PFO患者行介入封堵术治疗偏头痛22例临床效果观察

Clinical effect of interventional closure on 22 migraine patients with PFO

目的评价卵圆孔未闭(PFO)封堵术对偏头痛伴PFO患者的临床效果。方法选取2014年1月~2017年8月于潍坊市人民医院心内二科确诊的偏头痛合并卵圆孔未闭,并接受卵圆孔未闭封堵术患者22例,分为先兆偏头痛(MA)组14例和非先兆偏头痛(MO)组8例。门诊及电话追踪随访1年,术前及术后3d,12个月行右心声学造影(c-TTE)检查和心脏超声检查,所有患者术前及术后1,3,6,12个月行HIT-6评分并进行组间、组内比较。结果共21例封堵成功,1例未能通过未闭的卵圆孔,放弃封堵治疗,在院及随访期间无手术并发症出现,MA及MO组患者术后1,3,6,12个月HIT-6评分较术前均降低,差异有统计学意义(P<0.01)。组间比较示MA组患者术后6,12个月HIT-6较MO组患者改善降低,差异有统计学意义(P<0.05)。CTTE提示4例患者术后12个月仍有右向左分流(RLS)残余分流。结论 PFO堵术治疗可以有效终止或明显改善偏头痛伴PFO患者的头痛症状,其中以先兆偏头痛效果显著。

Objective To evaluate the clinical effect of patent foramen ovale closure for migraine patients with PFO.Methods Twenty-two migraine patients complicated with PFO were diagnosed in Weifang People’s Hospital from January 2014 to August 2017,and received transcatheter closure.Including 14 cases of MA and 8 cases of MO.All patients followed up for 1 year.Contrast transthoracic echocardiography and Transthoracic echocardiography were examined berore and after operation.Figured HIT-6 score and compared with each other between and in the group before and after closure 1,3,6,12 months.Results Successful transcatheter closure obtained in 21 patients,but 1 case failured to pass through the unclosed foramen ovale.No complications occurred during hospitalization and follow-up.HIT-6 score significantly reduced in patients with MA and MO at 1,3,6,12 months after PFO closure(P<0.01).Comparison between groups showed that HIT-6 in MA significant reduction than that in MO at 6 and 12 months after operation(P<0.05).c-TTE showed that 4 cases still had right to left shunt 12 months after operation.Conclusion PFO occlusion can significantly eliminate or improve the headache symptoms of migraine patients,especially in MA.