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神经系统发作性疾病与卵圆孔未闭关系的临床研究

徐扬舟，李亚萍，阳衡，叶辉，张志辉，宋治 * 扫描二维码
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【摘要】 背景 神经系统发作性疾病与卵圆孔未闭（PFO）均具有发作性特点，但目前神经系统发作性疾病与
PFO 的关系尚不明确。目的 探讨神经系统发作性疾病与 PFO 的可能关系。方法 采用横断面研究，选取中南大学湘
雅三医院的神经系统发作性疾病患者为研究对象并行经胸心脏超声检查，依据主要临床诊断分为偏头痛组（n=266）、
癫痫组（n=286）、晕厥组（n=187）、眩晕组（n=68）、短暂性脑缺血发作（TIA）组（n=48）。比较各组及组内不
同年龄患者 PFO 阳性率与人群整体 PFO 阳性率的差异。结果 共 1 030 例患者完成经胸心脏超声检查，共检出 390 例
PFO 患者，阳性率为 37.9%。去除无法归类者，340 例 PFO 阳性患者按右向左分流（RLS）分级：RLS 1 级 109 例，占
32.1%；RLS 2 级 148 例，占 43.5%；RLS 3 级 83 例，占 24.4%。各组 RLS 分级比较，差异无统计学意义（P>0.05）。
偏头痛组、癫痫组、晕厥组、眩晕组、TIA 组患者 PFO 阳性率依次为 46.2%、40.6%、35.8%、33.8%、22.9%。偏头痛组、
癫痫组与晕厥组患者 PFO 阳性率高于人群总体 PFO 阳性率（P<0.05）；偏头痛组、癫痫组、晕厥组、眩晕组 11~ 岁、
21~ 岁、31~ 岁患者 PFO 阳性率均高于人群总体 PFO 阳性率（P<0.05）。结论 PFO 与偏头痛、癫痫及晕厥可能存在
临床关联，在年轻患者中进行 PFO 筛选可能更有意义，但其机制尚待进一步研究。
【关键词】 神经系统疾病；卵圆孔，未闭；偏头痛；癫痫；晕厥；眩晕；脑缺血发作，短暂性
【中图分类号】 R 741 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2022.0094
徐扬舟，李亚萍，阳衡，等 . 神经系统发作性疾病与卵圆孔未闭关系的临床研究［J］. 中国全科医学，2022，25（24）：
3018-3021.［www.chinagp.net］
XU Y Z，LI Y P，YANG H，et al. Clinical investigation about relationship between neurological paroxysmal disorders and
patent foramen ovale［J］. Chinese General Practice，2022，25（24）：3018-3021.

Clinical Investigation about Relationship between Neurological Paroxysmal Disorders and Patent Foramen Ovale XU
Yangzhou，LI Yaping，YANG Heng，YE Hui，ZHANG Zhihui，SONG Zhi *
Neurology Department，the Third Xiangya Hospital of Central South University，Changsha 410013，China
*
Corresponding author：SONG Zhi，Doctoral supervisor，Chief physician；E-mail：docsong@126.com
【Abstract】 Background Both neurological paroxysmal disorders and patent foramen ovale （PFO） are characterized
by episodic nature，and at present，the relationship between neurological paroxysmal disorders and PFO is not clear. Objective
To investigate the possible relationship between neurological paroxysmal disorders and PFO. Methods A cross-sectional study
method was used. Transthoracic cardiac ultrasound was performed on all patients with neurological paroxysmal disorders from the
Third Xiangya Hospital of Central South University，who were classified into groups as migraine （n=266），epilepsy （n=286），
syncope（n=187），vertigo（n=68），transient ischemic attack（TIA）（n=48），according to the main clinical diagnosis.
The PFO positive rate at different ages within and between groups was compared with the overall PFO positive rate of the
population. Results Transthoracic cardiac ultrasound was completed in a total of 1 030 patients，and a total of 390 patients
were PFO with a positive rate of 37.9%. According to RLS grade of 340 PFO positive patients in different groups，109 cases
were RLS 1 grade，accounting for 32.1%；148 cases were RLS 2 grade，accounting for 43.5%；83 cases were RLS 3 grade，
accounting for 24.4%. There was no significantly difference in RLS grades in different groups（P>0.05）. The PFO positive rates
in the migraine，epilepsy，syncope，vertigo and TIA group were 46.2%，40.6%，35.8%，33.8%，22.9%，respectively. The
PFO positive rate of the migraine，epilepsy，and syncope group was higher than the overall PFO positive rate of the population，
respectively（P<0.05）；in the migraine，epilepsy，syncope and vertigo group，the PFO positive rate over 11 years，21 years
and 31 years was higher than the overall PFO positive rate in the population，respectively（P<0.05）. Conclusion There might
be a clinical association between PFO and migraine，epilepsy and syncope. It may be more meaningful to screen PFO in younger
patients，but the mechanism of which needs to be further investigated.
【Key words】 Nervous system diseases；Foramen ovale，patent；Migraine disorders；Epilepsy；Syncope；Vertigo；
Ischemic attack，transient

410013 湖南省长沙市，中南大学湘雅三医院神经内科
*
通信作者：宋治，博士生导师，主任医师；E-mail：docsong@126.com
本文数字出版日期：2022-06-16