应用对比增强经颅多普勒评价偏头痛与右向左分流的关系

Contrast enhanced transcranial Doppler in evaluating the relationship between migraine with right to left shunt

目的评估偏头痛患者合并右向左分流（RLS）的阳性率，探讨偏头痛与RLS的关系。方法连续收集2015年4月-2016年3月收治于吉林省人民医院神经内科的偏头痛患者95例，分为先兆偏头痛组和无先兆偏头痛组。应用对比增强经颅多普勒（c—TCD）检测两组患者RLS的阳性率及分流量，同时比较两组患者年龄、性别、病程、发作频率、持续时间、头痛影响程度情况。结果人组的偏头痛患者中31例为先兆偏头痛，64例为无先兆偏头痛，两组比较，先兆偏头痛组RLS阳性率较无先兆偏头痛组显著升高（P=0．011），且先兆偏头痛组小量分流率及大量分流率均显著高于无先兆偏头痛组（P=0．007，P=0．043），中量分流率两组间比较差异无统计学意义（P〉0．05）。两组患者年龄、性别、病程、发作频率、持续时间、头痛影响程度比较差异无统计学意义（P〉0．05）。结论偏头痛与RLS存在一定的关系，尤其是先兆偏头痛，RLS可能是触发先兆偏头痛的一个因素。

Objective To evaluate the positive rate of right to left shunt （RLS） in patients with migraine,and to explore the relationship between migraine with right to left shunt. Methods 95 cases of patients with migraine cured in internal Medicine-Neurology of Jilin Provincial People＇s Hospital from April 2015 to March 2016 were selected and divided into aura migraine group and non-aura migraine group.Contrast enhanced transcranial Doppler （c-TCD） was used to detect the positive rate and flow rate of RLS in two groups. Age, sex, course of disease, frequency of attack,duration of illness, the degree of influence of headache of the two groups were compared, Results There were 31 cases of patients with aura migraine and 64 cases of patients with non aura migraine among the 95 cases.Comparing with the non aura migraine group,RLS positive rate of aura migraine group was significantly increases （P=0.011）.The small amount of shunt rate and large number of shunt rate of aura migraine group were significantly higher than those of non aura migraine group （P=O.OO7,P=O.O43）.There was no significant difference between the two groups （P〉0.05）. There were no significant difference in the age,sex,course of disease, frequency of attack, duration of attack,headache and effect of the two groups （P 〉 0.05）. Conclusion Migraine has a certain relationship with RLS,especially aura migraine,RLS may be one of the factors that trigger migraine with aura.