卵圆孔封堵术对老年人群卒中风险的保护作用
Protective effect and clinical value of closure of patent foramen ovale on the elderly population with stroke risk
夏成 1周持恒 2向世强3
作者信息
- 1. 武汉科技大学医学部公共卫生学院,武汉 430062;武汉亚洲心脏病医院心血管病科,武汉 430022
- 2. 武汉亚洲心脏病医院心血管病科,武汉 430022
- 3. 武汉科技大学医学部公共卫生学院,武汉 430062
- 折叠
摘要
隐源性卒中(CS)是缺血性脑卒中的特殊类型,与卵圆孔未闭(PFO)之间的关系密切.以存在卒中风险的老年PFO群体为研究对象,通过长期随访研究,旨在明确PFO封堵术对脑血管不良事件的保护作用及临床优势,终点指标包括复发性脑卒中/复发性短暂性脑缺血,其余指标包括一般情况资料与基线临床指标.随访结果显示治疗后3 a,保守治疗组的脑血管不良事件发病率(5/21,P=0.03)显著高于PFO封堵组(1/39),Logistic分析结果显示,是否接受PFO封堵术是预测有卒中风险老年患者预后发生脑血管不良事件的唯一独立危险因素(OR=11.562,P=0.003),提示PFO封堵术可使有卒中风险的老年人群获益,与接受PFO封堵术相比,药物保守治疗组未来3 a内发生脑血管不良事件的危险是前者的11.562倍.
Abstract
The number of stroke patients in China ranks first in the world.Cryptogenic stroke(CS),a special type of ischemic stroke,is closely related to patent foramen ovale(PFO).This study focuses on the elderly PFO population at risk of stroke.Through long-term follow-up studies,the aim is to clarify the protective effect and clinical advantages of PFO closure on cerebrovascular adverse events.The endpoint indicators include recurrent stroke/recurrent transient cerebral ischemia,while the remaining indicators include general information and baseline clinical indicators.The follow-up results showed that the incidence rate of cerebrovascular adverse events in the conservative treatment group(5/21,P=0.03)was significantly higher than that in the PFO closure group(1/39)3 years after treatment.Logistic analysis showed that whether to accept PFO closure was the only independent risk factor for predicting cerebrovascular adverse events in elderly patients with stroke risk(OR=11.562,P=0.003),suggesting that PFO closure surgery can benefit elderly individuals at risk of stroke.Compared with the group receiving PFO closure surgery,the conservative drug treatment group had an 11.562 times higher risk of developing cerebrovascular adverse events in the following 3 years.
关键词
老年群体/缺血性卒中/隐源性卒中/卵圆孔未闭封堵术/多因素分析/预后分析/独立性影响因素Key words
elderly population/ischemic stroke/cryptogenic stroke/closure of patent foramen ovale/multi-factor analysis/prognostic analysis/independence influencing factors引用本文复制引用
出版年
2024
NETL
NSTL
万方数据