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|本期目录/Table of Contents|

c-TCD应用加血生理盐水混合液与生理盐水混合液诊断右向左分流阳性率的比较

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2015年第4期
页码:
401-403
栏目:
结构性心脏病
出版日期:
2015-04-20

文章信息/Info

Title:
Value of adding blood to agitated saline for detection of right-to-left shunt by contrast transcranial Doppler ultrasound
作者:
刘 平1; 2; 赵 洋1; 宋 强3; 杨李智2; 张玉顺3
(1.西安交通大学医学院,陕西 西安 710061；
2.延安大学咸阳医院心内科，陕西 咸阳 712000；
3.西安交通大学第一附属医院心内二科，陕西 西安 710061)
Author(s):
LIU Ping1; 2;  ZHAO Yang1;  SONG Qiang3;  YANG Li-zhi2;  ZHANG Yu-shun2
(1.School of Medicine, Xi’an Jiaotong University, Xi’an 710061, Shaanxi, China；
2.Department of Cardiology, Xianyang Hospital, Yan’an University, Xianyang 712000, Shaanxi, China；
3.Second Department of Cardiology, First Affiliated Hospital, Medical College, Xi’an Jiaotong University, Xi’an 710061, Shaanxi, China)
关键词:
卵圆孔未闭; 右向左分流; 经颅多普勒超声声学造影; 造影剂
Keywords:
patent foramen ovale (PFO);  contrast agent;  right-to-left shunt;  contrast agent
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 比较经颅多普勒超声声学造影（c-TCD)应用加血生理盐水混合液（ASB）与生理盐水混合液（AS)作为对比剂诊断右向左分流(RLS)的阳性检出率（阳性率）。方法 收集不明原因脑卒中和（或）偏头痛患者521例。分别应用生理盐水混合液、加血生理盐水混合液在静息及Valsalva动作（Valsalva maneuver，VM)条件下行c-TCD检查并进行比较。结果 ASB组静息状态下c-TCD 检测RLS阳性率29.9%(156/521)，VM后阳性率45.1%(235/521)。AS组RLS阳性率14.2%(74/521)，VM后阳性率可达33.0%(172/521)。两组VM后阳性率均明显高于静息状态（P<0.01）。ASB组静息状态或VM后阳性率均显著高于AS组（P<0.05）。ASB组静息状态或VM后RLS程度亦显著高于AS组。结论 加血生理盐水混合液对比剂应用于c-TCD可显著提高诊断RLS的阳性率。
Abstract:
AIM To compare the efficacy of two contrast agents (CAs), namely, agitated saline (AS) and AS with blood (ASb), in the diagnosis of right-to-left shunt (RLS) by contrast-enhanced transcranial Doppler (c-TCD). METHODS The study was conducted in 521 consecutive patients with patent foramen ovale (PFO), who suffered from cryptogenic stroke and/or migraine. For each patient, we performed c-TCD both at rest and during Valsalva maneuver using two different contrast agents: AS and ASb and compared the results. RESULTS RLS was detected respectively in 30% at rest and in 45% during Valsalva maneuver using ASb, and in 14% and in 33% using AS (P<0.01). The positive rates of both ASb and AS during Valsalva maneuver were obviously higher than those at rest. The positive rate and the number of micro-embolic signals using ASb were statistically higher than those using AS. CONCLUSION SASb can significantly increase the efficacy of c-TCD contrast agent in the diagnosis of right-to-left shunt and clinically can be widely used as a standard contrast agent.

参考文献/References

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[9]Droste DW,Jekentaite R,Stypmann J,et al.Contrast transcranial Doppler ultrasound in the detection of right-to-left shunts:Comparison of Echovist(R)-200 and Echovist(R)-300,timing of the Valsalva maneuver, an general recommendations for the performance of the test[J].Cerebrovascular Diseases,2002, 13(4):235-241

备注/Memo

备注/Memo:
收稿日期：2015-03-13.
通讯作者：张玉顺，教授，主要从事结构性心脏病研究 Email：zys2889@sina.com
作者简介：刘平，硕士生 Email:1121181805@qq.com
更新日期/Last Update: 2015-04-22