偏头痛患者降钙素基因相关肽与局部脑血流量变化的相关研究

Correlation of calcitonin gene-related peptide and regional cerebral blood flow in patients with migraine attacks

目的研究偏头痛患者发作期降钙素相关基因肽（CGRP）和局部脑血流的变化及二者的相关性。方法收集自2010年5月至2012年5月山西医科大学第一医院神经内科门诊经临床确诊的38例急性偏头痛发作期患者的临床资料，所有患者进行SPECT检查与CGRP测定，其中14例于发作间歇期进行复查．并与20名健康体检者进行对照观察，分析偏头痛患者发作期与间歇期脑血流灌注与血浆cGRP的变化及二者关系。结果（1）偏头痛患者发作期脑血流变化均以下降为主，额叶（左侧0．97±0．03、右侧0．96±0．04）、颞叶（左侧0．89±0．04、右侧0．90±0．07）与对照组（左额1．02±0．04、右额1．00±0．02、左颞0．98±0．06、右颞1．02±0．09）比较，差异有统计学意义（P〈0．05）；（2114例间歇期患者脑血流灌注有所增加，其中左额（1．00±0．03）、双侧颞（左0.93±0．05、右0．98±0．04）、右枕叶（1．02±0．02）与发作期（左额0．98±0．03、左颞0．90±0．05、右颞0．92±0．06、右枕1．00±0．03）比较，差异有统计学意义（P〈0．05）；（3）发作期及间歇期偏头痛患者的CGRP（63．37±5．70、51．39±7．33）均较对照组（46．09±6．67）高，差异有统计学意义（P〈0．05）；（4）偏头痛患者急性发作期的CGRP与双侧脑血流灌注存在相关（r=-0．375．P=0．020），而偏头痛患者急性间歇期和健康对照者的CGRP与双侧脑血流灌注不存在相关（r=O．436，P=0．119；r=0．112，P=0．638）。结论偏头痛患者急性发作期脑血流变化以下降为主，其血清CGRP含量表达增高，且与局部脑血流量变化密切相关。

Objective To investigate the changes of ealcitonin gene-related peptide （CGRP） and regional cerebral blood flow （rCBF） and their correlation in patients with migraine. Methods Thirty-eight patients with acute migraineurs, collected in our hospital from May 2010 to May 2012, and 20 healthy controls were enrolled; their clinical data were retrospectively analyzed; brain SPECT examination was performed and CGRP was determined; 14 patients in the intermission of migraine （after treatment） were reexamined. The rCBF and plasma concentration of CGRP were analyzed and the correlation was compared. Results （1） The rCBF was decreased during migraine attacks; statistical signifieances were noted between patients during migraine attacks and healthy controls （the left frontal lobe： 0.97±0.03 vs. 1.02±0.04, the right one： 0.96±0.04 vs. 1.00±0.02; the left temporal lobe： 0.89±0.04 vs. 0.98±0.06, the right temporal lobe： 0.90±0.07 vs. 1.02±0.09, P〈0.05）; （2） The rCBF was increased in the 14 intermittent patients （after treatment）; statistical significances were noted between intermittent patients and attack patients （before treatment） （left frontal lobe： 1.00±0.03 vs. 0.98±0.03, left temporal lobe： 0.93±0.05 vs. 0.90±0.05, right temporal lobe： 0.98±0.04 vs. 0.92±0.06, right occipital lobe： 1.02± 0.02 vs. 1.00±0.03, P〈0.05）; （3） The plasma concentrations of CGRP （63.37±5.70, 51.39±7.33） during migraine attacks and intermission were statistically higher than healthy controls （46.09±6.67, P〈0.05）; （4） Pearson correlation coefficient between plasma concentration of CGRP and rCBF of two hemisphere during migraine attacks was noted （r=-0.375, P=0.020）, while no correlation was noted in patients at intermission period （r=0.436, P=0.119） and healthy controls （r=0.112, P=0.638）. Conclusion The rCBF is low and the plasma concentration of CGRP is high during migraine attacks, and there is correlation between the two factors.