介入封堵术在偏头痛合并卵圆孔未闭患者中的临床疗效和安全性  

Clinical efficacy and safety of percutaneous closure in patients with patent foramen ovale complicated with migraine

作　　者：程正兴 邱丘 李艺 余洁 张刚成[2] CHENG Zheng-xing;QIU Qiu;LI Yi;YU Jie;ZHANG Gang-cheng(Department of Cardiovascular Medicine,Wuhan University of Science and Technology of Medical School,Wuhan 430022,China;Department of Cardiovascular Medicine,Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430022,China)

机构地区：[1]武汉科技大学医学院,武汉430022 [2]武汉科技大学附属武汉亚洲心脏病医院,武汉430022

出　　处：《岭南心血管病杂志》2021年第5期558-562,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨介入封堵术在偏头痛合并卵圆孔未闭(patent foramenovale,PFO)患者中的临床疗效和安全性。方法前瞻性纳入武汉亚洲心脏病医院2018年11月至2020年1月确诊为偏头痛合并PFO并行封堵术的患者50例。于术前及术后1个月、3个月、6个月评估头痛影响测验-6(headache impacttest-6,HIT-6)评分、视觉模拟疼痛评分(visual analoguescale,VAS)、头痛发作频率、头痛持续时间,用于评估PFO封堵术对偏头痛的疗效。其次,选取在同一时间段就诊于本院的偏头痛合并PFO且没有行封堵术的患者,根据年龄、性别、经颅多普勒超声(transcranial doppler,TCD)发泡试验分流量分级相匹配的50例患者作为非封堵组,以经食道超声心动图确诊PFO当天作为入组时间,随访6个月,并与封堵组患者术后6个月比较HIT-6评分、头痛发作频率、头痛持续时间。结果封堵组患者均成功置入封堵器,术后未发现手术并发症;术后1个月、3个月、6个月HIT-6评分[(48.42±10.02)分、(43.38±8.03)分、(40.38±5.24)分]、VAS评分[(2.82±0.14)分、(1.54±0.61)分、(0.88±0.04)分]、头痛发作频率[(2.62±0.13)次/个月、(1.44±0.62)次/个月、(0.82±0.18)次/个月]、头痛持续时间[(1.39±1.27)h/次、(0.85±1.02)h/次、(0.56±0.14)h/次]与术前比较,差异有统计学意义(P<0.05)。6个月随访时,封堵组患者偏头痛发作指标[HIT-6评分(40.38±5.24)分、头痛发作频率(0.82±0.18)次/个月、头痛持续时间(0.56±0.14)h/次]较非封堵组患者[HIT-6评分(53.80±5.36)分、头痛发作频率(4.88±1.91)次/个月、头痛持续时间(2.19±1.19)h/次]明显好转,差异有统计学意义(P<0.05)。结论介入封堵术在偏头痛合并PFO治疗中有效、安全。Objectives To explore the clinical efficacy and safety of percutaneous closure in patients with patent foramen ovale(PFO)complicated with migraine.Methods A total of 50 patients diagnosed with PFO combined with migraine and treated with percutaneous closure of PFO were prospectively included in Wuhan Asian Heart Hospital from November 2018 to January 2020.The headache impact test-6(HIT-6)score,visual analogue scale(VAS),headache frequency and headache duration were evaluated in pre-operation and post-operation at 1 month,3 months,and 6 months,to evaluate the efficacy of percutaneous closure in patients with PFO combined with migraine.Secondly,50 patients with migraine combined with PFO and not treated with PFO closure were selected at the same time.The 50 patients matched according to age,sex and shunt grade of the transcranial doppler(TCD)foaming test were treated as non-interventional closure group.The date of PFO of non-interventional closure group was diagnosed by transesophageal echocardiography at the enrollment time,followed up at 6 months.The HIT-6 score,headache frequency and headache duration of non-interventional closure group were compared with the interventional closure group in post-operation at 6 months.Results All the patients in interventional closure group were successfully implanted with occluder,and no complications were found after operation.The scores of HIT-6[(48.42±10.02)points,(43.38±8.03)points,(40.38±5.24)points],VAS scores[(2.82±0.14)points,(1.54±0.61)points,(0.88±0.04)points],headache frequency[(2.62±0.13)times/month,(1.44±0.62)times/month,(0.82±0.18)times/month]and headache duration[(1.39±0.27)hours/time,(0.85±0.02)hours/time,(0.56±0.14)hours/time]were significantly reduced at 1 month,3 months and 6 months after operation compared with those of pre-operation and the differences were statistically significant(P<0.05).At 6 months follow-up,indicators of migraine attack in interventional closure group[the score of HIT-6 was(40.38±5.24)points,headache frequency was(0.82±0.1

关 键 词：卵圆孔未闭 偏头痛 介入封堵术 

分 类 号：R541.7[医药卫生—心血管疾病]