DE-ICER在无先兆偏头痛平衡针刺后血脑屏障改变中的评估作用及与镇痛效果的关系  

The Role of DCE-MRI in the Evaluation of Blood-brain-barrier Alteration after Balanced Acupuncture in Migraine without Aura and Its Relationship with Analgesic Effect

作　　者：张倩倩 李岩 任虹 肖爱伟 刘珊珊 于桂泳 ZHANG Qianqian;LI Yan;REN Hong;XIAO Aiwei;LIU Shanshan;YU Guiyong(Department of Rehabilitation Medicine,Hengshui People’s Hospital,Hengshui 053000,Hebei,P.R.China)

机构地区：[1]衡水市人民医院康复医学科,河北衡水053000

出　　处：《影像科学与光化学》2023年第1期11-16,共6页Imaging Science and Photochemistry

摘　　要：探讨动态增强磁共振成像(DCE-MRI)在无先兆偏头痛平衡针刺后血脑屏障改变中的评估作用及与镇痛效果的关系。选取157例无先兆偏头痛患者,根据平衡针刺后疗效分为总有效组(n=115)和无效组(n=42),比较两组治疗前和治疗4周后DCE-MRI血脑屏障参数[双侧丘脑、基底神经节、杏仁核、白质血脑屏障渗透(Ktrans)、血浆分数(Vp)]。结果显示,总有效组头痛程度评分低于无效组,治疗前、治疗4周后杏仁核Vp高于无效组(P<0.05);杏仁核Vp与疗效呈正相关(P<0.001);头痛程度评分、治疗前杏仁核Vp均为影响镇痛效果独立因素(P<0.05),二者联合预测镇痛无效的AUC最大。因此,DCE-MRI的Vp值可用于反映无先兆偏头痛平衡针刺疗效,可用于评估血脑屏障改变,对镇痛效果具有高度诊断效能。This paper investigated the role of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the assessment of blood-brain-barrier alterations after balanced acupuncture in migraine without aura and its relationship with analgesic effect.157 patients with migraine without aura were divided into a total effective group(n=115)and ineffective group(n=42)according to the effect of balance acupuncture.Compared the DCE-MRI blood-brain barrier parameters[bilateral thalamus,basal ganglia,amygdala,white matter blood-brain barrier penetration(Ktrans),plasma fraction(Vp)]before and after 4 weeks of treatment between the two groups.The results showed that the headache degree score was lower in the total effective group than in the ineffective group,and the amygdala Vp was higher in the pre-treatment and after 4 weeks of treatment than in the ineffective group(P<0.05).The amygdala Vp was positively correlated with the treatment efficacy(P<0.001).The headache degree score and pre-treatment amygdala Vp were both independent factors influencing the analgesic effect(P<0.05),and the two combined prediction of analgesia ineffectiveness had the largest AUC.Thus Vp values of DCE-MRI can be used to reflect the efficacy of balanced acupuncture in migraine without aura,and also can be used to assess blood-brain barrier alterations,and has high diagnostic efficacy for analgesic effects.

关 键 词：无先兆偏头痛 动态增强磁共振成像 血脑屏障 平衡针刺 

分 类 号：R246.6[医药卫生—针灸推拿学]