应用M-模经颅多普勒超声技术评价头痛与卵圆孔未闭的关系  

The assessment of the association between headache and patent oval foramen(PFO):Power M-mode transcranial Doppler study

作　　者：郭珍妮[1] 杜微[1] 黄妍[1] 杨弋[1] 冯加纯[1] 吴江[1] 饶明俐[1] 邢英琦[1] 

机构地区：[1]吉林大学白求恩第一医院神经内科,吉林长春130021

出　　处：《中风与神经疾病杂志》2011年第7期594-596,共3页Journal of Apoplexy and Nervous Diseases

基　　金：吉林省卫生厅资助项目([2010Z070]号)

摘　　要：目的观察头痛、有先兆偏头痛(MA)、无先兆偏头痛(MO)患者卵圆孔未闭(PFO)的发生率,以及较大分流的发生率。方法头痛患者268例,其中MA组59例,MO组158例,其他类型头痛组51例,健康对照组75例。以肘前静脉注射激活的生理盐水作为造影剂,并结合Valsava动作,行M-模经颅多普勒超声(mpTCD)监测,诊断PFO并对分流量进行分级。安静状态时出现阳性结果则判断为"永久型"分流,Valsava动作后出现阳性结果则判断为"功能型"分流。注射生理盐水后20 s内微栓子信号超过30个判断为大量分流。结果全部头痛患者中PFO的发生率为44%,其中永久型分流53例,功能型分流43例。MA组存在分流的患者数显著多于对照组(P<0.001),也多于其他头痛组(P<0.01)。MO组存在分流的患者数高于对照组及其他头痛组,但未获得统计学差别(分别为P=0.054和P=0.3)。较大分流量在MA组、MO组、其他头痛组和对照组的发生率分别为37%、15%、8%、4%,MA组、MO组均显著高于对照组(分别为P<0.01和P<0.05)。结论有先兆偏头痛组患者存在较多PFO,而且偏头痛组较大分流量的患者较多。Objective To investigate the incidence of PFO in the patients with headache including migraine with aura（MA）,migraine without aura（MO）and other headache.Methods The study was conducted in the First Hospital of Jilin University.268 patients with headache were enrolled from Neurology Department.They were divided into three groups,59 with MA,158 with MO,51 with other headache and 75 controls.Permanent shunt was defined as MES be detected by mpTCD without Valsava maneuver,while functional shunt diagnosis was made only after Valsava maneuver.A shunt was divided into minor（n≤30） and major（n30） according to the number of MES injected in 20s,whether Valsava or not.Results The incidence of shunt in all headache patients was 44%,including permanent shunt（n=53） and functional shunt（n=43）.The incidence of shunt was 66% in MA,36% in MO,27% in others and 27% in control group,respectively.The number of MA group with shunt was more than control group（P〈0.001）and more than other groups（P〈0.01）.The rate of major shunt was 37% in MA,15% in MO,8% in others and 4% in control group,respectively.Compared with control group,the rate of major shunt in MA and MO is obviously higher（P〈0.01 and P〈0.05 respectively）.Conclusion A great many MA patients were associated with PFO,and migraine patients with major shunt are more than others.

关 键 词：M-模经颅多普勒超声 卵圆孔未闭 偏头痛 

分 类 号：R747.2[医药卫生—神经病学与精神病学]