[1]任明明 韩振 吴军 胡俊 郭雨竹 黄磊 许志锋 欧阳春 符鹏程.经导管封堵治疗卵圆孔未闭并发隐匿性脑卒中或短暂性脑缺血发作的临床效果[J].卒中与神经疾病杂志,2020,27(02):152-155.[doi:10.3969/j.issn.1007-0478.2020.02.002]
 Ren Mingming*,Han Zhen*,Wu Jun,et al.Clinical effect of transcatheter closure of patent foramen ovale with occult stroke or transient ischemic attack[J].Stroke and Nervous Diseases,2020,27(02):152-155.[doi:10.3969/j.issn.1007-0478.2020.02.002]
点击复制

经导管封堵治疗卵圆孔未闭并发隐匿性脑卒中或短暂性脑缺血发作的临床效果()
分享到:

《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第27卷
期数:
2020年02期
页码:
152-155
栏目:
论 著
出版日期:
2020-03-15

文章信息/Info

Title:
Clinical effect of transcatheter closure of patent foramen ovale with occult stroke or transient ischemic attack
文章编号:
1007-0478(2020)02-0152-05
作者:
任明明 韩振 吴军 胡俊 郭雨竹 黄磊 许志锋 欧阳春 符鹏程
518000 广东省深圳市北京大学深圳医院心血管外科(任明明 韩振 黄磊 许志锋 欧阳春),神经内科(吴军 胡俊 郭雨竹); 深圳市龙华区中心医院(符鹏程)
Author(s):
Ren Mingming* Han Zhen* Wu Jun et al.
*Cardiovascular surgery, Peking University Shenzhen Hospital, Shenzhen Guangdong 518000
关键词:
经导管封堵 卵圆孔未闭 隐匿性脑卒中 短暂性脑缺血发作 临床效果
Keywords:
Transcatheter closure Patent foramen ovale Occult stroke Transient ischemic attack Clinical effect
分类号:
R743
DOI:
10.3969/j.issn.1007-0478.2020.02.002
文献标志码:
A
摘要:
目的 探讨经导管封堵治疗卵圆孔未闭并发隐匿性脑卒中或短暂性脑缺血发作的临床效果。方法 选取本院2016年2月-2018年8月收治的120例卵圆孔未闭并发隐匿性脑卒中或短暂性脑缺血发作患者为研究对象,分为对照组和实验组,每组各60例,对照组患者采用阿司匹林进行治疗,实验组患者进行经导管封堵治疗,观察2组患者的治疗效果、治疗前、治疗6个月后的临床指标水平变化、治疗前、治疗6个月后的血栓弹力图(TEG)指标水平变化以及治疗6个月后的并发症发生率和脑缺血事件复发率。结果 实验组的治疗效果明显好于对照组(P<0.05); 治疗6个月后实验组的射血分数、左室舒张末内径、心率和左室收缩末内径均高于对照组(P<0.05); 治疗6个月后实验组的α-角和MA值明显低于对照组,AA途径诱导的血小板控制率明显高于对照组(P<0.05); 治疗6个月后实验组的并发症发生率和脑缺血事件复发率明显低于对照组(P<0.05)。结论 经导管封堵对卵圆孔未闭并发隐匿性脑卒中或短暂性脑缺血发作的临床效果较好,可以提高患者的心功能,明显降低血小板聚集,降低患者的脑缺血事件复发率和并发症发生率
Abstract:
ObjectiveTo explore the clinical effect of transcatheter closure of patent foramen ovale complicated with occult stroke or transient ischemic attack.Methods 120 patients with patent foramen ovale complicated with occult stroke or transient ischemic attack were Selected as the study subjects in our hospital,from February 2016 to August 2018. They were divided into control group and experimental group. 60 patients in each group were treated with aspirin. The experimental group was treated with transcatheter closure therapy. The therapeutic effect, clinical parameters before and after treatment, changes of thromboelastogram(TEG)parameters before and after treatment, complications and recurrence rate after 3 months of treatment were observed.Results The results showed that the treatment effect of the experimental group was better than that of the control group; after treatment, the ejection fraction, left ventricular end diastolic diameter and left ventricular end systolic diameter of the experimental group were higher than those of the control group. After treatment, the alpha-angle and MA values of the experimental group were significantly lower than those of the control group, and the platelet control rate induced by AA pathway was significantly higher than that of the control group. The incidence of complications and recurrence in the experimental group were significantly lower than those in the control group(P<0.05).Conclusion Transcatheter occlusion of patent foramen ovale complicated with occult stroke or transient ischemic attack had a good clinical effect. It could improve the therapeutic effect of patients, improve their cardiac function, significantly reduce platelet aggregation, reduce the recurrence rate and complications of patients

