摘要
目的:评估偏头痛与卵圆孔未闭(patent foramen ovale, PFO)之间的关系,以及PFO封堵术治疗偏头痛的效果。方法:采用前瞻性病例研究方法,选取2012年1月至2015年5月就诊的PFO病人,收集病人的基本信息、完成头痛问卷、记录手术情况。根据是否行PFO封堵术将合并偏头痛的PFO病人分为手术组及对照组,根据病人是否伴有先兆将其中手术组分为先兆偏头痛组与无先兆偏头痛组两个亚组。结果:就诊的PFO病人共288例,根据纳入排除标准有55例病人入选,其中50例病人完成了6个月的随访。50例PFO中合并偏头痛病人23例,偏头痛发病率为23/50 (46%)。23例合并偏头痛的PFO病人,手术组17例,对照组6例。手术组中先兆偏头痛8例,无先兆偏头痛9例。手术组病人术后头痛频率、头痛持续时间、疼痛数字评分(numerical rating scale, NRS)、头痛影响评分(Headache Impact Test-6, HIT-6)均显著降低,手术前后对比差异有统计学意义(P <0.01);对照组头痛频率、头痛持续时间、NRS评分、HIT-6评分治疗前后差异无统计学意义;手术组与对照组相比两者性别、年龄、BMI、术前头痛频率、头痛持续时间、头痛NRS评分、HIT-6评分差异无统计学意义,术后两者的头痛频率及头痛持续时间差异无统计学意义,头痛评分及HIT-6评分差异有统计学意义(P <0.01)。先兆组与无先兆组相比术前及术后头痛频率、头痛持续时间、NRS评分、HIT-6评分差异均无统计学意义。结论:①PFO病人中偏头痛发病率较高;②PFO封堵术后病人NRS评分、HIT-6评分明显降低;③偏头痛病人的头痛情况及手术治疗效果与病人是否存在先兆无关。
Objective: To evaluate the relationship between the PFO and migraine, and to detect the effectiveness of PFO closure for migraine. Methods: The prospective case study method was used. PFO patients were selected from January 2012 to May 2015. Basic information of patients was collected, headache questionnaires were completed, and surgical conditions were recorded. PFO patients with migraine were divided into operation group and control group according to whether they were treated with PFO closure, and the surgery group was divided into migraine with aura group and migraine without aura group according to whether the patients were accompanied with aura. Results: A total of 288 PFO patients were admitted to the hospital. According to the inclusion and exclusion criteria, 55 patients were included, and 50 patients completed the 6-month follow-up. The incidence of migraine was 23/50(46%). There were 23 PFO patients with migraine, 17 in operation group and6 in the control group. There were 8 cases of migraine with aura and 9 cases of migraine without aura in operation group. The frequency, duration, NRS score and HIT-6 score of postoperative headache in patients in the operation group were significantly reduced, and the difference before and after surgery was statistically significant(P < 0.01). There was no significant difference in headache frequency, duration, NRS score and HIT-6 score before and after treatment in the control group. Compared with the control group, there was no statistically significant difference in gender, age, BMI, preoperative headache frequency, headache duration, NRS score and HIT-6 score between the operation group and the control group. There was no statistically significant difference in postoperative headache frequency and headache duration between the two groups, and there was statistically significant difference in headache score and HIT-6 score. There was no significant difference in preoperative and postoperative headache frequency, headache duration, NRS score and HIT-6 score between the group with aura and the group without aura. Conclusions:① PFO patients have a higher prevalence of migraine;② PFO occlusion, NRS and HIT-6 scores of patients were significantly decreased;③ migraine headaches and surgical outcomes were not associated with aura.
作者
王云霞
邱恩超
王广义
刘若卓
于生元
WANG Yun-Xia;QIU En-Chao;WANG Guang-Yi;LIU Ruo-Zhuo;YU Sheng-Yuan(Department of Neurology, The First Medical Center of PLA General Hospital Beijing 100853, China;Department of Neurology, The Fourth Medical Center of Chinese PLA General Hospital,Beijing 100037, China;Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China)
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2019年第5期344-350,共7页
Chinese Journal of Pain Medicine
基金
国家自然科学基金面上项目(81771180)
北京自然科学基金(7162178)
2015保健专项课题面上项目(15BJZ49)
北京科技专项(Z171100001117108)
国家自然科学基金青年科学基金资助项目(81500943)
关键词
偏头痛
卵圆孔未闭
封堵术
Migraine
Patent Foramen Ovale
Percutaneous PFO Closure
