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国际标准刊号(ISSN):1673-5110 国内统一刊号(CN):41-1381/R
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卵圆孔未闭伴房间隔膨出瘤与先兆偏头痛关系的超声心动图研究

作者 / Author:杨 娟 赵 娜 齐清华

关键词 / KeyWords:

偏头痛,右心声学造影,经食管,卵圆孔未闭,房间隔膨出瘤

卵圆孔未闭伴房间隔膨出瘤与先兆偏头痛关系的超声心动图研究

杨 娟 赵 娜 齐清华

郑州大学第一附属医院,河南 郑州 450052

作者简介:杨娟,Emailseaw114703988@163.com

摘要目的 应用经食管超声心动图(transesophageal echocardiograghyTEE)联合右心声学造影评估卵圆孔未闭(patent foramen ovalePFO)伴房间隔膨出瘤(atrial septal aneurysmASA)与先兆偏头痛(migraine with auraMA)的关系。方法 回顾性分析郑州大学第一附属医院 2018-01—2021-05 接受经食道超声心动图联合右心声学造影的 988 例患者的检查图像及临床资料。超声检查前,采用经过验证的头痛问卷,由两位神经科医生根据国际头痛标准诊断是否有先兆偏头痛,由超声医生在不知患者是否有偏头痛的前提下进行超声心动图检查,进行 RLS 分级,对无 FPO ASA 组、PFO 组、ASA 组和PFO ASA 组进行偏头痛及先兆偏头痛的单因素分析,并对有无先兆偏头痛患者的 RLS 分级进行比较。结果 孤立的PFO 15.38%,孤立的 ASA 3.04%PFO 合并ASA 7.29%。偏头痛发生率 19.03%MA 发生率 8.20 %。与无PFO ASA 组比较,PFO ASA 组无先兆偏头痛(OR=2.32495% CI1.225~4.41P=0.008)及有先兆偏头痛(OR=5.53395% CI3.031~10.1P<0.001)患病率显著增高。偏头痛患者中,PFO ASA 组有先兆发生的患病率显著增高(OR=2.38195% CI1.095~5.176)。在 RLS 分级中,2 级和 3 级分流在MA MA患者之间差异有统计学意义( χ2=7.912P=0.005);PFO ASA 2 级和 3 级分流显著高于PFO 组( χ2=7.023P= 0.008)。结论 PFO 合并ASA MA 显著相关,且出现右向左分流的程度增高,PFO 引起的偏头痛研究应集中于这种特殊的心房异常。

关键词】 偏头痛;右心声学造影;经食管;卵圆孔未闭;房间隔膨出瘤

中图分类号R747.2R445.1 文献标识码A 文章编号1673-5110 202124-2160-08 DOI10.12083/SYSJ.2021.24.007

An echocardiographic study of the relationship between patent foramen ovale with atrial septal bulging tumor and migraine aura

YANG JuanZHAO NaQI Qinghua

The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China

AbstractObjective To evaluate the relationship between patent foramen ovalePFOwith atrial septal aneurysmASAand migraine with auraMAby transesophageal echocardiographyTEEcombined with con⁃ trast echocardiography. Methods The examination images and clinical data of 988 patients who underwent tran- sesophageal echocardiography combined with right heart sonography in the First Affiliated Hospital of Zhengzhou University from January 2018 to May 2021 were analyzed retrospectively. Before the ultrasonic examinationthe pa⁃ tients were treated with a validated headache questionnaireand diagnosed by two neurologists to determine whether there was migraine aura according to the international headache standards. The ultrasonic doctor examined the pa⁃ tient by echocardiography without knowing whether the patient had migraine and RLS classification was conducted. Single factor analysis of migraine with aura and migraine without aura was performed in non FPO and ASA groupPFO groupASA group and PFO with ASA group. RLS classification of migraine with aura group and migraine without aura group were compared. Results Isolated PFO accounted for 15.38% isolated ASA accounted for 3.04%and PFO combined ASA accountedfor 7.29%. The incidence of migraine was 19.03%and the incidence of MA was 8.20%. Compared with the without PFO and ASAthe prevalence of migraine without auraOR=2.32495% CI1.225-4.41P=0.008and migraine with auraOR=5.53395% CI3.031-10.1P<0.001in PFO with ASA group were significantly higher. Among migraine patientsthe prevalence of aura in PFO with ASA group was significantly higherOR=2.38195% CI1.095-5.176. In RLS gradinggrade 2 and grade 3 shunts were statisti⁃ cally different between MA and non-MA patientsχ2=7.912P=0.005. The grade 2 and 3 shunts of PFO with ASA were significantly higher than those of patients with PFO aloneχ2=7.023P=0.008. Conclusion PFO combined with ASA is significantly correlated with MAand the degree of right to left shunt is increased. The study of mi⁃ graine caused by PFO should focus on this special atrial abnormality.

Key wordsMigraineRight heart contrast echocardiographyTransesophagealPatent foramen ovaleAtrial septal aneurysm
 

 

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