Eur Heart J:卵圆孔未闭和术后缺血性卒中的长期风险

2018-07-19 xiangting MedSci原创

PFO患者在术后很长一段时间内容易出现缺血性卒中。医生应考虑在计划进行大型非心脏手术的患者中实施PFO筛查方案。

术前诊断的卵圆孔未闭(PFO)与术后30天内缺血性卒中的风险升高相关。这项研究旨在评估在围手术期以外,PFO导致的缺血性卒中风险。

这项观察性研究纳入无卒中史、并在全身麻醉下接受非心脏手术的成年患者,采用多因素logistic回归分析了PFO与术后1年、2年缺血性卒中的关联。

纳入的144 563例患者中,术后1年和2年内共发生1642例(1.1%)和2376例(1.6%)缺血性卒中,PFO患者中分别有54例(4.7%)和76例(6.6%)缺血性卒中,无PFO患者中分别有1588例(1.1%)和2300例(1.6%)。PFO患者术后1年和2年内缺血性卒中的几率升高:分别为调整后的比值比(aOR)2.01,95%置信区间(CI)1.51-2.69;P<0.001和aOR 2.10,95%CI 1.64-2.68;P<0.001。接受对比经食管超声心动图检查的患者中,PFO的发生率为27%,PFO患者的卒中风险明显升高(aOR 3.80,95%CI 1.76-8.23;第1年P=0.001)。术后联合抗血栓治疗减弱了PFO归因性风险(优势比0.41,95%CI 0.22-0.75;P相互作用=0.004)。

PFO患者在术后很长一段时间内容易出现缺血性卒中。医生应考虑在计划进行大型非心脏手术的患者中实施PFO筛查方案。

原始出处:
Sabine Friedrich, et al. Patent foramen ovale and long-term risk of ischaemic stroke after surgery. Eur Heart J. 17 July 2018.

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    2018-07-21 zhaojie88
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    2018-07-21 slcumt
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    2018-07-20 哈哈869

    学了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1806261, encodeId=b7f91806261ad, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Dec 28 16:13:00 CST 2018, time=2018-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893083, encodeId=53a018930837b, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Tue Aug 28 23:13:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356854, encodeId=dff8135685450, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jul 21 01:13:00 CST 2018, time=2018-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401340, encodeId=2e591401340ba, content=<a href='/topic/show?id=80e89e0479a' target=_blank style='color:#2F92EE;'>#长期风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97047, encryptionId=80e89e0479a, topicName=长期风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Jul 21 01:13:00 CST 2018, time=2018-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562939, encodeId=cc4d1562939fe, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Jul 21 01:13:00 CST 2018, time=2018-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332844, encodeId=ba5e332844f7, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Jul 20 06:41:01 CST 2018, time=2018-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332843, encodeId=0b5c3328432f, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Jul 20 06:40:58 CST 2018, time=2018-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026111, encodeId=7930102611176, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Thu Jul 19 13:13:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332699, encodeId=cd553326997e, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Thu Jul 19 12:14:39 CST 2018, time=2018-07-19, status=1, ipAttribution=)]
    2018-07-20 哈哈869

    学了

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1806261, encodeId=b7f91806261ad, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Dec 28 16:13:00 CST 2018, time=2018-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893083, encodeId=53a018930837b, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Tue Aug 28 23:13:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356854, encodeId=dff8135685450, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jul 21 01:13:00 CST 2018, time=2018-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401340, encodeId=2e591401340ba, content=<a href='/topic/show?id=80e89e0479a' target=_blank style='color:#2F92EE;'>#长期风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97047, encryptionId=80e89e0479a, topicName=长期风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Jul 21 01:13:00 CST 2018, time=2018-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562939, encodeId=cc4d1562939fe, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Jul 21 01:13:00 CST 2018, time=2018-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332844, encodeId=ba5e332844f7, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Jul 20 06:41:01 CST 2018, time=2018-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332843, encodeId=0b5c3328432f, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Jul 20 06:40:58 CST 2018, time=2018-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026111, encodeId=7930102611176, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Thu Jul 19 13:13:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332699, encodeId=cd553326997e, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Thu Jul 19 12:14:39 CST 2018, time=2018-07-19, status=1, ipAttribution=)]
    2018-07-19 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1806261, encodeId=b7f91806261ad, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Fri Dec 28 16:13:00 CST 2018, time=2018-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893083, encodeId=53a018930837b, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Tue Aug 28 23:13:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356854, encodeId=dff8135685450, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jul 21 01:13:00 CST 2018, time=2018-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401340, encodeId=2e591401340ba, content=<a href='/topic/show?id=80e89e0479a' target=_blank style='color:#2F92EE;'>#长期风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97047, encryptionId=80e89e0479a, topicName=长期风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sat Jul 21 01:13:00 CST 2018, time=2018-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562939, encodeId=cc4d1562939fe, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Jul 21 01:13:00 CST 2018, time=2018-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332844, encodeId=ba5e332844f7, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Jul 20 06:41:01 CST 2018, time=2018-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332843, encodeId=0b5c3328432f, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Jul 20 06:40:58 CST 2018, time=2018-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026111, encodeId=7930102611176, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Thu Jul 19 13:13:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332699, encodeId=cd553326997e, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Thu Jul 19 12:14:39 CST 2018, time=2018-07-19, status=1, ipAttribution=)]
    2018-07-19 lietome2

    好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。

    0

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