慢性偏头痛患者血压变异分析

Analysis the blood pressure variability in patients with chronic migraine

目的研究慢性偏头痛患者24 h动态血压变异,为其临床治疗提供量化指标和依据。方法选取2018年1月至2018年6月就诊于泰兴市人民医院神经内科的偏头痛患者;同时选择同时期就诊于体检中心的健康体检者。采用24 h动态血压测量仪检测患者24 h动态血压,晨起空腹留取患者血清,采用ELISA法检测患者血清肾素、血管紧张素Ⅱ、内皮素-1及同型半胱氨酸水平。结果本研究共收集偏头痛患者60例,正常体检者30名,两组24 h动态血压分析结果显示,偏头痛组24 h血压水平明显高于正常组(P<0.05),血压变异系数亦明显高于正常组(P<0.05)。尤其表现为反勺型的血压特点,夜晚血压水平明显高于正常人群(P<0.05)。偏头痛组血清肾素、血管紧张素Ⅱ、内皮素-1、同型半胱氨酸水平明显高于正常组(均P<0.05)。结论慢性偏头痛患者存在血压变异,主要表现为反勺型的血压特点,夜晚血压水平高于正常人群,且变异系数较高。其机制可能与内皮素-1介导的肾素-血管紧张素-醛固酮系统活动增强有关。

Objective To analyze 24 h ambulatory blood pressure variability in patients with chronic migraine, and provide quantitative indicators and evidence for its clinical treatment.Methods The chronic migraine patients in the department of neurology of Taixing people’s hospital were selected from January 2018 to June 2018, and the healthy examination patients in the physical examination center were selected at the same time. The 24 h ambulatory blood pressure measurement instrument was used to detect 24 h ambulatory blood pressure. Serum was collected in the morning on an empty stomach. The serum levels of renin, angiotensin Ⅱ, endothelin-1 and homocysteine were measured by ELISA.Results A total of 60 migraine patients and 30 normal physical examination patients were collected in this study. The 24 h ambulatory blood pressure analysis showed that the 24 h blood pressure level in the migraine group was significantly higher than that in the normal group(P<0.05), and the blood pressure variability coefficient was significantly higher than that in the normal group(P<0.05). Especially the blood pressure characteristics of the reverse scoop type, and the night blood pressure level was significantly higher than that of the normal population(P<0.05). The levels of serum renin, angiotensinⅡ, endothelin-1 and homocysteine in migraine group were significantly higher than those in normal group(all P<0.05).Conclusions Blood pressure variability exists in chronic migraine patients, which is mainly characterized by back dipping blood pressure. The blood pressure level at night is higher than that of normal people, and the coefficient of variation is higher. The mechanism may be related to the enhanced activity of renin-angiotensin-aldosterone system mediated by endothelin-1.