【摘要】 目的 探讨经颅多普勒发泡试验(c-TCD)联合经胸超声心动图声学造影(c-TTE)在筛查卵圆孔未闭(PFO)所致隐源性脑卒中(CS)的临床价值。方法 169例CS患者均行c-TCD及c-TTE检查，分析c-TCD、c-TTE单独及联合对于PFO及阳性检出情况、对PFO的诊断效能及下右向左分流(RLS)分级情况的作用。结果 与c-TCD比较，联合检测的静息阳性率升高(P<0.05),与c-TTE比较，联合检测的静息阳性率及Valsalva阳性率均升高(P<0.05)。联合诊断PFO的灵敏度及特异度均高于c-TCD、c-TTE单独诊断(P<0.05)。与c-TCD比较，联合检测对RLS 0级、I级的检出率降低，对RLSⅡ级、Ⅲ级的检出率升高(P<0.05),与c-TTE比较，联合检测对RLSⅢ级的检出率升高(P<0.05)。结论 c-TCD联合c-TTE能够提高CS患者的PFO及PFO-RLS中大量分级的检出率，提高对PFO的诊断效能。更多还原

【Abstract】 Objective To explore the clinical value of transcranial Doppler foam test(c-TCD) combined with transthoracic echocardiography contrast acoustics(c-TTE) in screening for cryptogenic stroke(CS) caused by patent foramina ovale(PFO).Methods One hundred and sixty-nine with CS underwent the examination of c-TCD and c-TTE. The role of c-TCD and c-TTE alone and in combination on PFO positive detection and diagnostic efficacy of PFO as well as right-to-left shunt(RLS) levels was analyzed.Results Compared with c-TCD, the resting positive rate of the combination detection was higher(P<0.05). Compared with c-TTE, both resting and Valsalva positive rates of the combination detection were higher(P<0.05). The sensitivity and specificity of combined diagnosis of PFO were higher than that of c-TCD and c-TTE alone(P<0.05). Compared with c-TCD, the detection rate of RLS 0 and I levels was decreased while the detection rate of RLS Ⅱ and Ⅲ levels was increased(P<0.05). Compared with c-TTE, the detection rate of RLS Ⅲ level by the combination detection was increased(P<0.05).Conclusions c-TCD combined with c-TTE diagnosis can improve the detection rate of PFO in CS patients and the detection rate of middle to high levels of PFO-RLS. It also improves the diagnostic efficiency of PFO.更多还原