慢性偏头痛患者不同时期脑血流储备研究  

Study on cerebral blood flow reserve in different periods of the patients with chronic migraine

作　　者：陈潇潇 陈伯勇 林安娜 宋学萍 CHEN Xiaoxiao;CHEN Boyong;LIN Anna;SONG Xueping(Guangdong Yanling Hospital,Guangzhou 510515,China)

机构地区：[1]广东燕岭医院,广东广州510515

出　　处：《现代医院》2023年第9期1471-1473,共3页Modern Hospitals

基　　金：广东省医学科学技术研究基金(B2021358)。

摘　　要：目的 应用经颅多普勒超声(transcranial doppler, TCD)评价慢性偏头痛患者不同时期脑血流储备(cerebrovascular reserve, CVR)的变化。方法 收集自2021年7月-2023年1月在某院神经内科门诊确诊为慢性偏头痛患者56例作为观察组;选择同期在该院健康体检人员56例作为对照组。对观察组受试者分三个时间点进行TCD检测:头痛发作期(M期,患者头痛开始1 h后至明显缓解前1 h)、头痛发作后I期(I期,头痛明显缓解24 h内)、头痛发作后Ⅱ期(Ⅱ期,头痛明显缓解48 h内)。应用TCD检测技术分别对对照组及观察组三个不同的检测时间点进行双侧大脑中动脉的CVR检测。比较对照组与观察组不同时间点大脑中动脉的收缩储备、扩张储备、整体储备变化情况。结果 M期观察组的大脑中动脉收缩储备、扩张储备和整体储备均有明显下降,少于对照组,差异有统计学意义(P<0.05)。观察组在I期,大脑中动脉的收缩储备、扩张储备、整体储备开始回升并大于发作期,差异有统计学意义(P<0.05),但仍少于对照组,差异有统计学意义(P<0.05)。观察组在Ⅱ期,大脑中动脉的收缩储备、扩张储备、整体储备进一步回升,与对照组比较差异不显著,无统计学意义(P>0.05)。结论 偏头痛患者在偏头痛发作时脑血流储备明显下降,并持续到发作缓解后的24 h内,偏头痛发作缓解24 h后脑血流储备基本恢复正常水平。Objective To evaluate the changes of cerebral blood flow reserve(CVR)in different periods of the patients with chronic migraine by transcranial Doppler(TCD).Methods 56 patients with chronic migraine diagnosed in the outpatient department of Neurology Guangdong Yanling hospital from February 2020 to February 2022 were selected as the observation group,and 56 physical examinees from Physical Examination Department of Guangdong Yanling hospital were selected as the control group at the same time.TCD was detected at three time points in the observation group:headache attack stage(M phase,1 hour after headache onset to 1 hour before obvious relief),stage I after headache attack(within 24 hours after obvious headache relief),and stage II after attack(within 48 hours after obvious headache relief).The CVR of bilateral middle cerebral arteries was detected by TCD at three time points in the control group and the observation group.The systolic reserve,expansion reserve and overall reserve of the middle cerebral artery were compared between the control group and the observation group at different time points.Results The systolic reserve,expansion reserve and overall reserve of MCA in the observation group were significantly lower than those in the control group(P<0.05).In the observation group,the systolic reserve,expansion reserve and overall reserve of the middle cerebral artery began to rise and were greater than that in the attack stage,with statistical significance(P<0.05),but still less than that of the control group(P<0.05).In phase II,the systolic reserve,expansion reserve and overall reserve of the middle cerebral artery in the observation group were further increased,with no significant difference compared with the control group(P>0.05).Conclusion The cerebral blood flow reserve of patients with migraine is significantly decreased during the onset of migraine,and continues to be within 24 hours after the attack is relieved.The cerebral blood flow reserve basically returns to normal level after 24 hours of migrain

关 键 词：经颅多普勒超声 偏头痛 脑血流储备 

分 类 号：R747.2[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]