青年偏头痛与Willis环变异的相关性研究

Relationship between the migraine in adolescent and the variation of Willis circle

目的通过对青年头痛患者完善头CTA检查,探讨偏头痛与Willis环变异的相关性,为治疗策略提供临床依据。方法选择2017-01―2019-12联勤保障部队天津康复疗养中心神经内科头痛门诊就诊的青年头痛患者(病程2~10 a),完善头CTA检查,筛出偏头痛患者80例作为观察组,在其他非偏头痛患者中选择80例作为对照组,统计2组患者中Willis环变异的患病率,同时观察不同变异类型(ACoA缺如或重复、ACA-A1段缺如、PCoA缺如及FTP)的发病率。结果观察组中Willis变异患病率显著高于对照组(P=0.003),其中ACA-A1段缺如发病率显著高于对照组(P=0.004),ACoA变异、PCoA变异及FTP的发病率与对照组比较无明显差异(P>0.05)。二元Logistic回归分析显示,校正偏头痛遗传史的混杂因素,青年偏头痛和Willis变异呈正相关(OR=4.321,95%CI=2.545~7.358,P<0.001)。结论青年偏头痛可能和Willis环变异相关,主要为ACA-A1段变异;Willis环变异可能为青年偏头痛的独立危险因素。

Objective To explore the correlation between migraine and variation of Willis circle by improving the head CTA in young headache patients,and to provide clinical evidence for treatment strategies.Methods to check the head CTA for the young patients with headache(course 2-10 years)in the neurology department headache clinic of our hospital between January 2017 and December 2019,80 patients with migraine were selected as the observation group,and 80 patients without migraine were selected as the control group.To calculate the proportion of variation of Willis circle,and the occurrence rate of ACoA absence or repetition,ACA-A1 absence,PCoA absence and FTP.Results the total variation rate of the Willis circle in migraine patients was significantly higher than that in other patients,and the difference was statistically significant(P=0.003).The occurrence rate of absence in ACA-A1 was significantly higher than that in the control group(P=0.004),and the occurrence rates of ACoA variation,PCoA variation and FTP were not significantly different from those in the control group(P>0.05).Binary Logistic regression analysis showed a positive correlation between adolescent migraine and Willis variation after adjusting for confounding factors in the genetic history of migraine(OR=4.321,95%CI=2.545-7.358,P<0.001).Conclusion migraine in adolescent may be associated with the variation of Willis circle,mainly in the ACA-A1 segment Variation,and the variation of Willis circle may be a independent risk factor for the migraine.