[1]袁树华 李艾帆 李永芳 李兆妍 张杰.RoPE量表结合cTCD对隐源性脑卒中的应用价值[J].卒中与神经疾病杂志,2019,26(03):286-289.[doi:10.3969/j.issn.1007-0478.2019.03.007]
 Yuan Shuhua,Li Aifan,Li Yongfang,et al.The application value of RoPE scale combined with cTCD in cryptogenic stroke[J].Stroke and Nervous Diseases,2019,26(03):286-289.[doi:10.3969/j.issn.1007-0478.2019.03.007]
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RoPE量表结合cTCD对隐源性脑卒中的应用价值()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第26卷
期数:
2019年03期
页码:
286-289
栏目:
论 著
出版日期:
2019-06-25

文章信息/Info

Title:
The application value of RoPE scale combined with cTCD in cryptogenic stroke
文章编号:
1007-0478(2019)03-0286-04
作者:
袁树华 李艾帆 李永芳 李兆妍 张杰
450004 郑州市第一人民医院神经内科[袁树华 李艾帆(通信作者)李永芳 李兆妍]; 河南省人民医院医学影像科(张杰)
Author(s):
Yuan Shuhua Li Aifan Li Yongfang et al
Department of Neurology,Zhengzhou First People's Hospital,Zhengzhou 450000
关键词:
隐源性脑卒中 反常性栓塞 右向左分流
Keywords:
Cryptogenic stroke Paradoxical embolism Right to left shunt
分类号:
R743
DOI:
10.3969/j.issn.1007-0478.2019.03.007
文献标志码:
A
摘要:
目的 探讨反常性栓塞风险量表(Risk of Paradoxical Embolism, RoPE)结合经颅多谱勒超声发泡试验(contrast-enhanced transcranial Doppler, cTCD)对隐源性脑卒中(Cryptogenic stroke, CS)的应用价值。方法 收集2017年1月-2018年12月在郑州市第一人民医院神经内科住院的诊断为隐源性脑卒中且已完善cTCD 检查23例患者; 根据cTCD表现分为阳性组、阴性组,比较2组患者的一般资料和影像学特点; 应用RoPE量表对cTCD阳性患者进行评估,分析其与cTCD阳性率、分流量的相关性。结果 cTCD阳性组70%CS患者累及后循环、10.0%累及前循环、10%前后循环均受累; cTCD阴性组15.4%CS患者累及后循环、53.8%累及前循环、30.7%累及前后循环,其中累及后循环与cTCD阳性呈正相关(r=0.555,P<0.05)。cTCD阳性组80.0%CS患者累及皮层、10.0%累及深部、10.0%为混合性; cTCD阴性组23.1%CS患者累及皮层、30.75%累及深部、46.2%患者为混合性,其中累及皮层与cTCD阳性呈正相关(r=0.565,P<0.05)。cTCD阳性组吸烟10%,cTCD阴性组吸烟76.9%,吸烟与cTCD阳性呈负相关(r=-0.664,P<0.05)。cTCD阳性组男性患者占50%,cTCD阴性组男性患者占92.3%,性别与cTCD阳性呈负相关(r=-0.478,P<0.05)。其它因素高血压病、糖尿病、高脂血症及既往脑卒中病史与cTCD阳性之间未发现明确相关性(P>0.05)。RoPE评分与cTCD阳性率的相关性分析显示二者呈显著正相关(r=0.918,P=0.01)。cTCD阳性患者RLS分流量与RoPE评分的相关性分析显示二者呈显著正相关(r=0.894,P=0.000)。结论 发泡试验(cTCD)阳性患者临床易累及皮层和后循环供血区; RoPE量表联合cTCD可用于国内CS病因的筛查。
Abstract:
ObjectiveTo explore the application value of RoPE scale combined with cTCD in cryptogenic stroke.Methods 23 patients who were diagnosed as cryptogenic stroke and examined by cTCD were admitted to the department of neurology in Zhengzhou first people's hospital from January 2017 to December 2018. According to the results of cTCD, the patients were divided into two groups, such as positive group and negative group. The general information and imaging characteristics were compared in the two groups. RoPE scale was used to evaluate cTCD positive patients and the correlation between cTCD positive rate,shunt volume and RoPE scale were analyzed.Results 70% of CS patients in the positive group were involved in the posterior circulation, 10.0% involved in the anterior circulation, and 10% involved in the anterior circulation. 15.4% of CS patients in the negative group were involved in the posterior circulation, 53.8% involved in the anterior circulation, and 30.7% involved in the anterior circulation, and the involved posterior circulation was positively correlated with cTCD positive(r=0.555, P<0.05). In the positive group 80.0% of CS patients involved cortex, 10.0% involved deep part, and 10.0% were mixed, in the negative group 23.1% of CS patients involved cortex, 30.75% involved deep part, and 46.2% were mixed, and the involved cortex was positively correlated with cTCD positive(r=0.565, P<0.05). The smoking was 10% in the positive group and 76.9% in the negative group, the smoking was negatively correlated with cTCD positive(r=-0.664, P<0.05). The male patients was 50% in the positive group and 92.3% in the negative group, the male patients was negatively correlated with cTCD positive(r=-0.478, P<0.05). There were no clear correlation between hypertension, diabetes, hyperlipidemia,previous stroke history and cTCD positive(P>0.05).There was a significantly positive correlation between RoPE score and cTCD positive rate(r=0.918, P=0.01).There was a significantly positive correlation between RLS shunt volume and RoPE score in cTCD positive patients(r=0.894,P=0.000).Conclusion The cortical infarction and posterior circulation blood supply area infarction were involved in cTCD positive patients, and RoPE scale combined with cTCD could be used in etiology screening of cryptogenic stroke.

