Relation between directly detected patent foramen ovale and ischemic brain lesions in sport divers
Relation between directly detected patent foramen ovale and ischemic brain lesions in sport divers
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DOI：
10.7326/0003-4819-134-1-200101020-00009
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发表时间：
2001-01-02
影响因子：
39.2
通讯作者：
Kucher, N
中科院分区：
文献类型：
--
作者：
Schwerzmann, M;Seiler, C;Kucher, N
背景资料：在潜水员中，卵圆孔未闭的意义及其与反常气体栓塞的潜在关系仍然不确定。目的：评估存在卵圆孔未闭的潜水员减压疾病和缺血性脑损伤症状的患病率。设计：回顾性队列研究。设置：瑞士大学医院和三个潜水俱乐部。参与者：52名运动潜水员和52名非潜水对照组。测量：自我报告的减压事件、经食管超声心动图检查的卵圆孔未闭和磁共振成像检查的缺血性脑病变的患病率。结果：有卵圆孔未闭的潜水员发生减压疾病事件的风险是无卵圆孔未闭的潜水员的4.5倍（风险比，4.5 [95%CI，1.2 ~ 18.0]; P = 0.03），在潜水员中，卵圆孔未闭组和未闭组分别检测到每人1.23 +/- 2.0和0.64 +/- 1.22个缺血性脑损伤（平均值+/- SD）。在对照组中，每人检测到0.22 +/- 0.44和0.12 +/- 0.63个病变（所有组的P < 0.001）。结论：无论潜水员是否有卵圆孔未闭，潜水与缺血性脑病变有关。
Background: In divers, the significance of a patent foramen ovale and its potential relation to paradoxical gas emboli remain uncertain.Objective: To assess the prevalence of symptoms of decompression illness and ischemic brain lesions in divers with regard to the presence of a patent foramen ovate.Design: Retrospective cohort study.Setting: University hospital and three diving clubs in Switzerland.Participants: 52 sport divers and 52 nondiving controls.Measurements: Prevalence of self-reported decompression events, patent foramen ovale on contrast transesophageal echocardiography, and ischemic brain lesions on magnetic resonance imaging.Results: The risk for decompression illness events was 4.5-fold greater in divers with patent foramen ovate than in divers without patent foramen ovale (risk ratio, 4.5 [95% CI, 1.2 to 18.0]; P = 0,03), Among divers, 1.23 +/- 2.0 and 0.64 +/- 1.22 ischemic brain lesions per person (mean +/- SD) were detected in those with and those without patent foramen ovale, respectively. Among controls, 0.22 +/- 0.44 and 0.12 +/- 0.63 lesion per person were detected (P < 0.001 for all groups).Conclusions: Regardless of whether a diver has a patent foramen ovale, diving is associated with ischemic brain lesions.