发作性偏头痛慢性转化机制的研究  

The study of the mechanism about evolution from episodic migraine to chronic migraine

作　　者：梁瑞华[1] 张素平[1] 何锐[1] 

机构地区：[1]暨南大学附属第四医院广州市红十字会医院神经内科,广东广州510220

出　　处：《中风与神经疾病杂志》2016年第3期253-255,共3页Journal of Apoplexy and Nervous Diseases

基　　金：广东省中医药局建设中医药强省科研立项课题(No.20141219);广东省广州市卫生局医药卫生科技一般引导项目(No.20151A011016)

摘　　要：目的从枕叶皮质兴奋性及脑组织代谢角度探求发作性偏头痛慢性转化机制。方法对发作性偏头痛患者、慢性偏头痛患者及对照组分别进行中脑导水管周围灰质(PAG)区1H-MRS检测及VEP检查,测定3组NAA/Cr及Cho/Cr及VEP异常率。结果发作性偏头痛组NAA/Cr较慢性偏头痛组及对照组高,有显著性差异(P<0.05),后两组无明显差异(P>0.05),3组受试者Cho/Cr及VEP异常率无明显差异(P>0.05)。结论发作性偏头痛患者PAG区存在神经元代谢活化可能,提示发作性偏头痛慢性化过程中可能存在PAG区神经元代谢从活化至失代偿的演变过程。Objective To explore the mechanism of evolution from episodic migraine（ EM） to chronic migraine（ CM） by occipital excitability and brain metabolism. Methods The 1H-MRS metabolite rations（ NAA / Cr and Cho / Cr）at the periaqueductal gray（ PAG） and visual evoked potential（ VEP） were measured in the two migraine subgroups and controls. Results Patients with EM had the highest NAA / Cr ration at the PAG in comparison with those of CM and controls（ P〈0. 05）. The latter two groups had no difference（ P〉0. 05）. The Cho/Cr ratios had no difference at the PAG among the study groups（ P〉0. 05）. The abnormal rate of VEP had no difference among the study groups（ P〉0. 05）. Conclusion Neuronal metabolic activation maybe exits at the PAG in EM. A progressive dysfunction of Neuronal metabolism from activation to decompensation at PAG may occur from EM to CM.

关 键 词：偏头痛 皮质兴奋性 中脑导水管周围灰质 磁共振氢质子波谱分析 视觉诱发电位 

分 类 号：R747.2[医药卫生—神经病学与精神病学]