伴卵圆孔未闭偏头痛患者的临床特征及经导管封堵卵圆孔未闭术干预效果

Clinical characteristics of patients with patent foramen ovale complicated by migraine and the intervention effects of transcatheter closure of patent foramen ovale

目的探究伴卵圆孔未闭(patent foramen ovale,PFO)偏头痛患者的临床特征及经导管封堵卵圆孔未闭术干预的效果。方法前瞻性选取2021年1月至2021年12月接受治疗的262例PFO伴偏头痛患者作为研究对象,采用简单随机分组中掷硬币法分为A、B组,最终纳入A组150例,B组112例。A组患者采用经导管封堵卵圆孔未闭术治疗,B组患者采用药物干预治疗。比较2组患者一般资料、临床疗效,对比2组治疗前及治疗后3个月时头痛发生次数,采用视觉模拟评分法(visual analogue scale/score,VAS)及头痛影响测评量表(HIT-6)评分分别评价患者治疗前、治疗后3个月时头痛程度与病情对生活的影响。结果A组患者治疗总有效率98.00%(147/150)显著高于B组75.89%(85/112)(P<0.05);重复测量方差结果表明,2组患者治疗不同时点的头痛发生次数以时间因素为源、以组别为源的主体间效应及以时间与组别交互为源的主体内效应间比较差异有统计学意义(P<0.05);治疗后3个月,2组患者头痛发生次数均显著下降且A组低于B组(P<0.05);重复测量方差结果表明,2组患者治疗不同时点的VAS及HIT-6评分以时间因素为源、以组别为源的主体间效应及以时间与组别交互为源的主体内效应间比较具有统计学意义(P<0.05);治疗后3个月,2组患者VAS及HIT-6评分均明显降低且A组低于B组(P<0.05)。结论经导管封堵卵圆孔未闭术治疗PFO合并偏头痛患者效果显著,能够有效减少患者头痛发作次数,减轻头痛程度及对生活质量的影响,值得临床参考借鉴。

Objective To investigate the clinical characteristics of patients with patent foramen ovale(PFO)complicated by migraine and the intervention effects of transcatheter closure of patent foramen ovale.Methods A total of 262 patients with PFO complicated by migraine who were treated in our hospital from January 2021 to December 2021 were prospectively selected as the research subjects,who were randomly divided into group A(n=150)and group B(n=112).The patients in group A were treated by transcatheter closure of patent foramen ovale,however,those in group B were treated by drug intervention.The general data,clinical efficacy,and the frequency of headache before and at 3 months after treatment were observed and compared between the two groups.Moreover Visual Analogue Scale/Score(VAS)and Headache Impact Assessment Scale(HIT-6)scores were used to evaluate the effects of headache severity and disease condition before treatment and at 3 months after treatment on the life quality of patients.Results The total effective rate in group A was 98.00%(147/150),which was significantly higher than that[75.89%(85/112)]in group B(P<0.05).The results of repeated measures variance showed that there were significant differences in the frequency of headache occurrences at different time points,and the source of the inter-subject effect,and the time-group interaction as the source of the intra-subject effect between the two groups(P<0.05).After 3-month treatment,the frequency of headaches in both groups was decreased significantly,moreover,which in group A was significantly lower than that in group B(P<0.05).After 3-month treatment,the VAS scores and HIT-6 scores in both groups were significantly decreased,moreover,which in group A were significantly lower than those in group B(P<0.05).Conclusion The transcatheter closure of patent foramen ovale in treatment of PFO complicated by migraine has significant effects,which can effectively reduce the frequency of headache attacks,relieve the headache degree and its effects on the life quality of patients,therefore,which is worthy of clinical reference.