经颅多普勒超声声学造影联合Hcy、NLR对卵圆孔未闭合并隐源性脑卒中患者的预测价值

余江月; 邹永光; 李鹏飞; 黄嘉伟

doi:10.14188/j.1671-8852.2023.0692

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经颅多普勒超声声学造影联合Hcy、NLR对卵圆孔未闭合并隐源性脑卒中患者的预测价值

临床医学研究 | 更新时间：2026-11-05

- 经颅多普勒超声声学造影联合Hcy、NLR对卵圆孔未闭合并隐源性脑卒中患者的预测价值
- Predictive value of transcranial Doppler bubble test combined with Hcy and NLR in patients with patent foramen ovale complicated with cryptogenic stroke
- 武汉大学学报（医学版） 2025年46卷第3期页码：392-396
- 作者机构：
  
  1.武汉科技大学附属孝感医院心血管内科湖北孝感 432000
  2.武汉科技大学医学部医学院湖北武汉 430065
- 作者简介：
  
  余江月，男，1998—，医学硕士生，主要从事先天性心脏病的研究，E‑mail：3085738613@qq.com
  邹永光，男，1964—，医学硕士，主任医师，硕士生导师，主要从事心衰、心血管介入、先天性心脏病、高血压病研究，E‑mail：13871883238@139.com
- 基金信息：
  
  孝感市自然科学计划项目(XGK2022010014)
- DOI：10.14188/j.1671-8852.2023.0692
  中图分类号： R541.1
- 收稿：2023-12-22，
  
  纸质出版：2025-03-25
- 稿件说明：
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余江月,邹永光,李鹏飞等.经颅多普勒超声声学造影联合Hcy、NLR对卵圆孔未闭合并隐源性脑卒中患者的预测价值[J].武汉大学学报（医学版）,2025,46(03):392-396.

YU Jiangyue,ZOU Yongguang,LI Pengfei,et al.Predictive value of transcranial Doppler bubble test combined with Hcy and NLR in patients with patent foramen ovale complicated with cryptogenic stroke[J].Medical Journal of Wuhan University,2025,46(03):392-396.
余江月,邹永光,李鹏飞等.经颅多普勒超声声学造影联合Hcy、NLR对卵圆孔未闭合并隐源性脑卒中患者的预测价值[J].武汉大学学报（医学版）,2025,46(03):392-396. DOI： 10.14188/j.1671-8852.2023.0692.

YU Jiangyue,ZOU Yongguang,LI Pengfei,et al.Predictive value of transcranial Doppler bubble test combined with Hcy and NLR in patients with patent foramen ovale complicated with cryptogenic stroke[J].Medical Journal of Wuhan University,2025,46(03):392-396. DOI： 10.14188/j.1671-8852.2023.0692.

摘要

目的

探讨经颅多普勒超声声学造影（cTCD）联合同型半胱氨酸（Hcy）、中性粒细胞/淋巴细胞比值（NLR）在卵圆孔未闭（PFO）患者合并隐源性卒中的评估价值。

方法

选取武汉科技大学附属孝感医院2021年6月—2023年6月收治的卵圆孔未闭患者108例，其中合并隐源性卒中37例。所有患者均接受cTCD、Hcy检测，根据淋巴细胞、中性粒细胞计数计算NLR比值，根据cTCD将患者心脏右向左分流(RLS)水平分为：无分流（0级）、小量分流（1级）、中量分流组（2级）、大量分流组（3级），比较PFO合并隐源性卒中和未合并隐源性卒中之间RLS水平、Hcy、NLR的差异性，采用ROC曲线分析RLS水平、Hcy、NLR检测评估卵圆孔未闭合并隐源性卒中的价值。

结果

PFO患者合并隐源性卒中的RLS水平、Hcy、NLR比值高于未合并隐源性卒中患者（

0.05）；ROC曲线显示，RLS级数、Hcy、NLR单独及联合诊断PFO患者合并隐源性卒中的曲线下面积分别为0.759、0.698、0.720、0.851，联合诊断的约登指数明显高于各单项指标。

结论

cTCD结合Hcy、NLR检测有助于评估PFO合并隐源性卒中的发生风险。

Abstract

Objective

To evaluate the value of contrast transcranial Doppler (cTCD) combined with homocysteine (Hcy) and neutrophil/lymphocyte ratio (NLR) in the evaluation of cryptogenic stroke in patients with patent foramen ovale (PFO).

Methods

A total of 108 patients with PFO admitted to Xiaogan Hospital of Wuhan University of Science and Technology from June 2021 to June 2023 were selected

and 37 of them were complicated with cryptogenic. All patients underwent cTCD

blood routine

and homocysteine tests. NLR ratios were calculated according to lymphocyte and neutrophil count. According to the results of cTCD

the patients were divided into three groups: no shunt (grade 0)

small shunt (grade 1)

moderate shunt (grade 2)

and large shunt (grade 3) groups. The differences in RLS level

Hcy

and NLR ratios between PFO patients with and without cryptogenic stroke were compared. The value of PFO right to left shunt levels

Hcy

and NLR detection in evaluating PFO with cryptogenic stroke was analyzed by receiver operating characteristic (ROC) curve.

Results

The RLS level

Hcy

and NLR ratio were higher than those in patients without cryptogenic stroke (

0.05). The ROC showed that the area under the curve (

AUC

) of RLS level

Hcy

NLR

and combined diagnosis for PFO patients with cryptogenic stroke was 0.759

0.698

0.720

and 0.851

respectively. The Youden index of combined diagnosis was higher than that of each single index Conclusion

CTCD combined with Hcy and NLR helps evaluate the risk of PFO complicated with cryptogenic stroke.

关键词

Keywords

references

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