右向左分流相关认知障碍的潜在机制与临床 研究进展
Mechanisms and Clinical Advances in Cognitive Impairment Associated with Right-to-Left Shunt
DOI: 10.12677/acm.2026.1651862, PDF,   
作者: 李佳钰：重庆医科大学附属第二医院，神经内科，重庆；李小凤*：重庆医科大学附属第二医院，老年医学科，重庆
关键词: 右向左分流；卵圆孔未闭；认知障碍；机制；Right-to-Left Shunt； Patent Foramen Ovale； Cognitive Impairment； Mechanism
摘要: 右向左分流(Right-to-Left Shunt, RLS)是一种常见的解剖结构异常，以卵圆孔未闭(Patent Foramen Ovale, PFO)最为多见。近年研究发现，RLS不仅与隐源性卒中、偏头痛等疾病的发生密切相关，还可能作为独立危险因素造成认知功能损害。然而，目前关于RLS与认知障碍的研究尚处于探索阶段，具体机制有待进一步阐明。本文系统综述了RLS导致认知障碍的潜在机制及临床研究进展。RLS可能通过慢性微栓塞、代谢过滤功能受损、低氧血症、脑血流调节能力下降等途径影响认知功能。在此基础上，本文提出经皮封堵术是目前消除RLS的有效手段，有望通过阻断微栓塞路径、恢复肺循环代谢功能来减轻认知损害。
Abstract: Right-to-left shunt (RLS) is a common anatomical abnormality, with patent foramen ovale (PFO) as the most frequent cause. Recent studies have shown that RLS is not only closely associated with conditions such as cryptogenic stroke and migraine, but may also act as an independent risk factor for cognitive impairment. However, research on the relationship between RLS and cognitive impairment is still in its early stages, and the underlying mechanisms remain to be elucidated. This review systematically summarizes the potential mechanisms and clinical research progress on RLS-related cognitive impairment. RLS may affect cognitive function through chronic microembolism, impaired metabolic filtration, hypoxemia, and impaired cerebral blood flow regulation. Based on these insights, percutaneous closure has been proposed as the most effective intervention for eliminating RLS, which may alleviate cognitive deficits by blocking microembolic pathways and restoring pulmonary circulatory metabolic function.
文章引用：李佳钰, 李小凤. 右向左分流相关认知障碍的潜在机制与临床 研究进展[J]. 临床医学进展, 2026, 16(5): 688-694. https://doi.org/10.12677/acm.2026.1651862

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