介入封堵术联合氟桂利嗪治疗卵圆孔未闭伴偏头痛临床疗效分析

Clinical effects of interventional occlusion combined with flunarizine in treatment of patent foramen ovale complicated with migraine

目的探讨介入封堵术联合氟桂利嗪治疗卵圆孔未闭伴偏头痛的临床疗效。方法将134例卵圆孔未闭伴偏头痛患者按随机数字表法分为两组,每组67例。对照组予以介入封堵术治疗,观察组予以介入封堵术联合氟桂利嗪治疗,比较两组临床疗效,术前及术后1个月、3个月、6个月末偏头痛发作频率、持续时间、脑血流动力学指标和动静脉5-羟色胺水平。结果观察组治疗总有效率显著高于对照组(P<0.05)。术后1个月、3个月和6个月末两组偏头痛发作频率较术前显著降低(P<0.05),持续时间较术前显著缩短(P<0.05);术后3个月、6个月末观察组偏头痛发作频率显著低于对照组(P<0.05),持续时间显著短于对照组(P<0.05)。术后1个月、3个月、6个月末两组大脑中动脉和基底动脉平均血流速度较术前显著减缓(P<0.05),术后1个月、3个月末观察组显著慢于对照组(P<0.05)。术后1个月、3个月、6个月末两组动脉5-羟色胺水平均较术前显著降低(P<0.05),静脉5-羟色胺水平与术前比较差异无统计学意义(P>0.05),观察组动脉5-羟色胺水平显著低于对照组(P<0.05),两组静脉5-羟色胺水平比较差异无统计学意义(P>0.05)。结论介入封堵术联合氟桂利嗪在治疗伴卵圆孔未闭偏头痛方面疗效确切,能有效缓解患者的头痛发作频率和持续时间,改善患者的脑血流动力学和动脉5-羟色胺水平。

Objective To explore the clinical effects of interventional occlusion combined with flunarizine in treatment of patent foramen ovale(PFO)complicated with migraine.Methods A total of 134 patients with PFO and migraine were divided into two groups according to random number table method,with 67 cases in each group.The control group was treated with interventional occlusion,and the observation group was treated with interventional occlusion combined with flunarizine.Clinical effects,frequency and duration of migraine attack,cerebral hemodynamic indexes and arteriovenous 5-hydroxytryptamine(5-HT)levels before surgery,1 month,3 months,and 6 months after surgery were compared between the two groups.Results The total effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05).At the end of 1 month,3 months and 6 months after operation,the frequency of migraine attack in the two groups was significantly lower than that before operation(P<0.05),and the duration was significantly shorter than that before operation(P<0.05).At the end of 3 months and 6 months after operation,the frequency of migraine attack in the observation group was significantly lower than that in the control group(P<0.05),and the duration was significantly shorter than that in the control group(P<0.05).At the end of 1 month,3 months and 6 months after operation,the middle cerebral artery(MCA)and basilar artery(BA)in the two groups were significantly slower than those before operation(P<0.05).At the end of 1 month and 3 months after operation,the observation group was significantly slower than the control group(P<0.05).At the end of 1 month,3 months and 6 months after operation,the arterial 5-HT levels in the two groups were significantly lower than those before operation(P<0.05),and there was no significant difference in the venous 5-HT level compared with that before operation(P>0.05).The arterial 5-HT level in the observation group was significantly lower than that in the control group(P<0.05),and there was no significant difference in the venous 5-HT level between the two groups(P>0.05).Conclusions Interventional occlusion combined with flunarizine is effective in treatment of migraine with PFO.It can effectively relieve the frequency and duration of migraine attack,and improve cerebral hemodynamics and arterial 5-HT levels in patients.