在卵圆孔未闭的患者中风复发

文摘

卵圆孔未闭(卵圆孔未闭)是更常见的中风患者比匹配控制,但中风机制和晚期预后并不广为人知。我们研究特性,共存的原因,连续140年中风复发患者(平均年龄44±14年)中风和卵圆孔未闭承认以人群为基础的初级保健中心。我们选择的患者340例(41%)560岁急性中风。最初的事件是脑梗死118例(84%)和TIA在22个(16%)。颅内插子的遮挡存在血管造影或经颅多普勒在大多数病人在12小时内发病,而静脉来源是临床上明显的只有6个病人(5.5%)。在出现肺栓塞,并发操作,凝血异常罕见,但是四分之一的病人有一个房间隔动脉瘤(ISA)共存与卵圆孔未闭。中风在场的另一个原因只有22名患者(16%),通常心脏(心房纤维性颤动、严重二尖瓣脱垂、无着丝粒的左心室段)。在平均随访3年,每年中风或死亡率为2.4%,但只有8个病人有复发性梗塞(每年1.9%)。这个低的复发与初始中风的严重程度,造成在一半的病人禁用后遗症。多变量分析显示,房沟通,最近的历史偏头痛,大脑后动脉梗塞,和中风的共存的原因与复发有关,而ISA和治疗类型(促凝剂或antiaggregant疗法,手术闭合卵圆孔未闭)。 However, given the low number of events, these findings must be taken with caution. In conclusion, our study shows that stroke associated with PFO with or without ISA is not commonly due to a coexisting cause of stroke. It is usually embolic, although a definite source cannot often be demonstrated. The presenting stroke is often severe, but recurrence is uncommon. The demonstration of factors associated with a higher risk of recurrence in subgroups of patients is critical for the long-term management of these patients.