丛集性头痛患者内分泌功能的检测

Study on the pathogenesis of cluster headache

目的 通过检测丛集性头痛 ( CH)患者的内分泌功能探讨 CH的发病机制。方法 采用放射免疫分析法检测了 2 6例 CH患者 ( CH组 )在丛集期和缓解期血清睾酮 ( T)、雌二醇 ( E2 )、催乳激素 ( PRL)以及生长激素( GH)水平 ,并与 2 5例正常对照者 ( NC组 )及 1 8例偏头痛患者 ( MC组 )进行比较。结果 ( 1 ) CH患者在丛集期血清 T、GH、E2 、PRL水平较 NC组和 MC组明显降低。其中男性患者血清 T、E2 、PRL水平与 NC组和 MC组比较具有高度显著性差异 ( P <0 .0 1 ) ;女性患者血清 T、E2 、PRL水平及所有患者血清 GH水平与 NC组和 MC组比较有显著差异 ( P<0 .0 5)。 ( 2 ) CH患者缓解期血清 T、GH、E2 、PRL水平与 NC组和 MC组比较 ,差异不明显 ( P>0 .0 5)。 ( 3 ) CH患者丛集期与缓解期血清 T、GH、E2 、PRL水平比较 ,差异不明显 ( P >0 .0 5)。结论 CH丛集期内分泌功能明显降低 ,结合临床特点 ,提示下丘脑功能改变作为起步机制在丛集性头痛发作中起重要作用。

Objective To explore the pathogensis of cluster headache(CH). Methods The serum Testosterone (T),Growth hormone (GH),Estradiol (E 2) and Prolactin (PRL) were detected by radioimmunoassay in 26 patients with cluster headache (CH group) during cluster period(CP) and remission period(RP), 25 normal controls(NC group) and 18 migraine controls(MC group). Results (1) The levels of serum T, GH, E 2 and PRL were decreased during CP in male patients with CH as compared with those in control groups(NC and MC group) (P<0.01); The levels of serum T, E 2, PRL during CP in female patients and the levels of serum GH in all patients were significantly decreased as compared with those in control groups(P<0.05). (2) The difference in the levels of serum T, GH, E 2, and PRL was not significant(P>0.05) between the patients during RP and control groups. (3) In patients with CH, the difference in the levels of serum T, GH, E 2, and PRL between CP and RP was not significant(P>0.05).Conclusion The endocrinal function is markedly reduced during CP in patients with CH . Combined with the clinical features, a disordered pacemaker mechanism owing to the dysfunction of the hypothalamus is decisive in CH attack.