2024 年第 7 期 第 19 卷

卵圆孔未闭封堵术后血清标志物水平变化及其临床意义

Serum biomarker changes and clinical significance after patent foramen ovale closure

作者：叶粟黄浩佳胡海波潘湘斌张凤文吕建华

英文作者：Ye Su Huang Haojia Hu Haibo Pan Xiangbin Zhang Fengwen Lyu Jianhua

单位：国家心血管病中心中国医学科学院北京协和医学院阜外医院结构性心脏病中心，北京100037

英文单位：Center of Structural Heart Disease Fuwai Hosapital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

关键词：卵圆孔未闭；卵圆孔未闭封堵术；同型半胱氨酸

英文关键词：Patentforamenovale;Patentforamenovaleclosure;Homocysteine

• 摘要：

• 目的 探讨卵圆孔未闭（PFO）封堵术后血清标志物水平的变化并探讨其临床意义。方法 回顾性纳入2019年12月到2022年10月在中国医学科学院阜外医院行PFO封堵术的患者210例。比较患者封堵术前后的血清标志物水平，包括中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、平均血小板体积(MPV)、同型半胱氨酸(Hcy)、白蛋白、总胆固醇以及高密度脂蛋白胆固醇。选取所有患者中PFO并发脑卒中者为观察组（151例），本院同时期入住的149例房间隔缺损患者作为对照组。比较观察组封堵术前后和对照组Hcy水平。结果 PFO患者封堵术后NLR、PLR、MPV水平均高于封堵术前，Hcy、白蛋白、总胆固醇、高密度脂蛋白胆固醇水平均低于封堵术前，差异均有统计学意义（均P＜0.05）。PFO封堵术前观察组的Hcy水平明显高于对照组［（13.11±10.15）μmol/L比（10.38±3.44）μmol/L］，差异有统计学意义（P＜0.01）,封堵术后观察组的Hcy水平［（11.12±9.68）μmol/L］与对照组比较差异无统计学意义（P＞0.05）。结论 PFO封堵术后患者Hcy水平显著降低，高Hcy水平可能与PFO并发隐源性脑卒中密切相关。综合来看，对于PFO患者，监测其Hcy水平是有临床意义的。

• Objective To investigate the changes of serum markers after patent foramen ovale (PFO) closure and its clinical significance. Methods A total of 210 patients who underwent PFO closure in Fuwai Hospital, Chinese Academy of Medical Sciences from December 2019 to October 2022 were included retrospectively. The levels of serum markers before and after occlusion were compared, including the neutrophil/lymphocyte (NLR), the platelet/lymphocyte (PLR), mean platelet volume (MPV), homocysteine (Hcy), albumin, total cholesterol, and high-density lipoprotein cholesterol levels. PFO patients with stroke were selected as the observation group (151 cases), and 149 patients with atrial septal defect in our hospital during the same period were selected as the control group. The Hcy levels were compared between the observation group and the control group before and after occlusion. Results  The levels of NLR, PLR, and MPV in patients after occlusion were higher than those before occlusion, while the levels of Hcy, albumin, total cholesterol, and high-density lipoprotein cholesterol were lower than those before occlusion (all P＜0.05). The Hcy level in the observation group before PFO closure was significantly higher than that in the control group ［（13.11±10.15）μmol/L vs （10.38±3.44）μmol/L］ (P＜0.01). There was no significant difference in Hcy level between the observation group ［（11.12±9.68）μmol/L］ after occlusion and the control group(P>0.05). Conclusion  The level of Hcy significantly decreased after PFO closure, and high level of Hcy may be closely related to PFO-associated cryptogenic stroke. In conclusion, it is clinically meaningful to monitor the Hcy level in patients with PFO.