伴先兆偏头痛与脑白质病变进展的临床研究

Clinical research between migraine with aura and white matter lesions progression

目的利用磁共振成像(MRI)前瞻性评估病程中的脑白质病变(WML)进展与伴先兆性偏头痛及其与血管性危险因素的相关性。方法选取泰安市中心医院2007年9月至2011年12月就诊的71例具有伴先兆偏头痛的患者,记录患者基线期一般情况及血管性危险因素,对比分析观察期前后MRI检查的WML情况并根据WML进行分组,应用线性相关和秩和检验评估头痛先兆特征与WML关系,并进一步评估与血管性危险因素是否相关。结果中位观察时间为28.4个月,失访9例(12.7%),62例研究对象中39例(61.3%)在基线期MRI检查中显示WML,随访期末12例(19.4%)显示有新发WML,新病变数目与患者先兆的持续时间(r=0.64,P=0.03)及年先兆发作次数(r=0.73,P=0.007)有显著相关性。结论部分伴先兆偏头痛患者的WML可以进展,可能与先兆的性质有关。

Objective To prospectively evaluate the correlation among migraineurs with aura, changes in white matter lesions （WML） and vascular risk factors by magnetic resonance imaging （MRI）. Methods Seventy-one cases of migraineurs with aura in the Center Hospital of Talan City were selected, clinical characteristics and cerebrovascular risk factors were recorded at baseline. The WML on MRI before and after observation period were comparatively analyzed and migraineurs were grouped according WML. The relationship between migraine characteristics and WML were evaluated by linear correlation and rank sum test, and its relationship with vascular risk factors were further evaluated. Results The mean follow-up period was 28.4 months,9 （ 12. 7% ）patients were lost. In the 62 patients, WML were present in 38 subjects （61.3%） at baseline MRI. At follow-up a total of 12 patients had new WML （19.4%）. There was a significant correlation between aura duration and number of new WML（r = 0. 64 ,P = 0. 03 ） ,and between the number of migraine attacks with aura and new WML（ r = 0. 73, P = 0. 007 ）. Conclusion The WML in some migralneurs with aura can progress and has relationship with aura features probably.