偏头痛合并卵圆孔未闭患者封堵术的疗效评价

The stuy of transcatheter closure in patients with migraine and patent foramen ovale

目的评价偏头痛合并卵圆孔未闭患者经封堵术后的疗效。方法选取2014年3月至2015年3月我院神经内科确诊的偏头痛合并卵圆孔未闭接受卵圆孔未闭封堵术患者56例,分为先兆偏头痛组和非先兆偏头痛组。其中先兆偏头痛组35例,男13例,女22例,平均年龄(43.74±7.72)岁;无先兆偏头痛组21例,男7例,女14例,平均年龄(42.90±7.84)岁。所有患者均在术前及术后1、3、6、12月进行头痛影响测定-6(HIT-6)评分,将患者术后HIT-6评分分别与术前比较,并进行组间对应时间HIT-6评分比较。结果 56例患者手术均成功。先兆偏头痛患者术后1、3、6、12月HIT-6评分较术前均降低,差异有统计学意义(均P<0.05)。无先兆偏头痛患者术后1月HIT-6评分较术前无明显降低,差异无统计学意义(P>0.05);术后3、6、12月HIT-6评分较术前均降低,差异有统计学意义(均P<0.05)。组间比较示先兆偏头痛组术后6、12月HIT-6评分较无先兆偏头痛组降低,差异有统计学意义(均P<0.05)。结论封堵术可终止或缓解合并卵圆孔未闭的偏头痛患者的头痛症状,其中以先兆偏头痛疗效明显。

Objective To evaluate the effect of transcatheter closure in patients with migraine and patent foramen ovale. Methods Patients with migraine diagnosed in our hospital were collected from March 2014 to March 2015. Right heart contrast echocardiography was performed and showed patent foramen ovale with right-to-left shunt, and further confirmed by the transesophageal echocardiography） 56 patients received transcatheter closure in the department of cardiology of the hospital. There were 35 cases of migrb.ine with aura, male 13, female 22, mean age （43.74± 7.72） ys. 21 cases of migraine without aura,male 7,female 14,mean age （42.90±7.84） ys. The Headache Impact Test-6 （HIT-6） score was measured before and at 1, 3, 6 and 12 months after closure in all patients. We compared the HIT-6 score between postoperative and preoperative, and analyzed the HIT-6 score in groups in corresponding time. Results 56 patients were successfully operated. The HIT-6 scores at 1, 3, 6 and 12 months after closure were reduced in migraine with aura group. The difference were statistically significant （P〈0.05 in all）. The HIT-6 score at 1 month after closure were no significant decreased compared with the preoperative in migraine without aura group. The difference has no sta- tistically significant （P〉0.05）. And at 3, 6 and 12 months after closure were reduced. The difference were statistically significant （P〈0.05）. Compared with migraine without aura group, The HIT-6 scores reduced at 6 and 12 months after closure in migraine with aura gronp. The difference were statistically significant （P〈0.05）. Conclusion This study shows that transcatheter closure can terminate or ease headache symptoms in migraine patients with patent foramen ovale, and has an obvious effect in migraine with aura.