参考文献/References:

[1] Finsterer J. Management of cryptogenic stroke[J]. Acta Neurologica Belgica, 2010, 110(2):135-147.
[2] Bronzetti G, Angelo C, Donti A, et al. Role of atrial fibrillation after transcatheter closure of patent foramen ovale in patients with or without cryptogenic stroke[J]. Inter J Cardiol, 2011, 146(1):17-21.
[3] Windecker S, Meier B. Patent foramen ovale and atrial septal aneurysm:when and how should they be treated[J]. ACC Current Journal Review, 2002, 11(3):97-101.
[4] Mojadidi MK, Roberts SC, Winoker JS, et al. Accuracy of transcranial doppler for the diagnosis of intracardiac Right-to-Left shunt a bivariate Meta-Analysis of prospective studies[J]. JACC-Cardiovascular Imaging, 2014, 7(3):236-250.
[5] Kent DM, Ruthazer R, Weimar C, et al. An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke[J]. Neurology, 2013, 81(7):619-625.
[6] Adams HP, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial[J]. Stroke,1993, 24(1):35-41.
[7] 郭雨竹,邢英琦.对比增强经颅多普勒超声诊断右向左分流相关问题探讨[J].中国卒中杂志,2016,11(7):515-529.
[8] Amin H, Greer DM. Cryptogenic stroke-theappropriate diagnostic evaluation[J]. Curr TreatOptions Cardiovase Med, 2014, 16(1):280.
[9] Jauss M, Wessels T, Trittmacher S, et al. Embolic lesion pattern in stroke patients with patent Foramen ovale compared with patients lacking an embolic source[J]. Stroke, 2006, 37(8):2159-2161.
[10] Yasaka M. Is stroke a paradoxical embolism in patients with patent foramen ovale? [J]. Intern Med, 2005, 44(5):434-438.
[11] Santamarina E, Gonzalez-Alujas MT, Munoz V, et al. Stroke patients with cardiac atrial septal abnormalities:Differential infarct patterns on DWI[J]. Journal of Neuroimaging, 2006, 16(4):334-340.
[12] Lasko T, Bhagwat JG, Zou K-h, et al. The use of receiveroperating characteristic curves in biomedical informatics[J]. Journal of Biomedical Informatics, 2005(38):404-415.
[13] Davis D, Gregson J, Willeit P, et al. Patent foramen ovale, ischemic stroke and migraine:systematic review and stratified meta-analysis of association studies[J]. Neuroepidemiology, 2013, 40(1):56-67.
[14] Wessler BS, Kent DM, Thaler DE, et al. The RoPE score and Right-to-Left shunt severity by transcranial doppler in the CODICIA study[J]. Cerebrovascular Diseases, 2015, 40(1/2):52-58.

更新日期/Last Update: 2019-06-25