非老年偏头痛患者脑血管反应性与脑白质高信号相关性分析  

Relationship between cerebrovascular reactivity and white matter hyperintensity in non senile migraine patients

作　　者：张守文 ZHANG Shouwen(Department of neuroelectrophysiology,Beijing dawanglu emergency hospital,Beijing 100122,China)

机构地区：[1]北京大望路急诊抢救医院神经电生理科,北京100122

出　　处：《新疆医学》2024年第12期1480-1483,共4页Xinjiang Medical Journal

摘　　要：目的探讨非老年偏头痛患者脑血管二氧化碳反应性(CO_(2)-CVR)与脑白质高信号(WMH)数量和体积的关系。方法研究对象为86例非老年偏头痛患者,另招募35例无头痛健康对照者,均采用MRI评估WMH数量和体积。另采用经颅多普勒超声屏气法测定双侧大脑中动脉平均血流速度,根据左右两侧平均血流速度计算屏气指数(BHI),用于评价CO_(2)-CVR。逻辑回归分析WMH数量和体积影响因素。结果86例患者中,60例(69.8%)发现WMH。偏头痛患者WMH发生率明显高于对照者(P<0.05);此外,偏头痛患者平均WMH数量及体积均高于对照者(所有P<0.05)。逻辑回归分析显示,BHI降低与偏头痛患者WMH数量增加相关(OR:0.032,95%CI:0.001-0.638,P=0.023)。在对照者中,BHI与WMH数量无关。BHI与偏头痛患者和对照者WMH体积增加均无关系,但年龄与偏头痛患者WMH体积增加相关(OR:1.076,95%CI 1.002-1.158,P=0.039)。结论非老年偏头痛患者CO_(2)-CVR降低和WMH数量增加存在相关性。Objective To evaluate the association between the cerebrovascular reactivity to carbon dioxide(CO_(2)-CVR)and the white matter hyperintensity(WMH)number and volume in patients with non senile migraine.Methods The subjects were 86 patients with migraine and 35 healthy controls without headache.The number and volume of WMH were evaluated by MRI.In addition,the average blood flow velocity of bilateral middle cerebral arteries was measured by transcranial Doppler ultrasound breath holding method,and the breath holding index(BHI)was calculated according to the average blood flow velocity of left and right sides to evaluate CO_(2)-CVR.The influencing factors of WMH number and volume were analyzed by logistic regression.Results WMH was found in 60 of 86 patients(69.8%).The incidence of WMH in migraine patients was significantly higher than that in the control group(P<0.05);In addition,the average number and volume of WMH in migraine patients were higher than those in the control group(all P<0.05).Logistic regression analysis showed that the decrease of BHI was independently associated with the increase of WMH in migraine patients(OR:0.032,95%CI:0.001-0.638,P=0.023).In the control group,it was not related to the number of WMH.BHI was not associated with increased WMH volume in migraine patients and controls,but age was associated with increased WMH volume in migraine patients(OR:1.076,95%CI 1.002-1.158,P=0.039).Conclusions There was a correlation between decreased CO_(2)-CVR and increased WMH in non senile migraine patients.

关 键 词：偏头痛 脑血管反应性 脑白质高信号 屏气指数 核磁共振成像 

分 类 号：R741.02[医药卫生—神经病学与精神病学]