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|本期目录/Table of Contents|

RESPECT远期随访结果能否结束PFO封堵疗效的争论？

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2016年第4期
页码:
377-379
栏目:
专家论坛
出版日期:
2016-04-01

文章信息/Info

Title:
Can RESPECT extended follow-up results end controversy of patent foramen ovale interventional therapy?
作者:
张玉顺1; 朱鲜阳2
（1.西安交通大学第一附属医院心内二科，陕西 西安 710061；
2.沈阳军区总医院先心病内科，辽宁 沈阳 110016）
Author(s):
ZHANG Yu-shun1;  ZHU Xian-yang2
(Second Department of Cardiology, First Affiliated Hospital, Medical College, Xi’an Jiaotong University, Xi’an, 710061, Shaanxi, China；
Department of Congenital Heart Disease, General Hospital, Shenyang Military Area Command, Shenyang 110016, Liaoning, China)
关键词:
卵圆孔未闭; 不明原因脑卒中; 随机对照试验; 治疗
Keywords:
patent foramen ovale;  cryptogenic stroke;  randomized controlled trial;  treatment
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
RESPECT研究是一项前瞻性多中心随机对照试验，对卵圆孔未闭（PFO）并发不明原因脑卒中患者应用Amplatzer PFO 封堵器（St.Jude Medical,Inc.,St.Paul,MN）经导管PFO封堵+药物治疗与单独药物治疗进行对比，比较其二者在降低脑卒中复发风险方面是否有统计学差异。初步研究结果于2013年发表在新英格兰医学杂志上，其结果表明在预防不明原因脑卒中复发方面，经导管PFO封堵与药物治疗相比无统计学差异。但2015年10月15日在美国TCT会议上，公布了RESPECT研究的长期随访结果，得出了预防不明原因脑卒中复发，使用Amplatzer PFO封堵器行经导管PFO封堵优于药物治疗的最终结论。本文主要简介了RESPECT研究的主要内容和近期、远期结果，并对其作出笔者的评价。
Abstract:
The RESPECT trial is a randomized clinical trial investigating the safety and efficacy of transcatheter patent foramen ovale (PFO) closure using the Amplatzer PFO occluder (St. Jude Medical, Inc., St. Paul, MN) in the secondary prevention of recurrent cryptogenic stroke vs. medical management. Results of the preliminary study were published in the New England Journal of Medicine in 2013, which showed that there was no significant difference in the prevention of cryptogenic stroke between transcatheter closure of PFO and drug treatment. During the Transcatheter Cardiovascular Therapeutics Conference in the United States (October 15, 2015), the extended follow-up results of the RESPECT study were announced and the results showed that Amplatzer PFO Occluder was superior to medical management in reducing recurrent cryptogenic ischemic stroke. This article explains the main content along with recent and long-term results of the RESPECT study and presents the author’s evaluation.

参考文献/References

[1]Sacco RL,Ellenberg JH,Mohr JP,et al.Infarcts of undetermined cause:the NINCDS Stroke Data Bank[J].Ann Neurol,1989, 25(4):382-390.
[2]Meissner I,Khandheria BK,Heit JA,et al.Patent foramen ovale:innocent or guilty? Evidence from a prospective population-based study[J].J Am Coll Cardiol,2006,47(2):440-445
[3]Cohnheim J.Thrombose und Embolie[M]// Vorlesungen über allgemeine pathologie.Berlin:Hirschwald,1877,Vol 1:134.
[4]Nellessen U,Daniel WG,Matheis G,et al.Impending paradoxical embolism from atrial thrombus:correct diagnosis by transesophageal echocardiography and prevention by surgery[J].J Am Coll Cardiol,1985,5(4):1002-1004.
[5]Brogno D,Lancaster G,Rosenbaum M.Embolus Interuptus[J].N Engl J Med,1994,330(24):1761-1762.
[6]Carroll JD,Saver JL,Thaler DE,et al.Closure of patent foramen ovale versus medical therapy after cryptogenic stroke[J].N Engl J Med,2013,368(12):1092-1100.
[7]Messé SR,Kent DM.Still no closure on the question of PFO closure[J].N Engl J Med,2013,368(12):1152-1153.

备注/Memo

备注/Memo:
收稿日期：2015-12-15.
作者简介：张玉顺，主任医师，现任西安交通大学医学院第一附属医院心血管病医院副院长，心内科和周围血管科主任。中国老年保健医学研究会心脏学会常务委员，中国医师协会心血管分会委员，结构性心脏病工作委员会副主任委员，亚太心脏联盟结构性心脏病分会副主任委员兼秘书长。《心脏杂志》副主编，《中国医师进修杂志》、《中国循证心血管医学》等杂志编委，主编及参编各类著作11部，发表文章180余篇。参加国家科技攻关计划2项，国家“八五”及“九五” 攻关课题等。获国家科技进步二等奖1项。擅长各种结构性心脏病的介入性诊断与治疗，以及对反常栓塞与心脑血管疾病、肺动脉高压等的研究。 Email：zys2889@sina.com
更新日期/Last Update: 2016-04-01