CAJ | 학술논문

目的观察正常人不同年龄组右向左分流（right-to-left shunt，RLS）的发生率、分流量、分流类型，以及比较两个年龄组RLS的特点。 　　方法收集接受对比增强经颅多普勒超声（contrast-enhanced transcranial Doppler，cTCD）的正常人群的临床资料。根据年龄将18～45岁纳入青年组，大于45岁纳入中年组。以肘前静脉注射激活的生理盐水作为造影剂，结合Valsalva动作，行M模经颅多谱勒超声（power M-mode transcranial Doppler，mpTCD）监测，诊断RLS并对分流量进行分级，分析不同分流量和分流类型（固有型和潜在型）在研究人群中的分布特点。 　　结果共195例正常人入组，RLS发生率为28.7%，其中小量分流39例（20%）。青年组RLS发生率为28.9%（39/135），中年组RLS发生率为28.3%（17/60），两组RLS发生率及分流量分布差异无显著性，且均以小量分流为主。固有型34例（60.7%），潜在型22例（39.3%）。青年组固有型25例（64.0%），潜在型14例（35.9%）；中年组固有型9例（52.9%），潜在型8例（47.1%）。组间分流类型差异无显著性。结论本研究所选人群中RLS发生率约为28.7%，且以小量分流者居多，青年人与中年人RLS发生率、分流量、分流类型无差异。
목적관찰정상인불동년령조우향좌분류（right-to-left shunt，RLS）적발생솔、분류량、분류류형，이급비교량개년령조RLS적특점。 　　방법수집접수대비증강경로다보륵초성（contrast-enhanced transcranial Doppler，cTCD）적정상인군적림상자료。근거년령장18～45세납입청년조，대우45세납입중년조。이주전정맥주사격활적생리염수작위조영제，결합Valsalva동작，행M모경로다보륵초성（power M-mode transcranial Doppler，mpTCD）감측，진단RLS병대분류량진행분급，분석불동분류량화분류류형（고유형화잠재형）재연구인군중적분포특점。 　　결과공195례정상인입조，RLS발생솔위28.7%，기중소량분류39례（20%）。청년조RLS발생솔위28.9%（39/135），중년조RLS발생솔위28.3%（17/60），량조RLS발생솔급분류량분포차이무현저성，차균이소량분류위주。고유형34례（60.7%），잠재형22례（39.3%）。청년조고유형25례（64.0%），잠재형14례（35.9%）；중년조고유형9례（52.9%），잠재형8례（47.1%）。조간분류류형차이무현저성。결론본연구소선인군중RLS발생솔약위28.7%，차이소량분류자거다，청년인여중년인RLS발생솔、분류량、분류류형무차이。
Objective To observe the incidence, shunt volume, shunt type of normal population, and compare RLS feature between two age groups. Methods Collect the clinical data of normal people who volunteered to undergo contrast-enhanced transcranial Doppler (cTCD). They are classified into two groups:young group (18 to 45 years old) and middle age group (more than 45 years old). Take the physiological saline activating via elbow intravenous injection as a contrast agent, and combine with Valsalva maneuver, diagnose RLS with mpTCD monitoring and grade the shunt volume. The distribution characteristics of different shunt volume and shunt type (the inherent and potential) in the study population were also analyzed. Results A total of 195 normal people were enrolled in our study, and RLS rate was 28.7%, with 39 cases as minor shunt (20%). RLS rate in young group was 28.9%(39/135), and RLS rate in middle age group 28.3%(17/60). There were no statistical differences between two groups in RLS rate and shunt volume distribution, and minor shunts take a predominate percent in all those shunts. Thirty four cases were inherent type (60.7%), and 22 cases potential type (39.3%). In young group, 25 cases were inherent type (64.0%), and 14 cases potential type (35.9%);in middle age group, 9 cases were inherent type (52.9%), and 8 cases potential type (47.1%). There was no statistical difference between two groups in shunt type distribution. Conclusion The incidence of RLS in the selected population in our study is about 28.7%, and the minor shunt takes a predominate percent. There are no significant differences between young group and middle age group in RLS incidence, shunt volume and shunt type.