参考文献/References:

[1] 黄浩佳,胡海波,徐仲英,等.经导管封堵术治疗卵圆孔未闭合并隐匿性卒中或短暂性缺血发作的近中期疗效观察[J].中国循环杂志,2017,32(4):377-379.
[2] Bender E.In the Clinic-Patent foramen ovale closure and stroke:PFO closure associated with fewer recurrent ischemic strokes compared to medical therapy[J].Neurology Today,2017,17(21):8-11.
[3] Mojadidi MK,Elgendy,Akram Y,et al.Transcatheter patent foramen ovale closure after cryptogenic stroke[J].JACC Cardiovasc Interv,2017,10(21):2228-2230.
[4] 高飞丹,潘孙雷,池菊芳,等.介入封堵治疗对缺血性脑卒中合并卵圆孔未闭患者的临床疗效[J].浙江临床医学,2017,19(8):1461-1462.
[5] 王玉洁,白璇,李新辉,等.缺血性卒中和短暂性脑缺血发作处理指南2008[J].中华脑血管病杂志(电子版),2008,2(4):214-256.
[6] 李承科,何琴,谯飞,等.氢氯吡格雷联合尼膜同治疗短暂性脑缺血发作的临床效果分析[J].重庆医学,2017,46(20):2777-2779.
[7] Danese A,Stegagno C,Tomelleri GA,et al.Clinical outcomes of secondary prevention strategies for young patients with cryptogenic stroke and patent foramen ovale[J].Acta Cardiol,2017,72(4):410-418.
[8] 王豪,宋嫣,邓雅琴,等.中青年隐源性缺血性脑卒中与卵圆孔未闭的临床研究[J].中国医学创新,2017,14(30):8-11.
[9] 刘文娟,张玉顺,成革胜,等.不同封堵器治疗卵圆孔未闭的有效性和安全性比较[J].中华心血管病杂志,2017,45(6):485-490.
[10] 江毓敏,刘强,陈世英,等.合并卵圆孔未闭的隐源性脑卒中患者的临床研究[J].宁夏医科大学学报,2017,39(3):260-263.
[11] Von KK,Kempny,Aleksander,et al.Device closure for patent foramen ovale following cryptogenic stroke:a survey of current practice in the UK[J].Open Heart,2017,4(2):e000636.
[12] 马玉梅,邓斌,张新燕,等.卵圆孔未闭封堵治疗隐源性卒中合并卵圆孔未闭疗效的Meta分析[J].中国神经免疫学和神经病学杂志,2018,25(3):54-59.
[13] Merkler AE,Gialdini G,Yaghi S,et al.Safety outcomes after percutaneous transcatheter closure of patent foramen ovale[J].Stroke,2017,48(11):3073.
[14] Xing YQ,Guo YZ,Gao YS,et al.Effectiveness and safety of transcatheter patent foramen ovale closure for migraine(EASTFORM)trial[J].Sci Rep,2016,6(1):39081.
[15] 付强,郭彩霞,杜丽娟,等.经导管封堵术治疗不明原因卒中合并卵圆孔未闭患者的临床疗效及预后[J].中华心血管病杂志,2018,46(11):882-886.
[16] 马莉花,李秀丽,胡浩,等.卵圆孔未闭相关隐源性卒中的治疗研究进展[J].解放军医学杂志,2018,43(4):356-360.
[17] 嵇华夏,黎庆伟,高永红,等.卵圆孔未闭封堵术与药物治疗隐源性卒中疗效和安全性的meta分析[J].临床心血管病杂志,2018,34(11):72-76.
[18] Moon J,Kang WC,Kim S,et al.Comparison of outcomes after device closure and medication alone in patients with patent foramen ovale and cryptogenic stroke in korean population[J].Yonsei Med J,2016,57(3):621-625.
[19] Prefasi D,Martinez-Sanchez P,Fuentes BA.The utility of the RoPE score in cryptogenic stroke patients <= 50 years in predicting a stroke-related patent foramen ovale[J].International Journal of Stroke,2016,11(1):NP7-NP8.
[20] 牛铭,李华,胡劼,等.超声心动图评价Chiari’s网合并卵圆孔未闭与缺血性脑卒中的关系[J].中国心血管病研究,2018,16(6):516-519.

备注/Memo

备注/Memo:
基金项目:广东省哲学社会科学“十二五”规划项目(2017B060500027)(2019-09-05收稿)
更新日期/Last Update: 2020-03-15