右心声学造影与RoPE量表在PFO相关隐源性卒中患者中的相关性及初步诊断
Correlation and Preliminary Diagnosis of Right Heart Echocardiography and RoPE Scale in Patients with PFO-Related Cryptogenic Stroke
DOI: 10.12677/acm.2026.1662383, PDF,   
作者: 李书涛：延安大学延安医学院，陕西 延安；张义和：延安大学附属医院心脑血管医院心血管外科CCU，陕西 延安
关键词: 隐源性卒中；卵圆孔未闭；经胸右心声学造影；RoPE量表；Cryptogenic Stroke； Patent Foramen Ovale； Transesophageal Right Heart Echocardiography； RoPE Scale
摘要: 目的：初步探索经胸右心声学造影(cTTE)分流等级与反常栓塞风险(RoPE)量表在卵圆孔未闭(PFO)相关性隐源性卒中(CS)患者中的相关性，评估二者联合诊断的临床价值。方法：回顾性纳入2023年1月至2025年1月延安大学附属医院心脑血管医院收治的86例CS患者，根据辅助检查结果分为PFO-CS组(41例)与非PFO-CS组(45例)。收集两组患者临床资料，采用cTTE评估右向左分流(RLS)等级，计算RoPE评分，分析两组指标差异、cTTE与RoPE评分的相关性。结果：① PFO-CS组RoPE评分[(6.12 ± 0.98)分]、皮层梗死率(70.7%)显著高于非PFO-CS组[(3.36 ± 1.19)分、31.1%] (t = 11.588，χ2 = = 13.471，P均<0.001)；② Valsalva动作下的RLS检出率(56.98%)明显高于静息状态下的检出率(37.21%)，且结果差异有统计学意义(χ2 = 6.744, P < 0.05)；③ Pearson相关性分析得出：cTTE分流等级与RoPE评分在PFO相关CS患者中呈显著正相关(r = 0.698, P < 0.001)；④ 年龄、皮层梗死、无高血压病史、无吸烟史等指标是PFO相关CS发生的重要影响因素。结论：cTTE分流等级与RoPE评分在PFO相关CS患者中呈显著正相关；Valsalva动作可显著提升RLS检出率。
Abstract: Objective: To preliminarily explore the correlation between the shunt grade of transesophageal echocardiography (cTTE) and the Risk of Paradoxical Embolism (RoPE) scale in patients with cryptogenic stroke (CS) associated with patent foramen ovale (PFO), and to evaluate the clinical value of their combined diagnosis. Methods: A retrospective study enrolled 86 CS patients admitted to the Cardiovascular Hospital of Yan’an University Affiliated Hospital from January 2023 to January 2025. Patients were categorized into PFO-CS (n = 41) and non-PFO-CS (n = 45) groups based on ancillary examination results. Clinical data were collected for both groups. Right-to-left shunt (RLS) severity was assessed using cTTE, and RoPE scores were calculated. Differences in clinical indicators between groups and correlations between cTTE and RoPE scores were analyzed. Results: ① The RoPE score [(6.12 ± 0.98) points] and cortical infarction rate (70.7%) in the PFO-CS group were significantly higher than those in the non-PFO-CS group [(3.36 ± 1.19) points and 31.1%, respectively] (t = 11.588, χ2 = 13.471, P < 0.001 for both); ② The detection rate of RLS during the Valsalva maneuver (56.98%) was significantly higher than that at rest (37.21%), with statistically significant differences (χ2 = 6.744, P < 0.05); ③Pearson correlation analysis revealed a significant positive correlation between cTTE shunt grade and RoPE score in PFO-associated CS patients (r = 0.698, P < 0.001); ④ Age, cortical infarction, absence of hypertension history, and absence of smoking history were identified as significant risk factors for PFO-associated CS. Conclusion: cTTE shunt grade and RoPE score showed a significant positive correlation in PFO-associated CS patients; the Valsalva maneuver significantly improved RLS detection rate.
文章引用：李书涛, 张义和. 右心声学造影与RoPE量表在PFO相关隐源性卒中患者中的相关性及初步诊断[J]. 临床医学进展, 2026, 16(6): 1681-1688. https://doi.org/10.12677/acm.2026.1662383

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