血清Hcy、PTX3水平与卵圆孔未闭合并偏头痛的相关性分析  

Correlation analysis of serum Hcy and PTX3 levels with patent foramen ovale and migraine

作　　者：张莺芳[1] 陈蓉[1] 李康睿 叶民[1] Zhang Yingfang;Chen Rong;Li Kangrui(Department of Neurology,Mingji Hospital Affiliated to Nanjing Medical University,Nanjing 210019,China)

机构地区：[1]南京医科大学附属明基医院神经内科,210019

出　　处：《中华保健医学杂志》2024年第4期435-438,共4页Chinese Journal of Health Care and Medicine

基　　金：南京市卫生科技发展专项资金项目(ZKX21061)。

摘　　要：目的 探讨血清同型半胱氨酸(Hcy)、正五聚蛋白-3(PTX3)水平与卵圆孔未闭(PFO)合并偏头痛(MA)的相关性分析。方法 选取2021年1月~2023年12月南京医科大学附属明基医院收治的95例PFO患者,根据是否存在MA症状分为MA组(40例)和无MA组(55例),另选取50例健康体检者为对照组。检测各组血清Hcy、PTX3水平,分析其与PFO患者合并MA的关系。结果 MA组血清Hcy、PTX3水平显著高于无MA组[(17.16±3.08)μmol/L vs.(13.41±2.93)μmol/L、(27.64±4.38)ng/ml vs.(22.85±3.57)ng/ml],差异有统计学意义(t=5.662、5.872,P<0.05)。MA组患者PFO直径、静息向右左分流(RLS、头痛影响测验-6(HIF-6))评分显著高于无MA组[(3.27±0.56)mm vs.(3.01±0.52)mm、(22.53±4.95)微泡/帧vs.(19.58±3.62)微泡/帧、(55.26±7.16)分vs.(21.95±4.41)分],差异有统计学意义(t=2.346、3.041、27.083,P<0.05)。PFO患者血清Hcy、PTX3水平与HIF-6评分均呈显著正相关(r=0.465、0.401,P<0.05)。多因素logistic回归分析显示,PFO直径大、静息RIS高、血清Hcy及PTX3水平升高是PFO患者合并MA的危险因素(P<0.05)。Hcy联合PTX3评估PFO合并MA曲线下面积为0.895,敏感度为85.0%,特异度为80.0%。结论 PFO合并MA患者血清Hcy、PTX3水平显著升高,其与头痛严重程度存在相关性,联合检测血清Hcy、PTX3水平有助于早期评估PFO患者合并MA风险。Objective To investigate the correlation between serum homocysteine(Hcy)and pentaprotein-3(PTX3)levels and patent foramen ovalis(PFO)complicated with migraine(MA).Methods Ninety-five patients with PFO admitted to our hospital from January 2021 to December 2023 were divided into MA group(40 cases)and non-MA group(55 cases)according to the presence of MA symptoms,and 50 healthy subjects were selected as control group.The levels of serum Hcy and PTX3 were detected in each group,and the relationship between them and the occurrence of MA in PFO patients was analyzed.Results The levels of serum Hcy and PTX3 in MA group were significantly higher than those in MA group[(17.16±3.08)μmol∕L vs.(13.41±2.93)μmol∕L,(27.64±4.38)ng∕ml vs.(22.85±3.57)ng∕ml](t=5.662,5.872,P<0.05).The PFO diameter,resting RIS and HIF-6 scores in MA group were significantly higher than those in MA group without MA[(3.27±0.56)mm vs.(3.01±0.52)mm,(22.53±4.95)microbubbles∕frame vs.(19.58±3.62)microbubbles∕frame,(55.26±7.16)points vs.(21.95±4.41)points],the difference was statistically significant(t=2.346,3.041,27.083,P<0.05).The levels of serum Hcy and PTX3 were significantly positively correlated with HIF-6 scores in PFO patients(r=0.465,0.401,P<0.05).Multivariate logistic regression analysis showed that large PFO diameter,high resting RIS,elevated serum Hcy and PTX3 levels were risk factors for MA in PFO patients(P<0.05).The area under the curve of Hcy combined with PTX3 for PFO secondary to MA was 0.895,with the sensitivity of 85.0%,and specificity of 80.0%.Conclusion The levels of serum Hcy and PTX3 in patients with PFO combined with MA are significantly increased,which is correlated with the severity of headache.Combined detection of serum Hcy and PTX3 levels is helpful for early assessment of MA risk in patients with PFO.

关 键 词：卵圆孔未闭 偏头痛 同型半胱氨酸 正五聚蛋白-3 

分 类 号：R743[医药卫生—神经病学与精神病学]