加巴喷丁对偏头痛病人发作期血浆降钙素基因相关肽、蛋白激酶C水平的影响  

EFFECT OF GABAPENTIN ON PLASMA CALCITONIN GENE-RELATED PEPTIDES AND PROTEIN KINASE C LEVELS IN PATIENTS WITH MIGRAINE ATTACK

作　　者：张家君[1] 张灿文 胡冬梅[2] 袁慧[2] 牛敬忠[2] 张颜波[2] 

机构地区：[1]泰山医学院附属医院超声科,泰安27100 [2]泰山医学院附属医院神经内科,泰安271000

出　　处：《中国疼痛医学杂志》2017年第12期907-911,共5页Chinese Journal of Pain Medicine

基　　金：山东省自然科学基金联合专项(ZR2015HL041);山东省医药卫生科技发展计划(2014WS0506);泰山医学院高层次培育课题(2016GCC02)

摘　　要：目的:通过观察偏头痛急性发作期病人加巴喷丁治疗后血浆降钙素基因相关肽(calcitonin gene-related peptide,CGRP)和蛋白激酶C(Protein kinase C,PKC)水平的变化,探讨加巴喷丁治疗偏头痛急性发作的作用机制。方法:偏头痛病人按照随机数字表法随机分为:氟桂利嗪对照组和加巴喷丁治疗组,对照组33例,治疗组35例。加巴喷丁组用药剂量在900~2 400 mg/d之间,分3次口服,疗程为3天。氟桂利嗪组每晚10时口服1次,剂量10 mg,疗程为3天。分别在给予加巴喷丁药物治疗前、治疗后12 h、治疗后24 h、治疗后48 h和治疗后72 h进行疼痛视觉模拟评分(visual analogue score,VAS)测定和外周空腹静脉血CGRP、PKC水平检测。结果 :氟桂利嗪组和加巴喷丁组病人治疗后VAS评分逐渐降低;加巴喷丁组VAS疼痛评分显著低于氟桂利嗪组(P<0.05)。氟桂利嗪组和加巴喷丁组病人治疗后12 h、24 h、48 h和72 h分别与治疗前相比,CGRP和PKC水平明显降低(P<0.05或P<0.01);加巴喷丁组与氟桂利嗪组治疗后12 h、24 h、48 h和72 h相比,CGRP和PKC水平明显降低(P<0.05或P<0.01)。结论:加巴喷丁能明显减轻偏头痛急性发作期VAS评分,对偏头痛急性发作期治疗有效。加巴喷丁能明显减少偏头痛急性发作期血浆CGRP和PKC水平,可能是加巴喷丁治疗偏头痛急性发作期机制之一。Objective： To measure the changes of CGRP and PKC levels in plasma of patients with acute migraine attack after treatment with gabapentin and to discuss the mechanism of gabapentin for treating acute migraine attack. Methods： Sixty-eight patients with migraine were divided into control group（flunarizine treatment）（n = 33） and gabapentin（GBP） group（n = 35） according to random number table method. GBP 900-2 400 mg/d was taken orally in 3 portions for 3 days and flunarizine 10 mg/d was taken orally for 3 days, respectively. The visual analog scores（VAS）, the CGRP and PKC levels in the patients’ peripheral venous blood were measured before and after（12 h, 24 h, 48 h and 72 h） gabapentin treatment. Results： The VAS was decreased in both flunarizine group and GBP group. The VAS in GBP group was lower than that in flunarizine group（P 〈 0.05）. The CGRP and PKC levels of patients at 12 h, 24 h, 48 h and 72 h after treatment decreased significantly in both flunarizine group and GBP group compared with that before the treatment（P 〈 0.05 or P 〈 0.01）. The CGRP and PKC levels in GBP group were significantly lower than that in flunarizine group at 12 h, 24 h and 48 h after treatment（P 〈 0.05）. Conclusion：Gabapentin can significantly reduce the VAS and has effect on the acute migraine attack and its The mechanism may depend on the decrease the CGRP and PKC levels in plasma.

关 键 词：偏头痛 加巴喷丁 降钙素基因相关肽 蛋白激酶C 

分 类 号：R747.2[医药卫生—神经病学与精神病学]