【摘要】 隐源性脑卒中是缺血性脑卒中的重要组成部分,隐源性脑卒中患者常合并卵圆孔未闭(PFO)。病理生理学上,"反常栓塞"被认为是PFO造成缺血性脑卒中的主要原因,但确切的病因机制可能需要其他多重因素参与促使形成反常栓塞。这些相关因素包括PFO的大小,以及其他的解剖学特征,如房间隔瘤、显著的Eustachian瓣膜、希阿里网和高凝状态等。经胸超声心动图造影和经颅多普勒造影常用于PFO的初步诊断,而经食管超声心动图造影是诊断PFO的金标准。目前推荐使用抗血小板聚集治疗隐源性脑卒中合并PFO,但抗凝治疗缺乏相关的研究数据。虽然仍存在争议,但基于3个大型随机临床试验的结果,目前并不推荐PFO封堵术进行隐源性脑卒中合并PFO治疗。更多还原

【Abstract】 Cryptogenic stroke is an important component of ischemic stroke,and often associated with patent foramen ovale(PFO). In pathophysiology, " abnormal embolism" is considered to be the main cause of ischemic stroke caused by PFO,but the exact etiology mechanism may require other multiple factors involved in promoting the formation of abnormal embolism. These related factors include the size of the PFO,as well as other anatomical features such as atrial septal aneurysm,significant Eustachian valves,Chiari’ s network and hypercoagulable state. Transthoracic echocardiography and transcranial Doppler angiography are commonly used in the initial diagnosis of PFO,while transesophageal echocardiography is the gold standard for the diagnosis of PFO. It is recommended to use antiplatelet aggregation to treat cryptogenic stroke with PFO,though current anticoagulation therapy still lacks relevant research data. Although there is still controversy,based on the results of three large randomized clinical trials,current guidelines do not recommend PFO occlusion for the treatment of cryptogenic stroke combined with PFO.更多还原