平RLS并半定量判定分流程度，联合TEE可以清晰显示PFO形态及准确测量其开放直径，进而确诊PFO-RLS。PFO直径与RLS严重程度存在低度关联。
Abstract:
AIM Applicating contrast transthoracic echocardiography(cTTE) joint Trans-esophageal Echocardiography (TEE), evaluating the clinical value of right to left shunt (RLS) in patent foramen ovale (PFO). METHODS 246 cases who are paradoxical embolism, and suspected PFO in clinical were examined by cTTE, We observe RLS at the resting state and after Valsalva action, and assess the degree of shunt; Patients with RLS were examined again for TEE, presence of PFO, measurement of PFO open diameter, observation of PFO morphology and other concomitant lesions, To made clear RLS of PFO eventually. Made between the line correlation analysis Between the size of PFO and the severity of RLS in the PFO-RLS group. RESULTS cTTE found 174 examples who with different degrees of RLS, 72 cases without RLS. The detection rate of RLS is significantly higher After Valsalva action than at the resting condition, the difference was statistically significant (P<0.01). 163 patients were found with PFO in 174 cases by TEE. Including 129 cases with color Doppler there is room left to right shunt, 34 cases with not obvious room level shunt. In 163 PFO- RLS cases, there is correlation between the diameter and the degree of RLS, but the correlation is low (P<0.05, CP=0.34). CONCLUSION cTTE can quickly find room level right-to-left shunt and semi-quantitative assess the extent of shunt, cTTE joint TEE can display the morphology and diameter of PFO clearly, and then confirmed PFO-RLS. PFO diameter is low associated with RLS severity.

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备注/Memo

备注/Memo:
收稿日期：2016-08-12.通讯作者：张小杉，主任医师，主要从事心脏超声研究 Email：13947133133@qq.com 作者简介：王婧，副主任医师，硕士 Email：2631368484@qq.com
更新日期/Last Update: 1900-01-01