偏头痛患者右心声学造影的特点及影响因素

Characteristics and influencing factors of contrast echocardiography of right heart in patients with migraine

目的利用右心声学造影检查探究有无先兆偏头痛患者卵圆孔未闭(PFO)情况及二者的相关性。方法选取2019-07—2021-07郑州大学附属中心医院收治的118例明确诊断的偏头痛患者为研究对象,根据头痛类型将其分为先兆偏头痛组(n=50)和无先兆偏头痛组(n=68),并选取同期体检的40名健康者为对照组,对所有受试者进行右心声学造影评估有无PFO及房水平右向左分流(RLS)程度。此外,统计偏头痛患者治疗前头痛发作频率、发作时间及头痛程度,分析其与有无PFO及RLS程度的相关性。结果先兆偏头痛组和无先兆偏头痛组患者治疗前发作频率、头痛发作时间、头痛程度比较差异无统计学意义(t=1.295、1.490、1.235,P>0.05)。先兆偏头痛组PFO发生率及PFO-RLS分流程度均明显高于无先兆偏头痛组和对照组,差异均有统计学意义(P<0.05),无先兆偏头痛组和对照组间PFO发生率和PFO-RLS分流程度比较未见统计学差异(χ^(2)=32.372、2.157、9.928、10.867,P>0.05)。Spearman相关性分析显示,偏头痛患者PFO分流大小与发作频率、头痛发作时间呈正相关(r=0.362、0.347,P<0.05),与头痛程度无相关性(r=0.198,P>0.05)。结论先兆偏头痛患者PFO发生率较高,且发作频率、头痛发作时间与RLS程度呈正相关。

Objective To explore the situation and correlation between patent foramen ovale(PFO)and migraine sufferers with and without aura by right heart contrast echocardiography.Methods A total of 118 pa⁃tients with definite migraine diagnosed in the Zhengzhou Central Hospital Affiliated to Zhengzhou University from July 2019 to July 2021 were selected as the research objects,and they were divided into migraine with aura group(n=50)and migraine without aura group(n=68)according to the type of headache.Meanwhile,40 healthy individuals were selected as the control group who underwent physical examination in our hospital during the same pe⁃riod,and right heart contrast echocardiography was performed in all patients to evaluate the presence or absence of PFO and the degree of right to left shunt(RLS)at the atrial level.In addition,the frequency of headache attacks,the number of days of attacks and the degree of headache in migraine patients before treatment were counted.The correlation between the above data and the presence or absence of PFO and the degree of RLS was analyzed and compared.Results There was no significant difference between the migraine with aura group and the migraine without aura group before treatment in attack frequency,days of headache attacks,and headache severity(t=1.295,1.490,1.235,P>0.05).The incidence of PFO and the degree of PFO-RLS shunt in the migraine with aura group were significantly higher than those in the migraine without aura group and the control group,and the difference was statistically significant(P<0.05).Compared with PFO-RLS shunt degree,there was no difference(χ^(2)=32.372,2.157,9.928,10.867,P>0.05).Spearman correlation analysis showed that the size of PFO shunt in migraine pa⁃tients was positively correlated with attack frequency and headache days(r=0.362,0.347,P<0.05),but had no cor⁃relation with headache severity(r=0.198,P>0.05).Conclusion The incidence of PFO in patients with migraine with aura was higher,and the frequency of attacks and the number of days of headache attacks were positively cor⁃related with the degree of RLS.