偏头痛与感染性头痛患者血清超敏C反应蛋白与降钙素基因相关肽测定的意义及相关性

Significance of detecting and correlation of serum high sensitivity C-reactive protein and calcitonin gene-related peptide levels in patients with migraine and infection-related headache

目的研究超敏C反应蛋白(hs-CRP)与降钙素基因相关肽(CGRP)在偏头痛与感染性头痛患者血清中的变化意义及相关性。方法选择39例偏头痛、38例感染性头痛患者及36例健康者,用免疫比浊法测定hs-CRP,放射免疫分析法测定血浆CGRP含量。结果 hs-CRP含量:偏头痛先兆期(3.86±1.45)mg/L、发作期(4.42±1.56)mg/L、间歇期(2.73±1.06)mg/L,感染性头痛(8.56±1.64)mg/L,均明显高于对照组(1.62±0.38)mg/L,分别P<0.01、P<0.05;而感染性头痛又明显高于偏头痛发作期(P<0.01)。CGRP含量:偏头痛发作期(80.64±10.83)pg/mL,感染性头痛(67.25±9.86)pg/mL,高于对照组(59.32±7.62)pg/mL,分别P<0.01、P<0.05;先兆期、缓解期与正常对照组比较差异无统计学意义。相关分析发现,偏头痛发作期hs-CRP与CGRP呈正相关(r=0.3426,P<0.05)。结论偏头痛患者hs-CRP阶段性改变,CGRP的释放与炎性标记物hs-CRP有明显相关性,hs-CRP可作为偏头痛发作各期的一种低水平炎性反应检验学指标,对感染性头痛有一定鉴别诊断意义。

Objective To investigate the significance of variation and correlations of serum high sensitivity C-reactive protein（hs-CRP） and calcitonin gene-related peptide（CGRP） levels in patients with migraine as well as patients with infection-related headache.Methods Serum hs-CRP and CGRP levels were measured with immune turbidimetry and radioimmunoassay in 39 patients with migraine,38 patients with infection-related headache and 36 non-headache patients in the normal control group,respectively.Results Serum hs-CRP levels in migraine patients[（3.86±.1.45）mg/L in aura stage,（4.42±1.56）mg/L in attack stage,and（2.73±1.06）mg/L during intermission]and in patients with infection-related headache（8.56±1.64） mg/L were significantly greater than those in patients in the normal control group[（1.62±0.38） mg/L,P0.01 and P0.05,respectively],while hs-CRP levels in patients with infection-related headache were remarkably higher than those of migraine patients during attack stage（P0.01）.CGRP levels in migraine patients in attack stage and patients with infection-related headache were higher than those in patients in the normal control group[（80.64±10.83）pg/mL,（67.25±9.86）pg/mL vs.（59.32±7.62）pg/mL,P0.01 and P0.05,respectively].Yet no significant difference was demonstrated between CGRP levels in migraine patients in aura stage or during intermission and in control group patients.Correlation study indicated that hs-CRP and CGRP levels were positively correlated（r=0.3426,P0.05）.Conclusion Serum hs-CRP level in migraine patients changes with different stages of migraine.Releasing of CGRP apparently correlates with the level of inflammatory marker hs-CRP.Thus hs-CRP may function as an indicator of low-level inflammatory response in stages of a migraine attack,having significance in migraine＇s differential diagnosis with infection-related headache.