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经胸超声心动图造影在评估偏头痛患者右向左分流中的应用价值
引用本文:刘素君,洪灿,刘红雨,周佳,王巧,刘珍玉,常帅.经胸超声心动图造影在评估偏头痛患者右向左分流中的应用价值[J].南华大学学报(医学版),2017(1):64-67.
作者姓名:刘素君  洪灿  刘红雨  周佳  王巧  刘珍玉  常帅
作者单位:南华大学附属第一医院超声科,湖南 衡阳 421001,南华大学附属第一医院超声科,湖南 衡阳 421001,南华大学附属第一医院超声科,湖南 衡阳 421001,南华大学附属第一医院超声科,湖南 衡阳 421001,南华大学附属第一医院超声科,湖南 衡阳 421001,南华大学附属第一医院超声科,湖南 衡阳 421001,南华大学附属第一医院超声科,湖南 衡阳 421001
基金项目:湖南省卫生计生委项目(编号 B2015-53). 
摘    要:目的 应用经胸超声心动图造影(c-TTE)评估偏头痛患者右向左分流(RLS)的发生率、来源及半定量分级,初步探讨其与偏头痛的关系。方法186例偏头痛患者和120例健康志愿者均接受c-TTE检查。观察左心腔内是否出现造影微泡来判断有无RLS;根据微泡出现的时间将RLS分为来源于卵圆孔未闭(PFO)的分流(PFO-RLS)和肺动静脉畸形(PAVMs)的分流(P-RLS);再依据每帧图像的微泡数量对RLS的分流量进行半定量分级。比较两组人群RLS发生率、来源及分流量之间的差异。结果偏头痛组的RLS总发生率(56.4%,105/186)、PFO-RLS发生率(40.3%,75/186)及大量分流率(18.8%,35/186)均高于健康组(均P<0.05),PFO-RLS中量分流率虽高于健康组,但两组差异无统计学意义(P>0.05);两组间的PFO-RLS少量分流率、P-RLS发生率及各半定量分流率差异无统计学意义(均P>0.05)。结论偏头痛与PFO-RLS尤其伴大量分流者存在密切联系。以少、中量分流为主的P-RLS在偏头痛和健康人群亦不少见,其临床意义有待进一步研究。

关 键 词:超声心动描计术    经胸    造影    偏头痛    右向左分流
收稿时间:2017/10/7 0:00:00
修稿时间:2017/12/28 0:00:00

The value of contrast transthoracic echocardiography in evaluatingright-to-left shunt in patients with migraine
Affiliation:Department Of Ultrasound,the First Affiliated Hospital,University of South China,Hengyang 421001,Hunan,China,Department Of Ultrasound,the First Affiliated Hospital,University of South China,Hengyang 421001,Hunan,China,Department Of Ultrasound,the First Affiliated Hospital,University of South China,Hengyang 421001,Hunan,China,Department Of Ultrasound,the First Affiliated Hospital,University of South China,Hengyang 421001,Hunan,China,Department Of Ultrasound,the First Affiliated Hospital,University of South China,Hengyang 421001,Hunan,China,Department Of Ultrasound,the First Affiliated Hospital,University of South China,Hengyang 421001,Hunan,China and Department Of Ultrasound,the First Affiliated Hospital,University of South China,Hengyang 421001,Hunan,China
Abstract:Objective To evaluate the incidence,source and semi-quantitative grading of right-to-left shunt(RLS)in patients with migraine by contrast transthoracic echocardiography(c-TTE),and to explore the relationship between RLS and migraine.Methods186 patients with migraine and 120 healthy volunteers underwent c-TTE.Subjects were diagnosed with RLS if there were microbubbles in the left heart.Further more,RLS was divided into RLS originated from patent foramen ovale(PFO-RLS) and pulmonary arteriovenous malformations (P-RLS),according to the time of emergence of microbubbles.And RLS was semiquantitativly graded according to the amount of microbubbles.Finally,the incidence,source and semiquantitative grading of RLS were compared between the two groups to see if there was any difference.ResultsThe incidence of total RLS (56.4%,105/186),PFO-RLS (40.3%,75/186) and severe PFO-RLS(18.8%,35/186) in the migraine group were higher than those in the healthy group (all P<0.05).Although the incidence of moderate PFO-RLS in the migraine group was higher,there was no significant difference between the two groups(P>0.05).There was no significant difference for the incidence of mild PFO-RLS,total P-RLS and semi-quantitative grading of P-RLS between the two groups (all P>0.05).ConclusionsThere is close relationship between migraine and PFO-RLS,especially the severe type.The mild and moderate P-RLS are also common in both groups,and their clinical significance needs further research.
Keywords:echocardiography  transthoracic  contrast  migraine  right-to-left shunt
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